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51. Contributors

Author

Abu-Shaweesh, Jalal M., primary, Accornero, Veronica H., additional, Als, Heidelise, additional, Anderson, Brenna L., additional, Aranda, Jacob V., additional, Arnold, James E., additional, Arora, Sundeep, additional, Bajaj, Komal, additional, Baley, Jill E., additional, Bancalari, Eduardo H., additional, Bandstra, Emmalee S., additional, Barksdale, Edward M., additional, Bearer, Cynthia F., additional, Blickstein, Isaac, additional, Blumer, Jeffrey L., additional, Butler, Samantha, additional, Calkins, Kara, additional, Caplan, Michael S., additional, Carlo, Waldemar A., additional, Chelimsky, Gisela, additional, Chock, Valerie Y., additional, Chwals, Walter J., additional, Cohen, Alan R., additional, Cooperman, Daniel R., additional, Crombleholme, Timothy M., additional, Curtis, Mario De, additional, Vries, Linda S. de, additional, Dell, Katherine MacRae, additional, Denne, Scott, additional, Devaskar, Sherin U., additional, Fiore, Juliann Di, additional, Donn, Steven M., additional, Edwards, Morven S., additional, Edwards, William H., additional, Erenberg, Francine, additional, Fanaroff, Avroy A., additional, Fanaroff, Jonathan M., additional, Fasano, Ross, additional, Flidel-Rimon, Orna, additional, Friedman, Smadar, additional, Gerber, Susan E., additional, Goldsmith, Jay P., additional, Gonik, Bernard, additional, Gould, Jeffrey B., additional, Gressens, Pierre, additional, Gross, Susan J., additional, Gruslin, Andrée M., additional, Gupta, Balaji K., additional, Hack, Maureen, additional, Halamek, Louis P., additional, Hamvas, Aaron, additional, Hellmann, Jonathan, additional, Hintz, Susan R., additional, Hoath, Steven B., additional, Horbar, Jeffrey D., additional, Hoyt, McCallum R., additional, Hüppi, Petra S., additional, Jain, Lucky, additional, Jobe, Alan H., additional, Judge, Nancy E., additional, Kaplan, Michael, additional, Kalhan, Satish C., additional, Kapur, Reuben, additional, Karunamuni, Ganga, additional, Kaufman, Lawrence M., additional, Kennedy, Kathleen A., additional, Kennell, John H., additional, Kitterman, Joseph A., additional, Klaus, Marshall H., additional, Kliegman, Robert M., additional, Langer, Oded, additional, Lazebnik, Noam, additional, Levene, Malcolm I., additional, Lim, Foong-Yen, additional, Lissauer, Tom, additional, Lopez, Suzanne M., additional, Lotze, Timothy E., additional, Naomi Luban, L.C., additional, Luchtman-Jones, Lori, additional, Magnuson, David K., additional, Mangurten, Henry H., additional, McClary, Jacquelyn, additional, Miller, Geoffrey, additional, Miller, Marilyn T., additional, Mohamed, Mohamed W., additional, Moore, Thomas R., additional, Morley, Colin J., additional, Morrison, Stuart C., additional, Narang, Anil, additional, Narendran, Vivek, additional, Nock, Mary L., additional, Palmert, Mark R., additional, Parikh, Aditi S., additional, Parry, Robert L., additional, Phelps, Dale L., additional, Poindexter, Brenda, additional, Polin, Richard A., additional, Puppala, Bhagya L., additional, Raju, Tonse N.K., additional, Ramachandrappa, Ashwin, additional, Redline, Raymond W., additional, Rigo, Jacques, additional, Robinson, Barrett K., additional, Rose, Susan R., additional, Rothenberg, Florence, additional, Safder, Shaista, additional, Saugstad, Ola Didrik, additional, Schaefer, Katherine S., additional, Scher, Mark S., additional, Sedin, Gunnar, additional, Shah, Dinesh M., additional, Shinwell, Eric S., additional, Shulman, Rayzel M., additional, Sibley, Eric, additional, Sinha, Sunil K., additional, Sivit, Carlos J., additional, Siwik, Ernest S., additional, Sprecher, Robert C., additional, Steinhorn, Robin H., additional, Stevenson, David K., additional, Stork, Eileen K., additional, Stork, John E., additional, Pas, Arjan B. te, additional, Thompson, George H., additional, Toltzis, Philip, additional, Turbow, Robert, additional, Tyson, Jon E., additional, Hare, George F. Van, additional, Vento, Maximo, additional, Vidyasagar, Dharmapuri, additional, Vogt, Beth A., additional, Vohr, Betty, additional, Walsh, Michele C., additional, Watanabe, Michiko, additional, Wherrett, Diane K., additional, White, Robert D., additional, Wiesner, Georgia L., additional, Wikenheiser, Jamie C., additional, Wilson, David B., additional, Wilson-Costello, Deanne, additional, Wolf, Richard B., additional, Wong, Ronald J., additional, Yoder, Mervin C., additional, Young, Thomas, additional, Zahka, Kenneth G., additional, and Zinn, Arthur B., additional

