Opioid-Free Anesthesia and Postoperative Outcomes in Cancer Surgery : A Systematic Review

This research received no external funding.Peer reviewedPublisher PD

Changes in Executive Functioning and Self-Management in Adolescents With Type 1 Diabetes: A Growth Curve Analysis

Objective To investigate the relation of changes in executive functioning to changes in diabetes self-management in a 2-year prospective study of a sample of youth aged 9–11 years at baseline (n = 239) with type 1 diabetes and their maternal caregivers. Research Design and Methods Youth and maternal caregivers completed the Diabetes Self-Management Profile (DSMP) at baseline, 12 months, and 24 months. Maternal caregivers completed the Behavioral Rating Inventory of Executive Functioning (BRIEF) at the same time points to assess global executive functioning, and the domains of behavioral regulation and metacognition. Results Youth reported self-management decreased over time (p < .01) while behavioral regulation (e.g., the child’s ability to shift cognitive set and moderate emotions and behaviors via emotional control) increased (p < .05). Changes in behavioral regulation significantly predicted rate of change in youth-reported self-management (p < .01). Global executive functioning and metacognition (e.g., the child’s ability to monitor, initiate, plan, organize, and sustain future-oriented problem solving and working memory) did not change over time and did not predict changes in self-management. Moreover, executive functioning and self-management did not predict changes in HbA1c. Conclusions Positive changes in behavioral regulation may enhance self-management of type 1 diabetes during the transition to adolescence

Family Therapy for Adolescents with Poorly Controlled Diabetes: Initial Test of Clinical Significance

Objective We examined a structured family therapy approach in promoting clinically meaningful improvements in parent–adolescent conflict in adolescents with poorly controlled diabetes. Method Eighteen adolescents with poorly controlled diabetes and their parent(s) participated in 10 sessions of home-based Behavioral Family Systems Therapy (BFST). Outcome comparisons were made using a sample of adolescents with poorly controlled diabetes (n = 40) from a previous study. Clinically significant improvements were determined by calculating SD differences between treatment and comparison groups on measures of diabetes-related and general parent–adolescent conflict. Results Home-based BFST produced change in diabetes-related family conflict ranging from 1/3 to 1/2 SD and general family conflict ranging from 1/3 to 3/4 SD. Conclusions BFST produced change in family conflict, a variable shown through previous research to relate to treatment adherence in adolescents with diabetes. The test of clinical significance represents an example of a method useful for pediatric research