Pediatric Diabetes Outpatient Center at Rhode Island Hospital: The impact of changing initial diabetes education from inpatient to outpatient.

BACKGROUND: This study compared outcomes and costs for new-onset Type 1 diabetes mellitus (T1DM) patients educated at the outpatient versus inpatient settings. METHODS/DESIGN: Retrospective study examining the following variables: 1) hemoglobin A1c (HbA1c), 2) severe hypoglycemia, 3) admissions for diabetic ketoacidosis (DKA) or ER visits, and 4) healthcare cost. RESULTS: 152 patients with new-onset T1DM from September 2007-August 2009. There were no differences between outpatient group (OG) and inpatient group (IG) in mean HbA1c levels at 1, 2 and 3 years post-diagnosis (OG 8%, 8.5%, 9.3%; IG 8.3%, 8.9%, 9%, p=0.51). Episodes of severe hypoglycemia, DKA, and ER visits were not different between the two groups. Mean total hospital costs for OG and pure OG were significantly less than IG (OG: $2886 vs. IG: $4925, p<0.001), (pure OG: $1044 vs. IG: $4925, p<0.0001). CONCLUSION: Our study demonstrates that outpatient- based pediatric diabetes education lowers healthcare cost without compromising medical outcomes. [Full article available at http://rimed.org/rimedicaljournal-2017-02.asp].

Associations among distorted cognitions and hypothetical parenting responses prior to parenthood.

Using path analytic methods, the present study used two social-cognitive models of maladaptive parenting to predict endorsements of child punishment in a sample of 101 young adults who had not yet become parents. Participants completed paper-and-pencil measures of expectations, attributions, current aggression, and responses to vignettes about child rearing and social situations. Results suggest that working models of parent-child relationships are related in predictable ways to endorsements of cognitive and behavioral responses toward children in vignettes, even in adults who are not yet parents. An extended model of maladaptive parenting that included beliefs and behaviors regarding current peer relationships was not validated. Gender moderated the influence of past punishment on level of unrealistic expectations about children and the influence of current peer aggression on endorsements of child punishment. Implications of gender differences in predictors and directions forfuture research are discussed.