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PubMed1992

The treatment of bulimia nervosa following surgery using a stimulus control procedure: a case study.

This single case report describes the treatment of a 35-year-old female, who was diagnosed as suffering from severe bulimia nervosa. Of interest were the frequent vomiting episodes which did not exist prior to two surgical operations performed on the client in order to reduce her overall body weight. The treatment, a stimulus control procedure, which spanned 20 sessions, lasted about 24 weeks and was deemed successful after a year follow-up. Of primary importance was the self-management aspect of the treatment program, which emphasized minimum therapist intervention. In addition, there was a complete absence of "cognitive components" deemed necessary by some authors for the long-term treatment success of bulimics. Different factors relating to the success of this treatment program are also reviewed.

Adult↗

PubMed1992

Asthma prevalence and management in Australian adolescents: results from three community surveys.

Three population surveys of asthma, conducted as part of a community-based asthma education program in southwestern Sydney, Australia, illustrate the relationship between health behaviors and asthma morbidity. The first survey was carried out in five secondary schools (n = 2514, 52% participation rate); the second survey, in eight schools (n = 4550, 82% participation rate); and, the third survey was conducted among patients who attended 38 general practices in the region (n = 633 adolescents, 72% participation rate). The prevalence of diagnosed asthma in Australian adolescents across all three studies was 16.5% (95% CI, 15.7%-17.3%). Asthma prevalence declined in males, but increased in females from ages 12-15 years. It was noted that smoking prevalence was similar in asthmatic adolescents, compared with nonasthmatics, and that the adoption of smoking occurred at similar ages. Further, behavioral self-management of asthma was infrequent in this group, with low levels of preventive practice and preventive medication use. We present a conceptual model of the barriers to optimal asthma management among asthmatic adolescents. The results of these surveys have led to community-wide efforts to improve asthma management and decrease smoking prevalence among these adolescents.

Adolescent↗

PubMed2026

Financial incentives and health coaching to improve glycemic outcomes among young adults with type 1 diabetes: A factorial randomized trial (SweetGoals).

AIM: This study aimed to improve glycemic control among young adults with type 1 diabetes (T1D), an at-risk and understudied population. METHOD: N = 300 young adults with T1D recruited nationally were randomized to the factorial combination of (1) financial incentives targeting glucose checking and mealtime behaviors and (2) web health coaching focused on increasing motivation and goal setting for self-management behaviors. All received a smartphone app that accessed device data and provided weekly goal feedback. The intervention lasted 6 months. HbA1c (A1c) was assessed at baseline, +6 months, and +12 months. The mean number of glucose checking and mealtime goals met per week during the intervention were tested as mediators of intervention effects on A1c at 12 months. RESULTS: A1c was significantly reduced from baseline to +12 months across all participants. Indirect effects of both incentives and coaching on A1c reductions were significant and partially mediated by mealtime but not glucose checking goal achievement. There was no synergistic (interaction) effect of incentives and coaching. CONCLUSION: Incentives and coaching both improved critical mealtime behavior but through different strategies. These results suggest that either intervention would be suitable for future testing and dissemination, and that lower cost of incentives may favor their prioritization.

Adolescent↗

PubMed2026

Smartphone apps for obesity management: A systematic review using self-determination theory.