Published
2011
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64. Approach to the Evaluation and Management of the Obese Child With Early Puberty.

Author

Tenedero, Christine B, Oei, Krista, and Palmert, Mark R

Abstract

With the declining age at onset of puberty and increasing prevalence of childhood obesity, early breast development in young obese girls has become a more frequent occurrence. Here, we examine available literature to answer a series of questions regarding how obesity impacts the evaluation and management of precocious puberty. We focus on girls as the literature is more robust, but include boys where literature permits. Suggestions include: (1) Age cutoffs for evaluation of precocious puberty should not differ substantially from those used for nonobese children. Obese girls with confirmed thelarche should be evaluated for gonadotropin-dependent, central precocious puberty (CPP) to determine if further investigation or treatment is warranted. (2) Basal luteinizing hormone (LH) levels remain a recommended first-line test. However, if stimulation testing is utilized, there is a theoretical possibility that the lower peak LH responses seen in obesity could lead to a false negative result. (3) Advanced bone age (BA) is common among obese girls even without early puberty; hence its diagnostic utility is limited. (4) Obesity does not eliminate the need for magnetic resonance imaging in girls with true CPP. Age and clinical features should determine who warrants neuroimaging. (5) BA can be used to predict adult height in obese girls with CPP to inform counseling around treatment. (6) Use of gonadotropin-releasing hormone analogues (GnRHa) leads to increased adult height in obese girls. (7) Obesity should not limit GnRHa use as these agents do not worsen weight status in obese girls with CPP. [ABSTRACT FROM AUTHOR]

Published
2022
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66. CONTRIBUTORS

