James E. Aikens

University of Michigan–Ann Arbor

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John D. Piette

University of Michigan–Ann Arbor

Laura R. Saslow

University of Michigan–Ann Arbor

Donald E. Nease

University of Colorado Anschutz Medical Campus

Nicolle Marinec

VA Center for Clinical Management Research

Ranak Trivedi

Center for Innovation

Rodica Pop‐Busui

University of Michigan–Ann Arbor

Michael S. Klinkman

University of Michigan–Ann Arbor

Elham Mahmoudi

University of Michigan–Ann Arbor

Lindsay S. Mayberry

Vanderbilt University Medical Center

Ananda Sen

University of Michigan–Ann Arbor

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University of Michigan–Ann Arbor

158

Michigan Medicine

Michigan United

Ann Arbor Center for Independent Living

VA Center for Clinical Management Research

University of Chicago

Health Services Research & Development

University of California, San Francisco

VA Ann Arbor Healthcare System

United States Department of Veterans Affairs

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Beliefs Around Hypoglycemia and Their Impacts on Hypoglycemia Outcomes in Individuals with Type 1 Diabetes and High Risks for Hypoglycemia Despite Using Advanced Diabetes Technologies

Diabetes Care (2022)

Yu Kuei Lin Caroline R. Richardson Iulia Dobrin Melissa DeJonckheere Kara Mizokami‐Stout

OBJECTIVE This study aimed to 1) identify the frequency of severe and level 2 hypoglycemia presenting in individuals with type 1 diabetes using continuous glucose monitoring systems (CGMs), including those with concomitant closed-loop insulin pumps, in a clinical practice setting and 2) evaluate the impact of beliefs around hypoglycemia in the development of severe and level 2 hypoglycemia in this population. RESEARCH DESIGN AND METHODS A cross-sectional survey study in adults with type 1 diabetes using CGMs >6 months was conducted at a large tertiary academic center. Participant demographics, 6-month severe hypoglycemia history, hypoglycemia beliefs (with the Attitude to Awareness of Hypoglycemia questionnaire), and 4-week CGM glucose data were collected. Statistical analysis was performed to assess the presentation of severe and level 2 hypoglycemia and identify associated risk factors. RESULTS A total of 289 participants were recruited (including 257 participants with CGM data within the last 3 months). Of these, 25.6% experienced at least one severe hypoglycemic episode in the last 6 months, and 13.6% presented with ≥1% of time in level 2 hypoglycemia on CGMs. Reporting beliefs about prioritizing hyperglycemia avoidance was associated with severe hypoglycemia development (P < 0.001), while having beliefs of minimal concerns for hypoglycemia was associated with spending ≥1% of time in level 2 hypoglycemia (P = 0.038). CONCLUSIONS Despite the use of advanced diabetes technologies, severe and level 2 hypoglycemia continues to occur in individuals with type 1 diabetes and high hypoglycemia risks. Human factors, including beliefs around hypoglycemia, may continue to impact the effectiveness of glucose self-management.

10.2337/dc21-1285

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Citations (29)

Rationale and Methods of a Trial to Evaluate a Depression Telemonitoring Program that Includes a Patient-Selected Support Person

Journal of Clinical Trials (2014)

John D. Piette Marcia Valenstein Daniel Eisenberg Michael D. Fetters Ananda Sen

To test the effectiveness of an automated telemonitoring program for patients with depression that includes feedback to clinicians and support for a family member or friend serving as a non-professional caregiver.

Depression

mHealth

Management of depression

Patient Health Questionnaire

Self-Management

10.4172/2167-0870.1000205

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Citations (8)

Social desirability, perceived stress, and PACT ratings in lung transplant candidates: A preliminary investigation

Journal of Clinical Psychology in Medical Settings (1996)

C. L. M. Carnrike Lance M. McCracken James E. Aikens

Candidacy

Social Desirability Bias

10.1007/bf01989289

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Citations (34)

Impact of using a broad-based multi-institutional approach to build capacity for non-communicable disease research in Thailand

Health Research Policy and Systems (2019)

Kathleen Potempa Benjaporn Rajataramya Debra L. Barton Naruemol Singha-Dong Rob Stephenson

