Background and rationale for the Society of Behavioral Medicine’s position statement: expand United States health plan coverage for diabetes self-management education and support

The Society of Behavioral Medicine (SBM) recognizes that diabetes self-management (DSM) education and support are fundamental to teaching people how to manage their diabetes and decrease disease-related complications. Implementation of the Patient Protection and Affordable Care Act provides an opportunity to expand DSM education and support to many people who are currently excluded from such services due to lack of insurance coverage, current policy barriers, or simple failure of healthcare systems to provide them. Extending the range and provision of such services could translate into reduced diabetic complications, a reduction in unnecessary healthcare utilization, and significant health-related cost savings on a national level. SBM recommends that public and private insurers be required to reimburse for 12 h of DSM education and support annually for anyone with diabetes. Further, SBM recognizes that a range of modes and providers of DSM education and support have been shown effective, and that patient preferences and resources may influence choice. To address this, SBM urges health organizations to increase and diversify approaches toward DSM education and support they offer

The Fundamental Value of Presence in Peer and Mutual Support: Observations from Telephone Support for High Risk Groups

“Being there” takes on considerable importance amidst recognition of the substantial deleterious effects of social isolation and loneliness. In particular, presence/ “being there” may be important features of the many contributions of peer and mutual support to health and wellbeing. This study examined how peer support may enhance a sense of presence based on a) contact data for years 2015-2016 from telephonic peer support services of Rutgers University Behavioral Health Care, and b) structured interviews with peer supporters and clients of these programs. Features of peer support that convey presence include a) 24/7 availability, b) structure of peer support around shared cultural roles – e.g., “Cop2Cop,” “Mom2Mom,” rather than shared diagnoses, c) training of supporters to provide a setting for open expression of feelings, and d) structural features such as IT systems that facilitate continuity by enabling those answering a call readily to refer to previous calls. Impacts include client reports of being understood, not being judged, and being cared for through routine follow-up, even though contact such as voicemails. Managers and peer supporters should recognize the diverse organizational and processes that convey presence/ “being there” and its central importance in peer and mutual support

The Fundamental Value of Presence in Peer and Mutual Support: Observations from Telephone Support for High Risk Groups

“Being there” takes on considerable importance amidst recognition of the substantial deleterious effects of social isolation and loneliness. In particular, presence/ “being there” may be important features of the many contributions of peer and mutual support to health and wellbeing. This study examined how peer support may enhance a sense of presence based on a) contact data for years 2015-2016 from telephonic peer support services of Rutgers University Behavioral Health Care, and b) structured interviews with peer supporters and clients of these programs. Features of peer support that convey presence include a) 24/7 availability, b) structure of peer support around shared cultural roles – e.g., “Cop2Cop,” “Mom2Mom,” rather than shared diagnoses, c) training of supporters to provide a setting for open expression of feelings, and d) structural features such as IT systems that facilitate continuity by enabling those answering a call readily to refer to previous calls. Impacts include client reports of being understood, not being judged, and being cared for through routine follow-up, even though contact such as voicemails. Managers and peer supporters should recognize the diverse organizational and processes that convey presence/ “being there” and its central importance in peer and mutual support

Finite size scaling for quantum criticality using the finite-element method

Finite size scaling for the Schr\"{o}dinger equation is a systematic approach to calculate the quantum critical parameters for a given Hamiltonian. This approach has been shown to give very accurate results for critical parameters by using a systematic expansion with global basis-type functions. Recently, the finite element method was shown to be a powerful numerical method for ab initio electronic structure calculations with a variable real-space resolution. In this work, we demonstrate how to obtain quantum critical parameters by combining the finite element method (FEM) with finite size scaling (FSS) using different ab initio approximations and exact formulations. The critical parameters could be atomic nuclear charges, internuclear distances, electron density, disorder, lattice structure, and external fields for stability of atomic, molecular systems and quantum phase transitions of extended systems. To illustrate the effectiveness of this approach we provide detailed calculations of applying FEM to approximate solutions for the two-electron atom with varying nuclear charge; these include Hartree-Fock, density functional theory under the local density approximation, and an "exact"' formulation using FEM. We then use the FSS approach to determine its critical nuclear charge for stability; here, the size of the system is related to the number of elements used in the calculations. Results prove to be in good agreement with previous Slater-basis set calculations and demonstrate that it is possible to combine finite size scaling with the finite-element method by using ab initio calculations to obtain quantum critical parameters. The combined approach provides a promising first-principles approach to describe quantum phase transitions for materials and extended systems.Comment: 15 pages, 19 figures, revision based on suggestions by referee, accepted in Phys. Rev.