BACKGROUND: While bariatric surgery and pharmacotherapy are effective treatments for obesity, ongoing supportive care remains a challenge. Smartphone applications (apps) may assist with symptom management, but their effectiveness and practical use in obesity treatment is unclear. This review evaluated the effectiveness, acceptability, and feasibility of these apps in supporting individuals following obesity treatment. To better understand how these apps may promote sustained engagement and behaviour change, their design was analysed using Self-Determination Theory (SDT). METHODS: A systematic search was conducted across MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, SCOPUS, and CENTRAL databases. Eligible studies included randomised and non-randomised interventions involving adults (≥18 years) with obesity (BMI ≥ 30 kg/m2) who had undergone bariatric surgery or pharmacotherapy. Interventions had to include an app designed to support post-treatment symptom management. Findings were synthesised narratively, and app features were mapped to SDT constructs of autonomy, competence, and relatedness. RESULTS: Five studies (three RCTs, two cohort studies) involving 1,133 participants were included (female: 78 %; median age: 47.63 years). Most apps targeted post-bariatric surgery care; only one focused on pharmacotherapy. Common features included tracking, reminders, and education, supporting autonomy and competence. Relatedness features such as communication and peer support were least represented. Two studies reported improvements in weight-related outcomes and one in medication adherence. Effects on quality of life, self-efficacy, and healthcare utilisation were not significant. Patient satisfaction was reported in one study, with 95 % expressing positive feedback, though formal assessments of feasibility and acceptability were limited. CONCLUSION: Smartphone apps show potential to support obesity management, particularly after bariatric surgery. While some evidence suggests benefits for weight loss and adherence outcomes, the limited studies and variability of reporting prevent conclusive observations in other outcomes. Future app development should integrate behavioural theory to address psychological needs, nutritional risks and promote holistic self-management beyond weight control.

Female↗

PubMed2026

Advancing nursing education through social and emotional learning: A systematic review guided by the Collaborative for Academic, Social, and Emotional Learning framework.

BACKGROUND: With Generation Z entering the nursing workforce in growing numbers, strengthening social and emotional learning is critical for academic success, professional adaptation, and safe practice. However, the existing evidence remains fragmented because of varied interventions and inconsistent approaches. OBJECTIVES: This systematic review examined (1) the social and emotional learning essential for nursing students and nurses within the Collaborative for Academic, Social, and Emotional Learning framework, (2) their impact on educational and clinical outcomes, and (3) implications for advancing nursing education and practice. METHODS: Following Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, five international (PubMed, EMBASE, CINAHL, PsycINFO, Cochrane) and three Korean (RISS, KoreaMed, KMBASE) databases were searched up to June 2025. Eighteen studies involving 2,952 participants met the inclusion criteria, including quasi-experimental quantitative studies, descriptive quantitative studies, qualitative studies, and mixed-methods studies. The methodological quality of the included studies was appraised using the Mixed Methods Appraisal Tool. RESULTS: Within the Collaborative for Academic, Social, and Emotional Learning framework, relationship skills and self-management were the most frequently studied competencies, emphasizing teamwork, communication, and stress regulation. Self-awareness and social awareness were underexplored, despite their importance in empathy, resilience, and reflective practice. Responsible decision-making was the least studied competency, despite its importance in ethical reasoning. Social and emotional learning was consistently associated with enhanced adaptation, communication, leadership, relationships, and clinical performance. Effective strategies included blended learning, simulation, reflective activities, and mentorship, which are aligned with Generation Z's learning preferences. CONCLUSION: Although social and emotional learning integration is associated with improvements in educational and clinical outcomes in nursing, current research has largely centered on relational and stress-related competencies while underrepresenting responsible decision-making. To cultivate reflective, empathetic, and ethically grounded nurses, curricula should integrate social and emotional learning through a balanced and structured approach. REGISTRATION: This study was registered on PROSPERO (ID: CRD420251005683).

Humans↗

PubMed1979

Personality and morbid obesity. Implications for dietary management through behavior modification.

Psychological investigations have failed to reveal a distinct personality type or psychodynamic conflict pattern in moderately and massively obese persons. Many of the psychological problems noted in the obese such as anxiety, depression, and poor self-esteem seem to be the result of, rather than the cause of, the obese state. Morbidly obese persons share an addictive behavior pattern that is also seen in persons with other types of addictions. The extent of their obesity points to the strong substance abuse component of the eating disorder. Behavior modification programs aimed at changing problematic eating patterns and teaching self-management skills in relation to food consumption have been moderately successful and have been shown to result in a mean post-treatment weiht loss of seven to 16 pounds. However, the majority of morbidly obese persons will not lose enough weight to make this an effective treatment program for them.

