Introduction: Effective diabetes self-management and collaborative responsibility sharing with parents are imperative for pediatric patients with type 1 diabetes mellitus, particularly as they gradually assume more self-care responsibilities. The primary goal of this study was to assess differences in adherence to self-care activities regarding sociodemographics and clinical characteristics in pediatric patients with type 1 diabetes. The secondary goal of this study was to understand the level of parental involvement in diabetes management and to assess the pediatric patients’ behaviors (independent or dependent on disease self-management) that relate to sociodemographic and clinical characteristics. Methods: This was a comparative cross-sectional and correlational study. The study sample included 182 children and adolescents who had been diagnosed with type 1 diabetes at least 3 months prior. Data collection instruments included a sociodemographic and questionnaire about Adherence to self-care activities and parental involvement in diabetes self-management, as well as a documentation sheet for recording clinical data. Results: A majority of participants (71%) exhibited non-adherence to self-care tasks, despite 78.0% asserting their independence in diabetes self-management. Notably, insufficient parental involvement in administering insulin therapy significantly predicted severe hypoglycemic episodes. Conclusions: Pediatric patients dealing with type 1 diabetes demonstrate a substantial degree of autonomy in managing their condition, paradoxically coupled with self-reported non-adherence to critical self-care responsibilities. Notably, children (aged 8–12) rely more heavily on parental support, especially concerning insulin therapy administration. The study underscores the crucial role of parental engagement in insulin therapy, as its deficiency significantly predicts the likelihood of severe hypoglycemic episodes.
The available data on the impact of air pollution on acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are inconsistent. We investigated the influence of air pollution on the number of severe AECOPD hospitalizations of non-infectious etiology in patients residing in Novi Sad, Serbia. In this time-series, we used a quasi-Poisson generalized linear model in conjunction with distributed lag non-linear models, after controlling for lag days, seasonal and long-term trends, and meteorological factors (air temperature and humidity), to estimate the relative risk (RR) of AECOPD hospitalization for each increase of 10 μg/m3 in the air pollutant concentration. A total of 552 AECOPD hospitalizations were registered during 2017–2022. With each 10 μg/m3 increase in the selected air pollutants’ concentration, the cumulative RR (lags0–7) in single-predictor models for AECOPD admission were 1.52 (95% CI 0.98–2.35) for PM10, 1.44 (95% CI 0.93–2.25) for PM2.5, 1.13 (95% CI 0.87–1.47) for SO2, and 0.99 (95% CI 0.69–1.42) for NO2. Similar results were found in multi-predictor models as well as in group analyses between smokers and non-smokers. In conclusion, no significant associations between exposure to air pollutants and the daily AECOPD admissions were found. There is an obvious need for additional research on the topic.
Background and Objectives: Inadequate treatment of asthma and chronic obstructive pulmonary disease (COPD) might have a negative impact on their progression. Inhalation therapy is the cornerstone of pharmacotherapy for these conditions. However, challenges such as low adherence, negative attitudes, and misconceptions about inhaled medications still persist, impeding effective disease management. This study aimed to evaluate adherence, ascertain the level of disease control in asthma and COPD, explore potential misconceptions surrounding inhalation therapy among patients with obstructive lung diseases and the general population in Vojvodina, and evaluate the reliability of newly developed questionnaires employed in the study. Materials and Methods: This cross-sectional study utilized a battery of questionnaires encompassing sociodemographic data, the Asthma Control Test (ACT), the COPD Assessment Test (CAT), along with two novel questionnaires—one for assessing adherence and another for analyzing attitudes toward inhalation therapy. Statistical analyses were conducted using SPSS software, version 25.0. Results: The average ACT score among patients with asthma was 17.31, while it was 19.09 for the CAT questionnaire among COPD patients. The composite score on the newly developed adherence assessment questionnaire was 2.27, exhibiting a reliability coefficient lower than recommended (α = 0.468). Significant statistical differences emerged among sample subgroups regarding attitudes and misconceptions toward inhalation therapy. The reliability coefficient for this questionnaire was deemed satisfactory (α = 0.767). Conclusions: Adherence rates were notably suboptimal in both subgroups of the studied population. The disease control levels were higher among asthma patients, while they exhibited less prevalent misconceptions regarding inhalation therapy compared to COPD patients and the healthy population.
Aim: To identify the determinants of self‐reported health‐related quality of life in children and adolescents with type 1 diabetes mellitus during the coronavirus pandemic.Design: A cross‐sectional study.Methods: The study sample included 182 children and adolescents who had been diagnosed with type 1 diabetes mellitus at least 3 months prior. Data collection instruments included sociodemographic and glycaemic control protocol adherence questionnaires, documentation sheet for recording clinical data, and Serbian versions of the EuroQol‐5D‐Y and KidScreen27 questionnaires, which were used to assess health‐related quality of life.Results: Glycaemic control adherence, presence of comorbidities, level of metabolic control, and type of insulin therapy were identified as key determinants of self‐reported health‐related quality of life.Patient or Public Contribution: No patient or public contributions.
Introduction. Diabetes mellitus is a chronic disease that affects all aspects of life of pediatric patients, especially the psychological aspect, and hence the health-related quality of life. The aim of the study was to evaluate the effects of sociodemographic and clinical factors of pediatric patients with type 1 diabetes mellitus on self-assessment of health-related quality of life. Material and Methods. The research was conducted as a cross-sectional study. The sample included 37 pediatric patients aged 8 to 18 years, who were diagnosed with the type 1 diabetes mellitus six months or longer before enrollment into the study. The research instruments used in the study were the Serbian version of child-friendly EuroQol-5D-Y youth questionnaire and medical history data (gender, age, time since diagnosis - in years, glycosylated hemoglobin values, type of insulin therapy). Results. The total score of general health on the visual analogue scale was 80.54 on average (standard deviation - 20.87). A negative correlation was found between the total score on the visual analogue scale and the duration of diabetes (? = -0.329, p < 0.05). The statistical significance of the difference in the distribution of respondents? responses in relation to the type of insulin therapy was confirmed in the domain ?Feeling of concern? (?2 (2) = 7.19, p < 0.05). Conclusion. The key determinants that influenced the self-assessment of the health-related quality of life in pediatric patients with type 1 diabetes mellitus are duration of the disease and the use of insulin analogues.
In addition to the detrimental health consequences, the early stages of the COVID-19 pandemic have yielded unforeseen benefits in terms of reducing air pollution emissions. This study investigated air pollution changes in Novi Sad, Serbia, during the COVID-19 lockdown (March–June 2020) and their correlation with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) hospitalizations. Using quasi-Poisson generalized linear models (GLM) and distributed lag non-linear models (DLNM), we examined the relationship between the number of AECOPD hospitalizations and the concentrations of selected air pollutants (PM10, PM2.5, SO2, and NO2) from March to June of 2019, 2020, and 2021. During the COVID-19 lockdown, significant reductions in most air pollutant concentrations and the number of AECOPD hospitalizations were observed. However, neither the study year nor its interaction with air pollutant concentration significantly predicted AECOPD hospitalizations (p > 0.05). The 95% confidence intervals of the relative risks for the occurrence of AECOPD hospitalizations at each increase in the examined air pollutant by 10 μg/m3 overlapped across years, suggesting consistent effects of air pollution on the risk of AECOPD hospitalizations pre-pandemic and during lockdown. In conclusion, reduced air pollution emissions during the COVID-19 lockdown did not lead to a statistically significant change in the number of AECOPD hospitalizations.