Author

Abbasi, Soraya, primary, Abman, Steven H., additional, Adamson, S. Lee, additional, Adzick, N. Scott, additional, Albertine, Kurt H., additional, Alman, Benjamin A., additional, Altschuler, Steven M., additional, Anderson, Page A.W., additional, Anthony, Russell V., additional, Aron, Elisabeth A., additional, Aslan, Ahmet R., additional, Asselin, Jeanette M., additional, Auten, Richard L., additional, Avery, Mary Ellen, additional, Avner, Ellis D., additional, Baldwin, H. Scott, additional, Ballard, Philip L., additional, Bancalari, Eduardo, additional, Barker, David J.P., additional, Barker, Pierre M., additional, Battaglia, Frederick C., additional, Beauchamp, Gary K., additional, Beesley, Jacqueline, additional, Benchimol, Corinne, additional, Bennet, Laura, additional, Berg, Robert A., additional, Berry, Gerard T., additional, Berseth, Carol Lynn, additional, Bhutani, Vinod K., additional, Blecher, Stan R., additional, Blood, Arlin B., additional, Bolender, David L., additional, Boyd, Robert D.H., additional, Brace, Robert A., additional, Brewer, Eileen D., additional, Brophy, Patrick D., additional, Broussard, Delma L., additional, Bucuvalas, John C., additional, Burrin, Douglas G., additional, Byrne, Bridgette M.P., additional, Byskov, Anne Grete, additional, Cairo, Mitchell S., additional, Cannon, Barbara, additional, Caplan, Michael S., additional, Caplin, Neil, additional, Carlson, Susan E., additional, Carlton, David P., additional, Cashore, William J., additional, Chaiworapongsa, Tinnakorn, additional, Chemtob, Sylvain, additional, Chevalier, Robert L., additional, Chheda, Sadhana, additional, Christensen, Robert D., additional, Chu, David H., additional, Clancy, Robert Ryan, additional, Clandinin, M. Thomas, additional, Clark, David A., additional, Cleary-Goldman, Jane, additional, Clyman, Ronald I., additional, Cohen, Pinchas, additional, Corey, Howard E., additional, Cotton, Robert B., additional, Cowart, Beverly J., additional, Cowett, Richard M., additional, Crombleholme, Timothy M., additional, Crowe, James E., additional, Cuttler, Leona, additional, D'Alton, Mary E., additional, Danzer, Enrico, additional, De León, Diva D., additional, Delivoria-Papadopoulos, Maria, additional, Diaz, George A., additional, Dickinson, Chris J., additional, Dormans, John P., additional, Durand, David J., additional, Edwards, A. David, additional, Ennever, John F., additional, Erickson, Robert P., additional, Erol, Bulent, additional, Fahim, Mohamed A., additional, Feld, Leonard G., additional, Feldman, Miguel, additional, Fernandez, Lucas G., additional, Field, Douglas G., additional, Fisher, Delbert A., additional, Fox, William W., additional, Frank, Hans-Georg, additional, Friedlich, Philippe S., additional, Friedman, Aaron L., additional, Friedman, Joshua R., additional, Garland, Marianne, additional, Gervasi, Maria-Teresa, additional, Gibson, James B., additional, Gluckman, P.D., additional, Goldberg, Michael J., additional, Goldman, Armond S., additional, Goldstein, Gary W., additional, Gomez, R. Ariel, additional, Gondos, Bernard, additional, Grant, Denis M., additional, Green, Lucy R., additional, Greenspan, Jay S., additional, Grimberg, Adda, additional, Grindley, Justin C., additional, Gross, Ian, additional, Guignard, Jean-Pierre, additional, Gunn, Alistair J., additional, Haddad, Gabriel G., additional, Hagstrom, J. Nathan, additional, Halpern, Kathrin V., additional, Hambidge, K. Michael, additional, Hamosh, Margit, additional, Hanson, Mark A., additional, Haramati, Aviad, additional, Harding, Richard, additional, Harris, Mary Catherine, additional, Haxhiu, Musa A., additional, Hay, William W., additional, Hayward, Anthony R., additional, Heird, William C., additional, Herrera, Emilio, additional, Hill, Harry R., additional, Hillemeier, A. Craig, additional, Hirschhorn, Kurt, additional, Hoath, Steven B., additional, Horst, David A., additional, Hunley, Tracy E., additional, Hunter, Christian J., additional, Husain, Shahid M., additional, Hutson, Susan M., additional, Ikegami, Machiko, additional, Inder, Terrie E., additional, Jobe, Alan H., additional, Johnson, Lois H., additional, Johnston, Michael V., additional, Johnston, Richard B., additional, Jones, Deborah P., additional, Jones, Peter Lloyd, additional, Jose, Pedro A., additional, Kalhan, Satish C., additional, Kallapur, Suhas, additional, Kaplan, Stanley, additional, Karpen, Saul J., additional, Kashyap, Sudha, additional, Kaskel, Frederick J., additional, Levitt Katz, Lorraine E., additional, Kaufmann, Peter, additional, Keeney, Susan E., additional, Kilpatrick, Laurie, additional, Kinsella, John P., additional, Kirby, Margaret L., additional, Kleinman, Charles S., additional, Kogan, Barry A., additional, Koldovský, Otakar, additional, Kon, Valentina, additional, Kopecky, Ernest A., additional, Korchak, Helen