Improving the school experience of children with diabetes: Evaluation of the KiDS project.

BACKGROUND: The International Diabetes Federation (IDF) launched the Kids and Diabetes in School (KiDS) project in collaboration with the International Society for Paediatric and Adolescent Diabetes (ISPAD) and Sanofi Diabetes to inform and teach school staff, children and parents on the management of diabetes in school. Brazil and India were chosen as pilot countries. METHODS: The evaluation was conducted using a qualitative methodology using semi-structured face to face in-depth interviews. Five out of fifteen schools were selected, where teachers and parents of children with and without diabetes were interviewed. Interviews took place one and three months after the implementation of KiDS. FINDINGS: Diabetes knowledge among the school staff and parents of children without diabetes was very limited prior to the KiDS Project in both countries. After introducing the KiDS information pack both groups mentioned increased knowledge on the management of diabetes. This was reflected through healthier food choices at school and the encouragement of physical activities. Increased awareness and understanding in the school staff were observed by parents of children with diabetes. INTERPRETATION: The KiDS project received positive feedback on the educational materials. The pack was deemed informative, interesting and engaging, creating increased awareness and understanding among school staff, parents and children. The project has created a demand for diabetes intervention in schools. The pack has been translated into fourteen languages and was downloaded over 17,000 times by November 2018.

"KiDS and Diabetes in Schools" project: Experience with an international educational intervention among parents and school professionals.

BACKGROUND: Although it is known that school care is a major challenge in diabetes treatment, there is still no published international initiative. OBJECTIVES: The aims of this study were to introduce an international educational intervention tool, the International Diabetes Federation (IDF) KiDS and Diabetes in Schools project (KiDS project), and to describe its impact on diabetes knowledge and behavior of caregivers and school professionals. METHODS: The KiDS project was developed with the support of IDF and the International Society for Pediatric and Adolescent Diabetes and provides online free material in 10 languages, directed to caregivers and school personnel. A pilot evaluation of the KiDS intervention was performed in Brazil. An educational intervention was conducted in 5 primary schools, with 42 parents and school staff, followed by 2 individual interviews after 1 and 3 months. The results were evaluated in a qualitative study with a descriptive design based on content analysis. RESULTS: School staff acquired new knowledge on diabetes and its treatment. They felt more confident when helping students with diabetes and said the educational intervention promoted a positive impact on the teacher-student relationship, on the caring for health, and on school infrastructure. Family members of children with diabetes stated that the educational intervention gave them an opportunity to strengthen and update information on treatment and improve their knowledge. CONCLUSIONS: The KiDS project is the first international tool directed to foster a safe and supportive environment and a better understanding of diabetes in schools. In this pilot evaluation, it achieved the goal of informing and changing the behavior of parents and school staff, thus improving the care provided to children with diabetes in schools.

Measurement of picometer-scale mirror dynamics.

A high-speed interferometer has been designed and built to measure the dynamics of the James Webb Space Telescope primary mirror system currently under testing. This interferometer is capable of tracking large absolute motion (i.e., piston) of the mirror's entire surface over orders of magnitudes of wavelengths displacement. Preliminary tests have shown it to be capable of measuring dynamic effects on the level of tens of picometers reliably. This paper reports the details of test setup to do so, the data system used to collect and process the data, and the algorithms to distill the dynamics motions detected. The results that were obtained are presented and followed by a discussion of the conclusions and potential applications of this measurement technique.

Screening for type 2 diabetes and pre-diabetes in general practice: a descriptive study of Maltese practices.

OBJECTIVE: The aim of this research study was to ascertain the awareness of Maltese family doctors to the prevalence and significance of impaired glucose regulation and early diagnosis of type 2 diabetes and whether practices were influenced by employment status, post-graduate training in diabetes or years since graduation. METHODS: A specially constructed questionnaire was distributed by mail to all the 298 family doctors listed as Specialists in Family Medicine in the Maltese Medical Council register. Participants had to be practising family medicine in Malta. Results were analysed using SPSS 20.0 aiming for a significance criterion of 0.05 and a power of 80%. RESULTS: Valid replies were received from 154 GPs (51.7%). 93.2% claimed to offer their patients some form of screening. Screening levels reached up to 95.9% in the presence of specific risk factors (e.g., high previous HbA1c levels) but fell to between 46.2% and 58.7% in patients over 50, the physically inactive and those who suffer from polycystic ovarian syndrome. Screening using capillary glucose is widespread (70.8%) as opposed to the oral glucose tolerance test (23.4%). Results also show a high use of urinalysis in screening (53.2%) and a paradoxical lack of use of HbA1c in screening by young doctors and by those with recent extra training in diabetes. CONCLUSIONS: The need for a structured screening programme in Malta and its viability need to be evaluated by further studies. Educational support to GPs together with logistic support for GPs needs to be improved.

An investigation of the glucose monitoring practices of nurses in stroke care: a descriptive cohort study.