Personality predictors of the time course for lung cancer onset

Numerous findings suggest that personality is linked to the incidence and experience of negative health outcomes. More specifically, trait negative affect is negatively related to a number of health outcomes. The current study expands our understanding of the link between personality and disease by examining the time course for lung cancer onset. In a sample of patients who had recently undergone surgical resection for lung cancer, a variety of negative affect-related personality variables were assessed to determine their relationship with age at surgery. After controlling for smoking behavior, it was found that trait negative affect was associated with time course for lung cancer onset, such that those with higher (vs. lower) levels of trait negative affect manifested lung cancer earlier in their lives. Thus, trait negative affect represents an independent risk factor among those prone to lung cancer (i.e. smokers)

Directive and Nondirective E-Coach Support for Weight Loss in Overweight Adults

Although e-coach support increases the effectiveness of Internet weight loss interventions, no studies have assessed influence of type of e-coach support

Patient Navigators Connecting Patients to Community Resources to Improve Diabetes Outcomes

BACKGROUND: Despite the recognized importance of lifestyle modification in reducing risk of developing type 2 diabetes and in diabetes management, the use of available community resources by both patients and their primary care providers (PCPs) remains low. The patient navigator model, widely used in cancer care, may have the potential to link PCPs and community resources for reduction of risk and control of type 2 diabetes. In this study we tested the feasibility and acceptability of telephone-based nonprofessional patient navigation to promote linkages between the PCP office and community programs for patients with or at risk for diabetes. METHODS: This was a mixed-methods interventional prospective cohort study conducted between November 2012 and August 2013. We included adult patients with and at risk for type 2 diabetes from six primary care practices. Patient-level measures of glycemic control, diabetes care, and self-efficacy from medical records, and qualitative interview data on acceptability and feasibility, were used. RESULTS: A total of 179 patients participated in the study. Two patient navigators provided services over the phone, using motivational interviewing techniques. Patient navigators provided regular feedback to PCPs and followed up with the patients through phone calls. The patient navigators made 1028 calls, with an average of 6 calls per patient. At follow-up, reduction in HbA1c (7.8 ± 1.9% vs 7.2 ± 1.3%; P = .001) and improvement in patient self-efficacy (3.1 ± 0.8 vs 3.6 ± 0.7; P < .001) were observed. Qualitative analysis revealed uniformly positive feedback from providers and patients. CONCLUSIONS: The patient navigator model is a promising and acceptable strategy to link patient, PCP, and community resources for promoting lifestyle modification in people living with or at risk for type 2 diabetes

COVID-19 restrictions and fathers of infants in neonatal care.

This is a letter without an abstract

How is neighborhood social disorganization associated with diabetes outcomes? A multilevel investigation of glycemic control and self-reported use of acute or emergency health care services

Abstract Background Diabetes management is influenced by a number of factors beyond the individual-level. This study examined how neighborhood social disorganization (i.e., neighborhoods characterized by high economic disadvantage, residential instability, and ethnic heterogeneity), is associated with diabetes-related outcomes. Methods We used a multilevel modeling approach to investigate the associations between census-tract neighborhood social disorganization, A1c, and self-reported use of acute or emergency health care services for a sample of 424 adults with type 2 diabetes. Results Individuals living in neighborhoods with high social disorganization had higher A1c values than individuals living in neighborhoods with medium social disorganization (B = 0.39, p = 0.01). Individuals living in neighborhoods with high economic disadvantage had higher self-reported use of acute or emergency health care services than individuals living in neighborhoods with medium economic disadvantage (B = 0.60, p = 0.02). Conclusions High neighborhood social disorganization was associated with higher A1c values and high neighborhood economic disadvantage was associated with greater self-reported use of acute or emergency health care services. Controlling for individual level variables diminished this effect for A1c, but not acute or emergency health care use. Comprehensive approaches to diabetes management should include attention to neighborhood context. Failure to do so may help explain the continuing disproportionate diabetes burden in many neighborhoods despite decades of attention to individual-level clinical care and education. Trial registration For this study, we used baseline data from a larger study investigating the impacts on patient-centered outcomes of three different approaches to self-monitoring of blood glucose among 450 adults with non-insulin dependent type 2 diabetes living in North Carolina. This study was registered as a clinical trial on 1/7/2014 ( https://clinicaltrials.gov/ct2/show/NCT02033499 )