M., additional, Koren, Gideon, additional, Krebs, Nancy F., additional, Kulik, Thomas J., additional, Kutikov, Jessica Katz, additional, La Pine, Timothy R., additional, Lasunción, Miguel Angel, additional, Laterra, John, additional, Lee, P.C., additional, Levine, Fred, additional, Lewis, David B., additional, Liacouras, Chris A., additional, Linshaw, Michael A., additional, Lister, George, additional, Loomis, Cynthia A., additional, Lorenz, John M., additional, Lobritto, Steven, additional, Lugo, Ralph A., additional, Maheshwari, Akhil, additional, Manco-Johnson, Marilyn J., additional, Mantilla, Carlos B., additional, Mariscalco, M. Michele, additional, Maródi, László, additional, Maršál, Karel, additional, Martin, Richard J., additional, Matthews, Dwight E., additional, McDuffie, Marcia, additional, McGowan, Jane E., additional, McManaman, James, additional, Mehmet, Huseyin, additional, Mennella, Julie A., additional, Metinko, Andrew, additional, Miller, Martha J., additional, Monagle, Paul, additional, Mortola, Jacopo P., additional, Mott, Glen E., additional, Mughal, M. Zulficar, additional, Mulroney, Susan E., additional, Munshi, Upender K., additional, Myatt, Leslie, additional, Myers, Margaret A., additional, Namgung, Ran, additional, Narkewicz, Michael R., additional, Nau, Heinz, additional, Nedergaard, Jan, additional, Neville, Margaret C., additional, Nielsen, Heber C., additional, Nogee, Lawrence M., additional, Noori, Shahab, additional, Norwitz, Errol R., additional, Norwood, Victoria F., additional, Ogata, Edward S., additional, Ohls, Robin K., additional, Olson, Thomas A., additional, Omari, Taher I., additional, Padbury, James F., additional, Palmert, Mark R., additional, Parravicini, Elvira, additional, Pereira, Gilberto R., additional, Perlman, Jeff M., additional, Philipps, Anthony F., additional, Pickoff, Arthur S., additional, Pinal, C.S., additional, Pleasure, David, additional, Pleasure, Jeanette, additional, Plonait, Sabine Luise, additional, Polin, Richard A., additional, Polk, Daniel H., additional, Pomeroy, Scott L., additional, Possmayer, Fred, additional, Post, Martin, additional, Power, Gordon G., additional, Prada, Jorge A., additional, Putet, Guy, additional, Pysher, Theodore J., additional, Quinn, Graham E., additional, Rabinovitch, Marlene, additional, Randell, Scott H., additional, Regnault, Timothy R.H., additional, Rieder, Michael J., additional, Rigatto, Henrique, additional, Rintoul, Natalie E., additional, Robillard, Jean E., additional, Robinson, Julian, additional, Romero, Roberto, additional, Rooney, Seamus A., additional, Rose, James C., additional, Rosenfeld, Charles R., additional, Ross, Arthur J., additional, Rudolph, Colin D., additional, Sahni, Rakesh, additional, Sarnat, Harvey B., additional, Satlin, Lisa M., additional, Saugstad, Ola Didrik, additional, Schibler, Kurt R., additional, Schulze, Karl, additional, Schwartz, Jeffrey, additional, Sedin, Gunnar, additional, Segar, Jeffrey L., additional, Seri, Istvan, additional, Setchell, Kenneth, additional, Shaffer, Thomas H., additional, Shaul, Philip W., additional, Shenai, Jayant P., additional, Sibley, Colin P., additional, Sieck, Gary C., additional, Siler-Khodr, Theresa M., additional, Silverstein, Faye S., additional, Simmons, Rebecca A., additional, Sivieri, Emidio M., additional, Slavkin, Harold C., additional, Snyder, Evan Y., additional, Snyder, Jeanne M., additional, Solhaug, Michael J., additional, Southern, Kevin W., additional, Spitzer, Adrian, additional, Spitzer, Alan R., additional, Stanley, Charles A., additional, Stapleton, F. Bruder, additional, Styne, Dennis, additional, Sweeney, William E., additional, Talner, Norman S., additional, Thornton, Paul S., additional, Truog, William Edward, additional, Tsang, Reginald C., additional, Tufro, Alda, additional, Ullrich, Nicole J., additional, Un, Socheata, additional, Van Aerde, John E., additional, van de Ven, Carmella, additional, van Goudoever, Johannes B., additional, Vannucci, Robert C., additional, Vannucci, Susan J., additional, van Tuyl, Minke, additional, Volpe, Joseph J., additional, Wallin, Reidar, additional, Warburton, David, additional, Ward, Robert M., additional, Weitkamp, Joern-Hendrik, additional, Werlin, Steven L., additional, Werner, Lynne A., additional, Wert, Susan E., additional, Westergaard, Lars Grabow, additional, Whitsett, Jeffrey A., additional, Wilke, Michaelann, additional, Williams, John V., additional, Williamson, Dermot H., additional, Winkelstein, Jerry A., additional, Winter, Jeremy S.D., additional, Woelkers, Douglas A., additional, Wolfson, Marla R., additional, Woroniecki, Robert P., additional, Yassir, Walid K., additional, Yip, Stephen, additional, Yoder, Mervin C., additional, Young, Sharla, additional, Young, Stephen L., additional, and Zhou, Dan, additional