Thailand’s transition to high middle-income country status has been accompanied by demographic changes and associated shifts in the nation’s public health challenges. These changes have necessitated a significant shift in public health focus from the treatment of infectious diseases to the more expensive and protracted management of non-communicable diseases (NCDs) in older adults. In 2010, in response to this shift in focus, the University of Michigan and colleagues at the Praboromarajchanok Institute for Health Workforce Development in Thailand began work on a broad-based multi-institutional programme for NCD research capacity-building in Thailand. To begin to build a base of intervention research we paired our programme’s funded Thai postdoctoral fellows with United States mentors who have strong programmes of intervention research. One direct impact of the programme was the development of research ‘hubs’ focused upon similar areas of investigative focus such as self-management of cancer symptoms, self-management of HIV/AIDS and health technology information applications for use in community settings. Within these hubs, interventions with proven efficacy in the United States were used as a foundation for culturally relevant interventions in Thailand. The programme also aimed to develop the research support structures necessary within departments and colleges for grant writing and management, dissemination of new knowledge, and ethical conduct of human subject research. In an effort to capitalise on large national health datasets and big data now available in Thailand, several of the programme’s postdoctoral fellows began projects that use data science methods to mine this asset. The investigators involved in these ground-breaking projects form the core of a network of research hubs that will be able to capitalise on the availability of lifespan health data from across Thailand and provide a robust working foundation for expansion of research using data science approaches. Going forward, it is vitally important to leverage this groundwork in order to continue fostering rapid growth in NCD research and training as well as to capitalise upon these early gains to create a sustaining influence for Thailand to lead in NCD research, improve the health of its citizens, and provide ongoing leadership in Southeast Asia.

Health administration

Health Services Research

Capacity Building

Non-communicable disease

Workforce Development

10.1186/s12961-019-0464-8

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Citations (2)

Stereotactic Body Radiotherapy as an Alternative to Brachytherapy in Gynecologic Cancer

BioMed Research International (2013)

Gregory J. Kubicek Jinyu Xue Qianyi Xu Sucha O. Asbell L E Hughes

Brachytherapy plays a key role in the treatment of many gynecologic cancers. However, some patients are unable to tolerate brachytherapy for medical or other reasons. For these patients, stereotactic body radiotherapy (SBRT) offers an alternative form of treatment.Retrospective review of patients prospectively collected on SBRT database is conducted. A total of 11 gynecologic patients who could not have brachytherapy received SBRT for treatment of their malignancies. Five patients have been candidates for interstitial brachytherapy, and six have required tandem and ovoid brachytherapy. Median SBRT dose was 25 Gy in five fractions.At last followup, eight patients were alive, and three patients had died of progressive disease. One patient had a local recurrence. Median followup for surviving patients was 420 days (median followup for all patients was 120 days). Two patients had acute toxicity (G2 dysuria and G2 GI), and one patient had late toxicity (G3 GI, rectal bleeding requiring cauterization).Our data show acceptable toxicity and outcome for gynecologic patients treated with SBRT who were unable to receive a brachytherapy boost. This treatment modality should be further evaluated in a phase II study.

Gynecologic oncology

10.1155/2013/898953

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Citations (50)

Effects of gender and depression on oral medication adherence in persons with type 2 diabetes mellitus

Gender Medicine (2007)

David P. Nau James E. Aikens Angela M. Pacholski

Depression

Patient Health Questionnaire

Medication Adherence

Cross-sectional study

Demographics

10.1016/s1550-8579(07)80041-6

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Citations (48)

Self-Rated Health and Glycemic Control in Type 2 Diabetes: Race by Gender Differences

Journal of Racial and Ethnic Health Disparities (2017)

Shervin Assari Maryam Moghani Lankarani John D. Piette James E. Aikens

Intersectionality

Self-rated health

Race and health

White (mutation)

10.1007/s40615-017-0416-3

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Citations (11)

Primary Care Physician Responses to a Panic Disorder Vignette: Diagnostic Suspicion and Clinical Management

The International Journal of Psychiatry in Medicine (1998)