Behavior Therapy↗

PubMed1979

Measures and methods in evaluating patient education programs for chronic illness.

Patient education provides a vehicle for increasing the self-management of chronic illness and promoting modifications of life styles, which are considered important strategies for prevention. Evaluating the impact of such programs is complex and poses a number of methodologic and technical problems. Outcome measures of patient education programs are defined and reviewed in terms of the existing evaluation literature and our own studies utilizing diabetes as a prototype condition. Important dimensions of adaptation are outlined and indices to measure it discussed in an effort to examine aspects of educational programs directed at facilitating coping and maintaining quality of life. Factors which influence outcome variables are identified and include: patient factors (e.g., age, ethnic, socioeconomic, cultural, personality, and emotional), disease factors (e.g., severity of illness, age of onset, length of illness, mode of therapy), system factors (e.g., patient's location in the health care system, relation of teaching program to other health care providers). The effects of these factors are described including their implications for research design.

Age Factors↗

PubMed1979

An interpersonal-effectiveness approach to consumer health education: rationale and case study.

The development and implementation of a program for teaching prospective consumers of medical care services interpersonal-effectiveness advocacy skills are described. Parents of developmentally disabled children attended one of two six-hour workshops to learn self-management, communication and social influence skills for dealing more effectively with health consultants. Consumer satisfaction evaluations indicated that the workshops were successful, and directions for future research and development are discussed.

Child↗

PubMed1975

The impact of illness in adolescence and coping behavior.

The emotional impact of serious illness or injury bears just as much potential for being disabling to an adolescent as does the condition itself. It is also these concerns and the possibilities for difficult behavior on the part of teenagers on the ward which frequently cause staff members to feel at a loss when caring for this reputedly difficult age group. But if one carefully examines the specific developmental stresses of illness and the various coping mechanisms by which the youth may counter them, a logical management approach emerges. To a large degree this approach depends on compensation, intellectualization, displacement and constructive denial but also recognizes that destructive denial, regression and projection do normally and naturally occur at various points in the course of illness and hospitalization and that panic and acting out may also readily occur, but less frequently. The deterence of the more deleterious responses and promotion of the more felicitious dependes on a ward setting which provides for the adolescent's growing need for independence and self-determination; for continued reassurance about body image integrity, for resumption of mastery and control; and for the maintenance or restoration of his sense of self-worth. These goals are achieved by encouraging the youth to be an active partner in his own care; to share in decisions made about his condition; to pursue just as much independent self-management as he can; to actively engage in establishing a peer group with other adolescents in the ward; to continue with his education, socialization, personal interests and outside peer contacts as much as possible; and to feel that the staff respects his dignity and privacy, likes him as a person and appreciates the courage and effort with which he is facing a difficult time.

Adolescent↗

PubMed1977

The Credit-Incentive system: motivating the participation of patients in a day hospital.

The Credit-Incentive System, a modified token economy, is a means of motivating the participation of day hospital patients in therapeutic activities through the use of contingent rewards. Credits are earned by patients for engaging in a wide variety of prosocial tasks and activities and can be spent for coffee, a free lunch, special time with professional staff, recreational events, and time off from the treatment centre. The receipt of credits is accompanied by social approval and recognition from the staff and other patients. Evaluations have shown that the credit system doubles the participation rate of patients in a partial hospitalization programme. The system also enhanced group cohesiveness, provides practice and feedback for cognitive re-integration, and offers opportunities of learning self-management. The results of two experiments suggest that the symbolic and social rewards mediated by the credits are the most important components of their effectiveness.

Adolescent↗

PubMed2026

Cost-Effectiveness of Electronic Patient-Reported Outcome Measure Interventions in Cancer: Systematic Review and Parameter Extraction for Economic Modeling.