Published
2004
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74. Part 3: Caring for Transgender Children: Mental Health and Timing of Gender-Affirming Care.

Author

Sorbara, Julia C., Chiniara, Lyne N., Thompson, Shelby, and Palmert, Mark R.

Subjects
TRANSGENDER children, MENTAL health, GENDER affirming care, MENTAL depression, PSYCHIATRIC drugs
Abstract

BACKGROUND: Gender-incongruent (GI) youth have high rates of mental health problems. Although gender-affirming medical care (GAMC) provides psychological benefit, some GI youth present to care at older ages. Whether a relationship exists between age of presentation to GAMC and mental health difficulties warrants study. METHODS: A cross-sectional chart review of patients presenting to GAMC. Subjects were classified a priori as younger presenting youth (YPY) (<15 years of age at presentation) or older presenting youth (OPY) (≥15 years of age). Self-reported rates of mental health problems and medication use were compared between groups. Binary logistic regression analysis was used to identify determinants of mental health problems. Covariates included pubertal stage at presentation, social transition status, and assigned sex. RESULTS: Of 300 youth, there were 116 YPY and 184 OPY. After presentation, more OPY than YPY reported a diagnosis of depression (46% vs 30%), had self-harmed (40% vs 28%), had considered suicide (52% vs 40%), had attempted suicide (17% vs 9%), and required psychoactive medications (36% vs 23%), with all P < .05. After controlling for covariates, late puberty (Tanner stage 4 or 5) was associated with depressive disorders (odds ratio 5.49; 95% confidence interval [CI]: 1.14-26.32) and anxiety disorders (odds ratio 4.18 [95% CI: 1.22-14.49]), whereas older age remained associated only with psychoactive medication use (odd ratio 1.31 [95% CI: 1.05-1.63]). CONCLUSIONS: Late pubertal stage and older age are associated with worse mental health among GI youth presenting to GAMC, suggesting that this group may be particularly vulnerable and in need of appropriate care. [ABSTRACT FROM AUTHOR]

Published
2021
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80. Alzheimer's disease and control brain contain soluble derivatives of the amyloid protein precursor that end within the beta amyloid protein region

Author

Pasternack, Jennifer M., Palmert, Mark R., Usiak, Marianne, Wang, Rong, Zurcher-Neely, Heidi, Gonzalez-De Whitt, Patricia A., Fairbanks, Michael B., Cheung, Tobun, Blades, Deborah, Heinrikson, Robert L., Greenburg, Barry D., Cotter, Robert J., and Younkin, Steven G.

