Real-world outcomes of Omnipod DASH system use in people with type 1 diabetes: Evidence from the Association of British Clinical Diabetologists (ABCD) study.

AIMS: To evaluate real-world outcomes in people with Type 1 Diabetes (PwT1D) initiated on Omnipod DASH® Insulin Management System. METHODS: Anonymized clinical data were submitted to a secure web-based tool within the National Health Service network. Hemoglobin A1c (HbA1c), sensor-derived glucometrics, total daily dose of insulin (TDD), and patient-reported outcome changes between baseline and follow-up were assessed. Individuals were classified to "new-to-pump" (switched from multiple daily injections) and "established-on-pump" (switched from a tethered insulin pump) groups. RESULTS: 276 individuals from 11 centers [66.7 % female; 92 % White British; median age 41 years (IQR 20-50); diabetes duration 20 years (IQR 11-31); 49.3 % within "new-to-pump" group] were included. Baseline HbA1c was 8.0 ± 1.3 % (64 ± 14 mmol/mol). At follow-up [3 years (IQR 1.5-3.2)], HbA1c reduced by 0.3 % [(3 mmol/mol); p = 0.002] across the total population, 0.4 % [(5 mmol/mol); p = 0.001] in those "new-to-pump" and remained unchanged in those "established-on-pump". TDD decreased in the "new-to-pump" cohort (baseline:44.9 ± 21.0units vs follow-up:38.1 ± 15.4units, p = 0.002). Of those asked, 141/143 (98.6 %) stated Omnipod DASH had a positive impact on quality of life. CONCLUSIONS: Omnipod DASH was associated with improvements in HbA1c in PwT1D "new-to-pump" and maintained previous HbA1c levels in those "established-on-pump". User satisfaction in all groups and TDD reduction in those "new-to-pump" were reported.

Impostor Phenomenon and Its Relationship to Self-Esteem Among Students at an International Medical College in the Middle East: A Cross Sectional Study.

The atmosphere of constant scrutiny of academic ability that prevails in medical colleges may leave some students at risk of expressing feelings of intellectual fraudulence and phoniness. Impostor phenomenon (IP) traits have been associated with anxiety, depression, job dissatisfaction, and poor professional performance. Internationally trained junior doctors exhibit stronger IP feelings than colleagues trained within their own country of citizenship. These feelings may develop during student life. International universities are diverse and complex environments where students may be emersed in a cultural milieu alien to their societies of origin, leading to feelings of isolation. Individuals with IP traits often perceive themselves as the "only one" experiencing this phenomenon, resulting in further isolation and negative self-evaluation, especially among women and underrepresented minorities. IP has also been linked to low self-esteem among students. This study assessed the prevalence of IP and its relationship to self-esteem among students at a campus of a European medical college with a large international student body situated in the Middle East. The self-administered questionnaires: Clance's Impostor Phenomenon Scale (CIPS) and Rosenberg's Self-Esteem Scale (RSES) were completed by 290 medical students (58.3% females). Participants' median (range) age was 19 years (16-35). Students were of 28 different nationalities; the largest proportions were from Gulf Corporation Council (GCC) countries. The prevalence of low self-esteem was 18.6%, while 45.2% of the students demonstrated traits suggestive of IP. There was a strongly negative correlation between CIPS and RSES (r = -0.71). No significant gender differences were found in IP. Similarly, no differences in IP were found when comparing between age groups, previous experience in higher education or year of study. Multivariate analysis showed that students from GCC countries had higher levels of self-esteem relative to students from other regions. Low self-esteem was a strong predictor of IP. Country of origin may influence students' self-esteem studying in international university settings.

Psychological Impact of COVID-19, Isolation, and Quarantine: A Cross-Sectional Study.

PURPOSE: The COVID-19 pandemic has resulted in mandatory isolation and quarantine. The objective of this study was to describe and compare the psychological impacts of COVID-19 isolation and quarantine. METHODS: This was a cross-sectional retrospective study. Participants were Bahrainis aged >18 years who had undergone either isolation or quarantine. Eligible participants were identified from the COVID-19 contacts (quarantine) and cases (isolation) database of Bahrain. Validated questionnaires for self-reported depression (Center for Epidemiological Studies - depression [CES-D]), posttraumatic stress (Impact of Event Scale - revised [IES-R]), and perceived stigma (Stigma Scale [SS]) were administered. RESULTS: Mean CES-D, IES-R, and SS scores were 16.76±5.65, 13.50±14.67, and 25.29±7.99, respectively. In sum, 40% (205 of 502) of participants showed clinically significant depression, and <20% (98 of 502) had indications of some posttraumatic distress, with greater depression and distress in those isolated than those quarantined. Perceived stigma was reported by 53.4% (268 of 502) of participants, more prominent among those quarantined. Depression and posttraumatic stress scores were significantly higher in females, college students, those with a history of mental health conditions, knowing a COVID-19 fatality, and experiencing social conflict. Age was a significant variable correlated with all three scales, with younger participants indicating more distress, depression, and stigma. Duration of segregation was significantly correlated with CES-D, score showing more depressive symptoms as the duration of isolation increased. Significant predictors were age, sex, history of mental illness, and COVID-19 status. CONCLUSION: Isolated and quarantined individuals reported depression, perceived stigma, and to a lesser extent distress. Psychological interventions identifying and targeting people with different-severity psychological burdens are in urgent need.

The influence of ball-juggling on emotional states, blood pressure and sleep-quality among medical students during end-of-year exam preparation.

Juggling-exposure therapy has been employed in the management of anxiety and post-traumatic stress disorder. However, there is little evidence of the effectiveness of juggling-exposure in improving emotional states in subclinical conditions. This study aimed at evaluating the effect of a course of juggling on emotional states, sleep quality and blood pressure among medical students at a critical stage of their academic training. Blood pressure, psychometric and quality of sleep assessments were performed pre- and post-examination period for two groups of students: juggling-exposed (n = 9) and non-juggling-exposed (n = 11). Juggling exposure consisted of practice-drills for one hour per week during the period spanning the student's scheduled exams. Comparisons were made between quantitative measures that were collected pre- and post-the course of juggling drills. Differences in scores and measures were expressed as percentage-change and compared between non-juggling and juggling groups. Overall, there was a decrease in depression and anxiety scores between the pre-to post-exam periods. This decrease was statistically significant for both non-juggling and juggling groups with respect to anxiety, but only the juggling-exposed group had a significant reduction regarding depression scores. However, when calculated as percentage-change over the pre-to post-exam period, there was no significant difference in any of the parameters for either of the two groups. Practicing juggling drills had an influence on emotional states.