Transfer of young adults with Type 1 diabetes from pediatric to adult diabetes care
Bibliographic record
Abstract
Young adulthood is a period of major transition in physical, psychological, and sociai development.Throughout this time, youth with Type I diabetes must continue to meet the extensive health and self-care demands ofdiabetes, during which they are transferred fiom pediatric to adult diabetes health care.Research indicates that many young adults with Type I diabetes do not continue with diabetes medical care and education upon transfer to adult health care, however research limitations and programmatic diflerences prohibit generalization ofresearch.The purpose ofthis study was to examine the experience of young adults with Type I diabetes in Winnipeg as they moved from specialized pediahic diabetes health cæe to specialized adult diabetes health cafe.Using the Health Belief Model as a conceptual fiamework, this expioratory fiveyear multi-site rehospective study used audits ofthe pediatric and adult diabetes health records to examine diabetes health, and follow-up with diabetes health care the year before and after hansfer.A mailed self-administered questionnaire included standardized tools to examine the subjects' health beliefs, and a number ofquestions to explore the subjects' experiences and recommendations regarding the transfer process.Bivariate analysis was conducted to examine the relationship between health beliefs, metabolic controi, and attendance at pediatric and adult diabetes health care.Content analysis was used to examine the selÊreport ofthe experiences ofthe 19 subjects, and to formulate major ttremes.Close to half of the zubjects reported having difficulty with their transfer.Their predominant recommendation for young adult care was for a specialized diabetes health care Transfer of young adults vi team for those aged 18 to 25, consisting ofboth the pediaaic and the adult diabetes team.The disbibution of the total number of visits, and of the frequency of Hemoglobin A1C measurement pre ærd post transfer was significant.Metabolic control remained suboptimal.The subject's age at the last visit to pediafics, selÊreport ofthe heþfrrlness oftransfer information from the pediatric diabetes team, and visits to specific pedianic staffconelated to metabolic c¿ntol or participation in adult health care.Further results, and recommendations for future research and for the development ofa tansition program are provided.Transfer ofyoung adults y¡l ACKNO\ryLEDGEMENTS I would like to thank my committee members for their expertise, guidance and support.In particular, I would like to thank my Chair, Dr. Pamela Hawranik, who in addition to sharing her wisdom, displayed a gentle and infinite ability to provide direction, focus and optimism.I also thank Dr. Murphy for his valuable input and balance
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.033 | 0.008 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".