Subjects
Alzheimer's disease -- Research, Amyloidosis -- Research, Biological sciences, Chemistry
Abstract

The amyloid precursor protein-soluble derivatives from Alzheimer's disease are studied to see if the derivatives are generated by cleavage within the beta amyloid protein as in cell culture or by an altered cleavage that produces potentially amyloidogenic soluble derivatives. The brain with Alzheimer's disease and the control brain had nonamyloidogenic soluble derivatives ending at position 15 of the beta amyloid protein. Soluble derivatives with the entire beta amyloid protein were not found in controls and experimental brains.

Published
1992

83. Targets and teamwork: Understanding differences in pediatric diabetes centers treatment outcomes

Author

Skinner, Timothy C, Lange, Karin S, Hoey, Hilary, Mortensen, Henrik B, Aanstoot, Henk-Jan, Castaňo, Luis, Skovlund, Soren, Swift, Peter Gf, Cameron, Fergus J, Dorchy, Harry R, Palmert, Mark R, Kaprio, Eero, Robert, Jean-Jacques, Danne, Thomas, Neu, Andreas, Shalitin, Shlomit, Chiarelli, Francesco, Chiari, Giovanni, Urakami, Tatsuhiko, Njølstad, Pål R, Jarosz-Chobot, Premyslawa K, Roche, Edna F, Castro-Correia, Cintia G, Kocova, Mirjana, Åman, Jan, Schönle, Eugen, Barrett, Timothy G, Fisher, Lynda, de Beaufort, Carine E, Hvidoere Study Group, University of Zurich, and Skinner, Timothy C

Subjects
2712 Endocrinology, Diabetes and Metabolism, 10036 Medical Clinic, 2724 Internal Medicine, 610 Medicine & health, 2735 Pediatrics, Perinatology and Child Health
Published
2018

86. Targets and teamwork:Understanding differences in pediatric diabetes centers treatment outcomes

Author

Skinner, Timothy C., Lange, Karin S., Hoey, Hilary, Mortensen, Henrik B., Aanstoot, Henk Jan, Castaňo, Luis, Skovlund, Soren, Swift, Peter Gf, Cameron, Fergus J., Dorchy, Harry R., Palmert, Mark R., Kaprio, Eero, Robert, Jean Jacques, Danne, Thomas, Shalitin, Shlomit, Chiarelli, Francesco, Chiari, Giovanni, Urakami, Tatsuhiko, Njølstad, Pål R., Jarosz-Chobot, Premyslawa K., Roche, Edna F., Castro-Correia, Cintia G., Kocova, Mirjana, Åman, Jan, Schönle, Eugen, Barrett, Timothy G., Fisher, Lynda, de Beaufort, Carine E., Skinner, Timothy C., Lange, Karin S., Hoey, Hilary, Mortensen, Henrik B., Aanstoot, Henk Jan, Castaňo, Luis, Skovlund, Soren, Swift, Peter Gf, Cameron, Fergus J., Dorchy, Harry R., Palmert, Mark R., Kaprio, Eero, Robert, Jean Jacques, Danne, Thomas, Shalitin, Shlomit, Chiarelli, Francesco, Chiari, Giovanni, Urakami, Tatsuhiko, Njølstad, Pål R., Jarosz-Chobot, Premyslawa K., Roche, Edna F., Castro-Correia, Cintia G., Kocova, Mirjana, Åman, Jan, Schönle, Eugen, Barrett, Timothy G., Fisher, Lynda, and de Beaufort, Carine E.

