BackgroundsFluctuation in glycemia due to hormonal changes, growth periods, physical activity, and emotions make diabetes management difficult during adolescence. Our objective was to show that a close control of patients’ self-management of diabetes by nurse-counseling could probably improve metabolic control in adolescents with type 1 diabetes.MethodsWe designed a multicenter, randomized controlled, parallel group, clinical trial. Seventy seven adolescents aged 12–17 years with A1C >8 % were assigned to either an intervention group (pediatrician visit every 3 months + nurse visit and phone calls) or to the control group (pediatrician visit every 3 months). The primary outcome was the evolution of the rate of A1C during the 12 months of follow-up. Secondary outcomes include patient’s acceptance of the disease (evaluated by visual analog scale), the number of hypoglycemic or ketoacidosis episodes requiring hospitalization, and evaluation of A1C rate over time in each group.ResultsSeventy-seven patients were enrolled by 10 clinical centers. Seventy (89.6 %) completed the study, the evolution of A1C and participants satisfaction over the follow-up period was not significantly influenced by the nurse intervention.ConclusionNurse-led intervention to improve A1C did not show a significant benefit in adolescents with type 1 diabetes because of lack of power. Only psychological management and continuous glucose monitoring have shown, so far, a slight but significant benefit on A1C. We did not show improvements in A1C control in teenagers by nurse-led intervention.Trial registrationClinical Trials.gov registration number: NCT00308256, 28 March 2006.
BackgroundThe incidence of childhood type 1 diabetes (T1D) incidence is rising in many countries, supposedly because of changing environmental factors, which are yet largely unknown. The purpose of the study was to unravel environmental markers associated with T1D.MethodsCases were children with T1D from the French Isis-Diab cohort. Controls were schoolmates or friends of the patients. Parents were asked to fill a 845-item questionnaire investigating the child’s environment before diagnosis. The analysis took into account the matching between cases and controls. A second analysis used propensity score methods.ResultsWe found a negative association of several lifestyle variables, gastroenteritis episodes, dental hygiene, hazelnut cocoa spread consumption, wasp and bee stings with T1D, consumption of vegetables from a farm and death of a pet by old age.ConclusionsThe found statistical association of new environmental markers with T1D calls for replication in other cohorts and investigation of new environmental areas.Trial registrationClinical-Trial.gov NCT02212522. Registered August 6, 2014. Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3690-9) contains supplementary material, which is available to authorized users.
This paper investigates the relationships between personality (i.e., trait Emotional Intelligence – trait EI – and the Big Five) and academic performance (AP). Academic motivation, procrastination, and major satisfaction were also studied. The sample consisted of 201 Lebanese undergraduates. The model represented a good fit. There was a negative direct effect of procrastination on AP and positive direct effects of major satisfaction and absorption on AP. Trait EI showed a negative direct effect on procrastination and a positive direct effect on major satisfaction, which, in turn, significantly predicted AP. Also, conscientiousness indirectly predicted AP, via procrastination, major satisfaction, and absorption. Findings point at individual differences contributing to AP and can be helpful to students, educators, and counselors in higher education.
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