James E. Aikens Lynne I. Wagner Alex Lickerman Marshall H. Chin Amber Smith

Objective: To study current patterns of panic disorder (PD) recognition and management by primary care physicians (PCPs). Method: We administered a vignette describing a female PD patient to 189 PCPs. Results: Three-quarters of respondents believed that PD was at least 50 percent probable, and the mean PD likelihood rating was 63 percent. Diagnostic suspicion was significantly higher for PD than for other anxiety disorders, major depressive disorder, and cardiac disorders. Medication was rated as significantly more necessary than medical testing and mental health referral. A benzodiazepine was suggested by 78 percent of respondents, while 35 percent suggested a serotonin reuptake inhibitor (SRI). Under half rated the patient as requiring medical testing, mostly for hyperthyroidism (70%) and/or cardiovascular disorder (62%), and half felt that the patient required mental health referral. Conclusions: The data suggest that most PCPs are able to recognize PD. However, they may be excessively inclined to prescribe benzodiazepines rather than more appropriate medications.

Vignette

Depression

Primary care physician

10.2190/3ath-c9f4-2rta-pxha

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Citations (12)

Sexual Functioning and Mood Among Long-Term Survivors of Clear-Cell Adenocarcinoma of the Vagina or Cervix

Journal of Psychosocial Oncology (1999)

Alicia K. Matthews James E. Aikens SUSAN P. HELMRICH Diane Anderson Arthur L. Herbst

Although establishing sexual relationships is viewed as an important developmental milestone for adults, sexual functioning has been a neglected area of investigation for survivors of gynecological cancer. This article describes the long-term effects of clear-cell adenocarcinoma, with a specific focus on sexual functioning as a major quality-of-life concern. The authors hypothesized that respondents with multiple factors that interfered with their sexual functioning would report greater sexual dysfunction, poorer adjustment, and relationship difficulties. Two additional goals were to describe late psychological effects, such as depressive symptoms, and to explore the relationship between health status, coping behavior, social support variables, and depressive symptoms. The findings provide preliminary support for a complex relationship between medical complications, sexual dysfunction, emotional adjustment, and marital/partner relationships: 38% of the respondents reported physical and psychosexual factors interfering with their sexual functioning. Although chronic sexual dysfunction is a legitimate concern by itself, the findings also suggest that sexual difficulties are associated with diverse problems involving mood, quality of life, and adjustment.

Psychosexual development

Sexual Functioning

10.1300/j077v17n03_02

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Citations (22)

Differential Rates of Psychopathology Symptoms in Periodic Limb Movement Disorder, Obstructive Sleep Apnea, Psychophysiological Insomnia, and Insomnia with Psychiatric Disorder

SLEEP (1999)

James E. Aikens Peter A. Vanable Lakshminarayana Tadimeti Brendan Caruana-Montaldo Wallace B. Mendelson

To determine patterns and relative intensity of psychopathology, as measured by the Minnesota Multiphasic Personality Inventory (MMPI), in 108 patients with either psychophysiological insomnia (PI; n=20), insomnia with psychiatric disorder (IPD; n=30), periodic limb movement disorder (PLM; n=28), or obstructive sleep apnea (OSA; n=30). Cross-sectional. University sleep disorders center. Subjects completed the MMPI prior to overnight diagnostic polysomnographic assessment followed by Multiple Sleep Latency Test (MSLT). Seventy five percent of the entire sample had at least one MMPI elevation (T>70). Groups showed significant baseline differences in age, BMI, and MSLT latency (all ps<.05). Logistic regression indicated that even after statistically controlling for these three diagnostic covariates, MMPI elevation was more likely among PLM and IPD patients than OSA or PI patients (all ps<.05). Followup pairwise comparisons indicated that this same pattern of group differences occurred for the Depression, Psychasthenia, and Schizophrenia scales (all ps<.05). Irrespective of age, obesity, and daytime sleepiness, patients with untreated PLM or IPD are more likely to experience clinically significant psychological difficulties than those with either OSA or PI. These differences are most likely to be manifested in terms of depressive symptoms, anxiety symptoms (tension, worry, guilt), social alienation, and diminished mental concentration. Finally, PLM may be associated with greater MMPI elevations than previously suspected, and agree with earlier clinical reports of high rates of psychiatric treatment in PLM.

Depression

10.1093/sleep/22.6.775

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Citations (51)