BACKGROUND: Complex digital interventions that integrate electronic patient-reported outcome measures (ePROM) into clinical practice in cancer have the potential to improve quality of life, increase survival, and reduce health resource use and costs. Such systems can help patients with cancer self-manage chemotherapy symptoms, reduce clinicians' workloads through automated decision support, and resolve problems earlier. However, more research on the cost-effectiveness of ePROM monitoring is needed. OBJECTIVE: This paper comprises two complementary components: (1) a systematic literature review summarizing and evaluating the quantitative and qualitative evidence related to the cost-effectiveness of ePROM monitoring and (2) a health economic model parameter extraction. We also conducted supplementary targeted searches and scoping to provide context to our findings. METHODS: We searched Ovid (including MEDLINE and Embase), Scopus, and the International Health Technology Assessment Database for original English-language papers published on or before March 2025 using search strings that combined terms related to ePROMs, health economics, and cancer/oncology. We included papers reporting health economic-related outcomes for ePROM interventions designed for adult cancer populations and excluded screening tools and conference abstracts. RESULTS: We included 34 publications from 27 unique studies and identified and analyzed 26 ePROM-integrated interventions within these. Most (23/26) of the included interventions explicitly described some form of alert handling and automated decision support based on remote ePROM monitoring. Of the 34 publications, 5 presented full cost-effectiveness analysis results, of which 3 were highly uncertain and lacked clear differences in costs and health outcomes between ePROMs and standard care; conversely, 2 presented strong evidence of cost-effectiveness due to quality-of-life improvements, reduced hospitalizations, and potentially more autonomy in health-related travel (eg, ePROM-monitored patients can drive or walk to the hospital instead of using taxis or ambulances). A further 5 publications reported partial health economic results (eg, cost-consequence and budget impact), of which 1 detected no difference in strategies; in contrast, 4 reported lower health resource use and costs of ePROMs, mainly due to hospitalization reductions. Overall, 12 of the 27 studies included a qualitative component but mostly focused on user experience and design-related themes; only 2 of these addressed economic-specific themes (eg, changes in workflow and resource use due to ePROM implementation and integration), indicating some potential for time saving due to ePROM monitoring. CONCLUSIONS: Some ePROM-integrated interventions demonstrated cost-effectiveness in cancer care, but the evidence base remains limited. Where evidence does exist, cost-effectiveness appears driven by reduced hospitalization and improved quality of life. Qualitative research within the included studies rarely addressed economic questions. We provide a detailed parameter extraction for use in future economic modeling and recommend research priorities, including quantitative mapping of ePROM symptom data onto health resource use patterns, and qualitative work exploring how ePROM implementation affects clinical workloads and patient-perspective costs.

Humans↗

PubMed2026

The Management of Type 1 Diabetes in Adults. The Updated 2026 Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD).

This 2026 consensus report from the European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA) builds on the 2021 consensus report to provide guidance for managing type 1 diabetes in adults. Reflecting the rapid advances in the field, this update places particular emphasis on the integration of new technologies, while all sections have been revised to incorporate new evidence, advances in clinical practice, and novel therapies, including interventions to delay the onset of stage 3 type 1 diabetes. It also broadens its scope to screening for long-term diabetes complications, and the management of obesity and cardiovascular risk factors. Psychosocial care and diabetes self-management education and support (DSMES) remain key elements.

Journal Article↗

PubMedDate not supplied

Evaluation of patient's knowledge of diabetes self-care.

A survey conducted at a Veterans Administration Hospital to evaluate patient capability for self-management found that over 35 per cent of the patients interviewed lacked any formal training. Seventeen patients had been placed on insulin without formal instruction. Almost one half the patients who claimed to have attended training programs could not demonstrate adequate knowledge or skills in any of the major areas of self-care: insulin administration, urine testing, diet, foot care, and management of hypoglycemia and hyperglycemia. While patients with training were more knowledgeable than patients without training, the difference was slight. The results indicate the need for systematic analysis of patient knowledge and the evaluation of training programs on a continuing basis.

Adult↗

PubMed1975

Instructional, pacing, and feedback control of respiratory behavior.

