Browsing by Subject "European Continental Ancestry Group"
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Item Developmental Expectations and Adolescent Type 1 Diabetes Management in Latino and Caucasian Families(2013-12-30) Sundaram, Saranya Easwar; Wiebe, Deborah J.; Wetherington, Crista E.; Gross-Toalson, JamiBACKGROUND: Transfer of responsibility for diabetes management is important across adolescence. It may contribute to poorer adherence and family conflict if unmatched to adolescent development. Research has primarily studied Caucasian samples, which may have different expectations for autonomy compared to Latino samples. This study examined developmental expectations for independence in both general and diabetes-related tasks in age- and sex-matched samples of Caucasian and Latino youth with type 1 diabetes. SUBJECTS: Participants included 118 10- to 15-year-old Caucasian and Latino adolescents with type 1 diabetes [M (SD) = 13.24 (1.69) years; 54% female] and their mothers. METHOD: Participants independently completed questionnaires measuring expectations for independence, diabetes responsibility and conflict, and adherence to diabetes management. In addition, adolescents completed an inventory measuring depressive symptoms, and HbA1c levels were obtained through medical records. RESULTS: Mothers and adolescents held different expectations for the age at which adolescents should make independent decisions about general and diabetes-related activities. In the overall sample, adolescents expected independence at younger ages for prudential activities, but at older ages for diabetes activities than did parents. These mother-adolescent differences occurred in different domains across ethnicity; Caucasians displayed mother-adolescent differences in expectations for diabetes activities, while Latinos displayed differing expectations for prudential activities. In the overall sample, expectations were associated with mother-reported conflict, but were minimally correlated with parental diabetes responsibility. Younger age expectations for prudential items were associated with poorer diabetes outcomes, but age expectations for personal and diabetes items were generally unrelated to diabetes outcomes. In contrast to expectations, associations of developmental expectations with diabetes responsibility, conflict, and outcomes were similar across Caucasian and Latino youth. DISCUSSION: Findings support that there were differing age expectations between parents and adolescents in prudential and diabetes-related activities. Different factors may influence how these expectations were associated with parental responsibility, conflict, and diabetes outcomes.Item Donald W. Seldin, M.D., Research Symposium finalist presentations(2020-05-29) Adomako, Emmanuel; Hinkamp, Colin; Liu, Po-Hong (Stuart); McAdams, Meredith; Omar, Wally; Segar, MatthewThis edition of the UT Southwestern Internal Medicine Grand Rounds features presentations by the six Foster Fellows selected as finalists from the Fifth Annual Donald W. Seldin, M.D. Research Symposium, which was held on May 21, 2020. These Foster Fellows presented work that spanned the breadth and depth of scholarly activity across the department, and at the close of Grand Rounds, one will be selected as the 2020 Seldin Scholar, in honor of Dr. Donald W. Seldin. The Grand Rounds presentation also includes additional awards honoring Clinical Vignettes and an award for work in Quality and Education at Parkland Hospital.Item Understanding the Stressful Challenges of Adolescent Type 1 Diabetes Management in Caucasian and Latino Youth(2013-12-30) Lee, Alyssa G.; Wiebe, Deborah J.; Lee, Simon Craddock; Hamann, HeidiBACKGROUND: Type 1 diabetes management poses many challenges and is a potential source of stress among adolescents with diabetes and their families. In primarily Caucasian samples, diabetes management outcomes (e.g., metabolic control) deteriorate across adolescence. A growing literature indicates that Latino youth have poorer diabetes control than do Caucasian youth. The broad objective of the present study was to examine ethnic differences in the experience and effects of stress on type 1 diabetes management during adolescence. SUBJECTS: Participants were Caucasian and Latina mothers and adolescents with type I diabetes (N=118 dyads; 48% Latino; 54% female; 10 to 15 years old; illness duration > 1 year; 25% on insulin pump). Adolescents were between 10 and 15 years of age (M = 12.74, SD = 1.64). METHOD: Demographic information was collected through maternal report, geographic identifiers from available census data, and medical records. Adolescents completed surveys measuring the occurrence of different types of stressful events relevant to a diverse population of Latino and Caucasian youth (i.e., stress dimensions of family conflict, peer hassles, school hassles, and economic stress), treatment adherence, and depressive symptoms. Metabolic control was determined from HbA1c recorded in medical records. Socio-demographic information was collected through a combination of maternal report and census tract data. RESULTS: On average, Latino participants were of a lower socioeconomic status (SES) than Caucasian participants. However, there were not significant ethnic group differences in terms of adolescent age, adolescent gender, illness duration, or insulin pump status. There were also no ethnic differences on adolescent report of different types of stress. In the full sample, heightened levels of each type of stress were associated with indicators of poorer diabetes management and poorer psychosocial adjustment. Hierarchical regression analysis revealed that the stresses of peer hassles, school problems, and family conflict were each associated with poorer outcomes regardless of ethnicity. However, ethnicity moderated associations of economic stress with both adherence and depressive symptoms. Economic stress was associated with poorer adherence and greater depression in Caucasian youth, but was unrelated in Latino youth. DISCUSSION: Latino and Caucasian youth in the sample for this study did not show significant differences in their report of the experience of stress, but Latino youth appeared resilient against the adversity of economic stress. This interaction pattern is consistent with the Latino paradox. Understanding resiliency factors in diverse populations may assist health care professionals in providing effective and culturally sensitive interventions.