Objective: Psychosocial concerns are common among youth with Type I diabetes; psychosocial screening and integrated care models can address these concerns. Medical providers are key stakeholders, but their perspectives on the role of mental health within pediatric diabetes care represent a gap in the literature. This study aimed to describe pediatric diabetes care providers' views on the relationship between psychosocial stress and diabetes, their experiences with psychosocial screening and psychological consultation within their clinic, and their suggestions for mental health professionals working with youth who have diabetes. Method: All endocrinologists, fellows, and diabetes educators involved with psychosocial screening and psychology consultations (N = 7; 71.4% female, 42.9% Hispanic/Latinx White, 28.6% Non-Hispanic/Latinx White, 28.6% Asian) at a single outpatient pediatric diabetes clinic participated in semistructured interviews. Qualitative data were analyzed via thematic content analysis. Results: Providers described a bidirectional relationship between psychosocial stress and diabetes management. They expressed positive views of psychosocial screening and the clinic's integrated psychology team, which allow them to focus on the medical aspect of care and gain comfort with mental health. Providers offered suggestions to improve coordination and communication with mental health professionals. Conclusions: Pediatric diabetes care providers valued psychosocial screening and benefited from collaboration with the clinic psychology team. Clinics without access to mental health professionals may struggle to sustain screening practices. Eliciting medical providers' opinions and using other implementation science strategies are important for incorporating psychosocial screening and intervention within pediatric diabetes clinics, especially for clinics with unique models for psychological services. Kaitlyn E. Brodar https://orcid.

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Introduction The Insomnia Severity Index is a commonly used instrument to assess the presence of insomnia symptoms as well as an outcome measure following an intervention. Longitudinal measurement invariance is a necessary property of an assessment instrument when it is repeated over time. The validity of conclusions regarding change in the construct ‘insomnia severity’ depend on scale equivalence at each measurement timepoint. Assessment of measurement invariance of the ISI in sleep apnea patients has never been performed. Methods Veterans with sleep apnea (n=654; AHI=36±28; 93% male; age=52±12; BMI=33±6) completed the ISI on the night of their overnight PSG and again when they picked up their PAP device. Invariance was determined by imposing a series of more restrictive equivalence constraints on a 2-factor model of the ISI. The series of constraints tested for configural, weak, strong and strict invariance. Invariance testing was modeled with exploratory structural equation modeling in Mplus (v. 7.0). Results The 2-factor model that emerged from the analysis showed items relating to nighttime symptoms loading on factor 1 and daytime symptoms loading on factor 2. The sleep ‘satisfaction’ item, however, had weak but similar loadings on both factors. The increasingly restrictive constraints imposed on the model revealed no decrement in model fit (RMSEA=.039 to.043; CFI=.987 to .980; TLI=.981-.977; SRMR=.027-.041). Conclusion The ISI met strict criteria for longitudinal measurement invariance demonstrating that it is a valid instrument to be used in repeated measures study designs of insomnia in sleep apnea patients. Change over time on the ISI is not due to the changing measurement characteristics of the ISI but to true changes in the ‘insomnia severity’ construct. Support None

Between 1999 and 2001, 355 hospital laboratories in Italy were asked to complete a questionnaire addressing mycobacterial test methods, 1-year workloads and laboratory safety features. Analysis of the data showed that rapid methods for mycobacterial testing were being used by most larger laboratories; however, sub-optimal methods were still in use in small and medium-size laboratories. In a country such as Italy, which has a low prevalence of tuberculosis cases, implementation of rapid technologies, combined with regionalisation of mycobacterial diagnostic services, seems to be the most reasonable and cost-effective strategy.

Objective: Adolescents with type 1 diabetes (T1D) frequently experience psychosocial concerns, and mental health screening is becoming increasingly common in routine diabetes care. However, little is known about what adolescents or their caregivers think about the role of mental health screening and intervention within the context of comprehensive diabetes care, or how their diabetes care providers should be involved in navigating mental health concerns. This study used qualitative methods to obtain the perspectives of adolescents with T1D and their caregivers regarding these issues.Methods: Participants were 13 adolescents with T1D (ages 12-19 years; M = 15.1 years; 53.8% female; 61.5% Hispanic/Latinx White) and 13 mothers, recruited from an outpatient pediatric endocrinology clinic in South Florida, who participated in semi-structured interviews via video teleconference. Thematic content analysis was used to evaluate participants' responses.Results: Adolescents and their mothers reported positive experiences with the clinic's psychosocial screening procedures and appreciated meeting with the psychology team during visits. They wanted the clinic to offer more opportunities for peer support. Mothers highlighted barriers to seeking mental health care outside of the clinic and the importance of mental health professionals understanding diabetes. Mothers also wanted the clinic to offer more on-site therapeutic services.Discussion: Study participants valued psychosocial screening and supported addressing mental health as a routine part of diabetes comprehensive care.