Procedures designed to affect respiration rate and amplitude were assessed for 4 groups of 8 subjects each. The groups were exposed to combinations of procedures providing feedback for decreasing respiration amplitude, pacing respiration rate, and instructions on rate and amplitude of breathing. After an initial baseline, effects were examined during both treatment and self-management phases for respiratory activity and concurrent heart-rate and electromyogram activity. Reliable effects of pacing on respiration rate, and a slight, but non-significant effect on amplitude were observed. No effects were observed for any heart-rate or electromyogram measures.

Auditory Perception↗

PubMed1975

Personal management of growth: productivity, decision-making, emotion, and social behavior in my senior year.

The writer used self-recording and charting of his own behavior as a way to observe and manage changes during his senior year at high school. The method used has implications for the application of behavior modification technology to self-management, and to behaviors that occur inside an organism's skin. The results have implications for study of the Senior Slump", for college and career planning in high school, for clarifying interpersonal attitudes, and for keeping track of one's emotional well-being.

Adolescent↗

PubMedDate not supplied

[Is it possible to improve the teaching methods of physicians who instruct patients? Comparative analysis of the same courses given before and after teacher's training].

The goal of the present study is to compare the pedagogic involvement of two groups of doctors, both of which were in charge of teaching the same courses to diabetic patients. Important structural differences were-shown exit between the two series of courses. The first group of ten doctors (who not undergone any pedagogic training) applied either ex-catedra teaching methods or proceeded by systematically asking questions to the patients. These scholastic methods led to passive attitudes in their patients in listening and replies to a large number of questions. In the second group of ten doctors (who had undergone pedagogic training) learning practices and a stimulating didactic material were used which resulted in more diversified and more attractive responses in the participation of the patients. Providing improved didactic means on the behalf of the doctors is aimed at obtaining better knowledge from patients who have themselves to assume the self-management of their treatment.

Diabetes Mellitus↗

PubMedDate not supplied

[The Zagreb Medical School from the "Croatian spring" to the first multi-party elections].

Schools of Medicine are institutions for an integrative approach to diseases and health, comprising at the same time scientific, teaching and treatment aspects of the nosological entities. These three functions are optimal only when academic freedom and sufficient financial support are satisfied. The authors analyze the last twenty years of academic performance of the University of Zagreb School of Medicine which were considerably influenced by the external political demands imposed by the so-called self-management phase of former communist regime. The constant restructuring of the internal organization, lower investments in science and quantitative expansion in all the activities of the School were the major characteristics of this period. International comparisons, especially in the light of recent development of molecular biology, demonstrate that this was rather growth than development of the oldest School of Medicine of Croatia. The authors emphasize the importance of academic freedom and strong international cooperation for the development and maintenance of quality of teaching schools.

Croatia↗

PubMed1992

[Asthma therapy: are bronchodilators obsolete?].

Short acting beta 2-agonists, such as salbutamol, fenoterol and terbutaline, are the most potent bronchodilating agents in the treatment of acute asthmatic attacks. In chronic asthma, however, they must be viewed as purely symptomatic treatment compared to antiinflammatory agents (inhaled corticosteroids, cromoglycate and nedocromil sodium), prophylactic agents which can also decrease airway hyperresponsiveness and thereby stabilize the disease. Modern asthma treatment are based on the present understanding of asthma pathophysiology and take into account the new therapeutic options with high dose inhaled steroids and long acting beta 2-agonists. Patients with only occasional asthma symptoms should receive inhaled short acting beta 2-agonists as needed. These agents continue to be central to the treatment of any asthmatic attack. If asthma symptoms occur more than 4-6 times a week a regular inhalative antiinflammatory regimen should be initiated (e.g. inhalative corticosteroids b.i.d.). In cases with frequent symptoms or persisting airway obstruction, regularly administered inhalative bronchodilators (beta 2-agonists, possibly long acting) should be added to high dose inhaled steroids. Treatment of severe acute asthma should always include systemic glucocorticosteroids (e.g. prednisone 30-60 mg/day). Special emphasis should be placed on self-management plans, encouraging patients to monitor and treat their disease themselves in close cooperation with the physician.

Acute Disease↗