Abstract

Objective: The reason for center differences in metabolic control of childhood diabetes is still unknown. We sought to determine to what extent the targets, expectations, and goals that diabetes care professionals have for their patients is a determinant of center differences in metabolic outcomes. Research Design and Methods: Children, under the age of 11 with type 1 diabetes and their parents treated at the study centers participated. Clinical, medical, and demographic data were obtained, along with blood sample for centralized assay. Parents and all members of the diabetes care team completed questionnaires on treatment targets for hemoglobin A1c (HbA1c) and recommended frequency of blood glucose monitoring. Results: Totally 1113 (53% male) children (mean age 8.0±2.1years) from 18 centers in 17 countries, along with parents and 113 health-care professionals, participated. There were substantial differences in mean HbA1c between centers ranging from 7.3±0.8% (53mmol/mol±8.7) to 8.9±1.1% (74mmol/mol±12.0). Centers with lower mean HbA1c had (1) parents who reported lower targets for their children, (2) health-care professionals that reported lower targets and more frequent testing, and (3) teams with less disagreement about recommended targets. Multiple regression analysis indicated that teams reporting higher HbA1c targets and more target disagreement had parents reporting higher treatment targets. This seemed to partially account for center differences in Hb1Ac. Conclusions: The diabetes care teams' cohesiveness and perspectives on treatment targets, expectations, and recommendations have an influence on parental targets, contributing to the differences in pediatric diabetes center outcomes.

Published
2018

98. Targets and teamwork: Understanding differences in pediatric diabetes centers treatment outcomes.

Author

Skinner, Timothy C., Lange, Karin S., Hoey, Hilary, Mortensen, Henrik B., Aanstoot, Henk‐Jan, Castaňo, Luis, Skovlund, Soren, Swift, Peter G. F., Cameron, Fergus J., Dorchy, Harry R., Palmert, Mark R., Kaprio, Eero, Robert, Jean‐Jacques, Danne, Thomas, Neu, Andreas, Shalitin, Shlomit, Chiarelli, Francesco, Chiari, Giovanni, Urakami, Tatsuhiko, and Njølstad, Pål R.

Subjects
TREATMENT of diabetes, ATTITUDE (Psychology), BIOLOGICAL assay, BLOOD sugar monitoring, CHILDREN'S hospitals, GOAL (Psychology), HEALTH care teams, HEMOGLOBINS, TYPE 1 diabetes, MEDICAL personnel, QUESTIONNAIRES, TEAMS in the workplace, MULTIPLE regression analysis, TREATMENT effectiveness, PARENT attitudes, CHILDREN
Abstract

Objective: The reason for center differences in metabolic control of childhood diabetes is still unknown. We sought to determine to what extent the targets, expectations, and goals that diabetes care professionals have for their patients is a determinant of center differences in metabolic outcomes. Research Design and Methods: Children, under the age of 11 with type 1 diabetes and their parents treated at the study centers participated. Clinical, medical, and demographic data were obtained, along with blood sample for centralized assay. Parents and all members of the diabetes care team completed questionnaires on treatment targets for hemoglobin A1c (HbA1c) and recommended frequency of blood glucose monitoring. Results: Totally 1113 (53% male) children (mean age 8.0 ± 2.1 years) from 18 centers in 17 countries, along with parents and 113 health‐care professionals, participated. There were substantial differences in mean HbA1c between centers ranging from 7.3 ± 0.8% (53 mmol/mol ± 8.7) to 8.9 ± 1.1% (74 mmol/mol ± 12.0). Centers with lower mean HbA1c had (1) parents who reported lower targets for their children, (2) health‐care professionals that reported lower targets and more frequent testing, and (3) teams with less disagreement about recommended targets. Multiple regression analysis indicated that teams reporting higher HbA1c targets and more target disagreement had parents reporting higher treatment targets. This seemed to partially account for center differences in Hb1Ac. Conclusions: The diabetes care teams’ cohesiveness and perspectives on treatment targets, expectations, and recommendations have an influence on parental targets, contributing to the differences in pediatric diabetes center outcomes. [ABSTRACT FROM AUTHOR]

Published
2018
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99. Adrenal insufficiency: still a cause of morbidity and death in childhood

Author

Shulman, Dorothy I., Palmert, Mark R., and Kemp, Stephen F.

Subjects
Adrenal gland diseases -- Development and progression, Adrenal gland diseases -- Diagnosis, Adrenal gland diseases -- Complications and side effects
Abstract

Adrenal insufficiency is relatively rare in childhood and adolescence. Signs and symptoms may be nonspecific; therefore, the diagnosis may not be suspected early in the course. If unrecognized, adrenal insufficiency [...]

Published
2007

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