Glucose derangement is commonly observed among adults admitted to hospital with acute stroke. This paper presents the findings from a descriptive cohort study that investigated the glucose monitoring practices of nurses caring for adults admitted to hospital with stroke or transient ischaemic attack. We found that a history of diabetes mellitus was strongly associated with initiation of glucose monitoring and higher frequency of that monitoring. Glucose monitoring was continued for a significantly longer duration of days for adults with a history of diabetes mellitus, when compared to the remainder of the cohort. As glucose monitoring was not routine practice for adults with no history of diabetes mellitus, the detection and treatment of hyperglycaemia and hypoglycaemia events could be delayed. There was a significant positive association between the admission hospital that is most likely to offer stroke unit care and the opportunity for glucose monitoring. We concluded that adults with acute stroke, irrespective of their diabetes mellitus status prior to admission to hospital, are vulnerable to both hyperglycaemic and hypoglycaemic events. This study suggests that the full potential of nurses in the monitoring of glucose among hospitalised adults with stroke has yet to be realised.

Systematic review of descriptive cohort studies on the dynamics of glycaemia among adults admitted to hospital with acute stroke.

AIM: This article presents the results of a systematic review of descriptive cohort studies on the dynamics of glycaemia among adults admitted to hospital with acute stroke. BACKGROUND: Hyperglycaemia is common among adults admitted to hospital with stroke. DESIGN: Systematic review. DATA SOURCES: A search for descriptive cohort studies published between January 1996-June 2011, was conducted in MEDLINE, PubMed and Embase electronic databases. The search was performed using the terms 'stroke', 'hyperglycaemia' and/or 'glucose' combined and limited to adults and English language publications. Searching of citations from identified studies supplemented the electronic searches. REVIEW METHODS: A systematic review was conducted of eight studies, meeting the criteria of: (1) descriptive cohort studies; (2) adults admitted to hospital with acute stroke; and (3) glycaemic status monitored over at least two consecutive days from admission to hospital. The review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis standards. RESULTS: The dynamics of glycaemia after stroke has been investigated in seven prospective cohort studies and one retrospective study. The patterns that emerged were persisting normoglycaemia, transient hyperglycaemia, persisting hyperglycaemia and delayed hyperglycaemia. Surges in glycaemia are likely on days 2 and 3 and some adults will not exhibit hyperglycaemia till day 7. CONCLUSION: Further large cohort studies are required to explore the dynamic of glycaemia after stroke for at least 1 week duration. The timing of formal screening for diabetes mellitus is important, as early screening may overestimate detection rates.

Structured diabetes education for children and adolescents.

The implementation of structured diabetes education for children and adolescents with type 1 diabetes has gained momentum in the past few years. This article reviews government policy in respect of structured diabetes education, evidence about such programmes for children and adolescents, and problems of methodological inadequacy of past research in this area.

Diabetes education: what do adolescents want?

AIMS AND OBJECTIVES: To establish adolescents' beliefs regarding the need for structured diabetes education and their views on how such a programme should be organised and what topics need to be addressed. BACKGROUND: Structured diabetes education programmes have become common place in diabetes care in recent years. Despite the use of these programmes in adult patients, to date, there exists no tried or tested programme for adolescents. Prior to the development of programmes for this age group, there is a need to establish their views on programme content, delivery mechanisms and how best to introduce structured education in this population. DESIGN: An exploratory qualitative study. METHODS: Five focus group interviews were undertaken across three acute Hospital Trusts in Northern Ireland. A total of 21 adolescents between 13-19 years were interviewed. Data were analysed by means of a thematic content analysis framework. RESULTS: All participants expressed a need for a structured education programme specifically tailored to their needs. The complexity of existing diabetes regimens brought with it feelings of frustration and guilt for the majority of adolescents. Many felt isolated and alone. Dietary management and insulin adjustment were seen as very complex. CONCLUSION: Participants favoured a structured diabetes education programme that was short in duration, practical in nature, positive in outlook and relevant to daily life. Relevance to clinical practice. Programmes should address the specific needs of adolescents, be delivered in a practical manner and be realistic for everyday use.

Perceived barriers and facilitators to implementing research findings in the Irish practice setting.

BACKGROUND: Studies have consistently demonstrated that nurses are increasingly recognizing the role research has to play in their daily practice. Despite this recognition the actual application of research findings in the practice setting is still poor. To date, the barriers to implementing research findings in the Republic of Ireland's practice setting have not been explored empirically. This study sought to address this gap. AIMS: The aims of this study were to ascertain what Registered Nurses practising in the Republic of Ireland perceive as barriers to the implementation of research findings in the practice setting and to explore what they perceive would facilitate them in using research findings in their daily practice. DESIGN: Cross-sectional survey. METHODS: A non-probability strategy was employed with all Registered Nurses who commenced a nursing-focused academic course accredited by the University of Dublin, Trinity College, between September 2001 and February 2002 invited to participate. The ethical rights of the participants in terms of anonymity, privacy and informed consent were assured through a number of mechanisms. Data were collected via the Barriers scale. FINDINGS: Eight of the top 10 ranked barriers were organization centred. The top barrier was a perception of insufficient authority to instigate change in the practice setting. The perceived key facilitators to implementing research findings included protected time for retrieval and evaluation of research findings, instrumental support from management, informed supportive personnel in the practice settings and accessible educational opportunities to augment critical reading skills. RELEVANCE TO CLINICAL PRACTICE: The Irish Government is committed to provide the people of Ireland with an evidence-based health service. From a nursing perspective the findings of this study indicate that a number of strategies have to be introduced or enhanced in the practice settings before this commitment can be realized.