Consensus Recommendations for the Use of Automated Insulin Delivery (AID) Technologies in Clinical Practice

International audienceThe significant and growing global prevalence of diabetes continues to challenge people with diabetes (PwD), healthcare providers and payers. While maintaining near-normal glucose levels has been shown to prevent or delay the progression of the long-term complications of diabetes, a significant proportion of PwD are not attaining their glycemic goals. During the past six years, we have seen tremendous advances in automated insulin delivery (AID) technologies. Numerous randomized controlled trials and real-world studies have shown that the use of AID systems is safe and effective in helping PwD achieve their long-term glycemic goals while reducing hypoglycemia risk. Thus, AID systems have recently become an integral part of diabetes management. However, recommendations for using AID systems in clinical settings have been lacking. Such guided recommendations are critical for AID success and acceptance. All clinicians working with PwD need to become familiar with the available systems in order to eliminate disparities in diabetes quality of care. This report provides much-needed guidance for clinicians who are interested in utilizing AIDs and presents a comprehensive listing of the evidence payers should consider when determining eligibility criteria for AID insurance coverage

Late effects awareness website for pediatric survivors of acute lymphocytic leukemia

<div><p>Objectives</p><p>Every day 43 children are newly diagnosed with cancer. Fortunately, almost 90% of these childhood cancer patients will survive. However, 60–90% of these survivors will experience late effects, health problems that occur months or years after treatment has ended. Late effects could occur as a result of the disease, its treatment, and patient-related factors. The two main objectives of this research are to: 1) Examine the existence of all web-based resources for childhood cancer survivors with acute lymphocytic leukemia which focus on medical and psychological aspects of late effects, and 2) Create an innovative website specifically designed to fill this void.</p><p>Materials and methods</p><p>A systematic literature review, followed by input from >20 different organizations, resulted in the creation of LEAP³ AHEAD (Late Effects Awareness for Patients, Physicians and the Public; Advancing Health and Eliminating All Disparities), a multi-dimensional website centering on late effects.</p><p>Results</p><p>An extensive review revealed 14 pediatric cancer websites, none of which focused exclusively on late effects. LEAP³ AHEAD is the first interactive website for acute lympocytic leukemia childhood cancer survivors and families, as well as physicians, and the public to: a) increase awareness about risks, detection, diagnosis, treatment, and prevention of medical and psychological late effects, b) provide suggestions to successfully reintegrate into schools, careers, and socially, and c) present opportunities including camps, scholarships, and pet therapy programs.</p><p>Conclusion</p><p>LEAP³ AHEAD is the first national website to provide a comprehensive, accessible, affordable, and multi-dimensional resource for pediatricians, internists, nurse practitioners, psychologists, survivors and their families, as well as the public about late effects.</p></div

Current websites on late effects in childhood cancer survivors.

<p>Current websites on late effects in childhood cancer survivors.</p

Awareness and knowledge of Human Papillomavirus (HPV) among ethnically diverse women varying in generation status

Although Human papillomavirus (HPV) is a common sexually transmitted infection, there is limited knowledge of HPV with ethnic/racial minorities experiencing the greatest disparities. This cross-sectional study used the most recent available data from the California Health Interview Survey to assess disparities in awareness and knowledge of HPV among ethnically/racially diverse women varying in generation status (N = 19,928). Generation status emerged as a significant predictor of HPV awareness across ethnic/racial groups, with 1st generation Asian-Americans and 1st and 2nd generation Latinas reporting the least awareness when compared to same-generation White counterparts. Also, generation status was a significant predictor of HPV knowledge, but only for Asian-Americans. Regardless of ethnicity/race, 1st generation women reported lowest HPV knowledge when compared to 2nd and 3rd generation women. These findings underscore the importance of looking at differences within and across ethnic/racial groups to identify subgroups at greatest risk for poor health outcomes. In particular, we found generation status to be an important yet often overlooked factor in the identification of health disparities

Assessment on the Use of the Suinn-Lew Asian Self Identity Acculturation Scale in Health Studies of Asian Immigrant Populations

The most widely used measure of acculturation among Asians populations is the Suinn-Lew Asian Self-Identity Acculturation Scale (SL-ASIA). Purpose: This systematic review aims to: (a) describe population characteristics and methodology used in health studies assessing acculturation, as measured by the SL-ASIA; (b) evaluate the use of the SL-ASIA in the included studies; (c) summarize associations between acculturation, as measured by the SL-ASIA, and health outcomes; and (d) provide recommendations for future research. Methods: An electronic search was conducted using PsycINFO and MEDLINE. Studies using the SL-ASIA in the context of mental or physical health outcomes in Asian adult populations were included, for a total of 14 studies. Results: Most studies were conducted with Chinese, Korean, and Vietnamese immigrants, with the majority being foreign-born. All studies used cross-sectional designs with convenience sampling. More than half used a modified version of the scale, and less than half used a translated version. Psychometric properties and pilot testing of modified/translated versions of the SL-ASIA were underreported. Most findings on the relationship between acculturation, as measured by the SL-ASIA, and health are consistent with research in other immigrant populations. Conclusions: Future studies should include underrepresented groups for a more representative picture of Asian immigrant health, and follow established methodologies for translations of the SL-ASIA. Associations drawn between health and acculturation from the use of the SL-ASIA will facilitate understanding of within-group Asian immigrant differences in the adaptation process, and identify at-risk populations