Janet H. Silverstein

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During recent years, the American Diabetes Association (ADA) has published detailed guidelines and recommendations for the management of diabetes in the form of technical reviews, position statements, and consensus statements. Recommendations regarding children and adolescents have generally been included as only a minor portion of these documents. For(More)
OBJECTIVES To examine family factors as predictors of metabolic control in children with type 1 diabetes and determine whether adherence behaviors mediate this relationship. METHOD Participants were 109 children (ages 8-18) and a parent. Measures of diabetes-specific family functioning and an adherence interview were completed. Glycosylated hemoglobin(More)
OBJECTIVE Open-label studies indicate that oral dichloroacetate (DCA) may be effective in treating patients with congenital lactic acidosis. We tested this hypothesis by conducting the first double-blind, randomized, control trial of DCA in this disease. METHODS Forty-three patients who ranged in age from 0.9 to 19 years were enrolled. All patients had(More)
OBJECTIVE The psychosocial functioning of overweight youth is a growing concern. Research has shown that overweight children report lower quality of life (QOL) than their non-overweight peers. This study sought to extend the literature by examining the association between peer victimization, child depressive symptoms, parent distress, and health-related QOL(More)
OBJECTIVE To assess the effectiveness of parent-only vs family-based interventions for pediatric weight management in underserved rural settings. DESIGN A 3-arm randomized controlled clinical trial. SETTING All sessions were conducted at Cooperative Extension Service offices in underserved rural counties. PARTICIPANTS Ninety-three overweight or obese(More)
OBJECTIVE Accurate assessment of diabetes regimen adherence behaviors in youth is a challenging endeavor and is limited by a paucity of empirically supported measures. The purpose of this research is to further demonstrate the validity and reliability of the Self-Care Inventory (SCI), a youth and parent report measure of adherence with diabetes self-care(More)
We detected limited mobility of small and large joints in 92 (30 per cent) of 309 patients with diabetes who were one to 28 years old. Among patients who had had diabetes for more than 4.5 years (the shortest duration at which microvascular complications were noted), 82 of 169 had joint limitation. Forty-one of these 82 also had microvascular complications,(More)
Connective tissue is ubiquitous and subject to alterations that result in changes in the extracellular matrix of vessels and tissues leading to the long-term complications of diabetes. This article reviews only those abnormalities of interstitial connective tissue involving skeleton, joints, skin, and periarticular tissues. Abnormalities in the skin and(More)
OBJECTIVE Our objective was to formulate practice guidelines for the treatment and prevention of pediatric obesity. CONCLUSIONS We recommend defining overweight as body mass index (BMI) in at least the 85th percentile but < the 95th percentile and obesity as BMI in at least the 95th percentile against routine endocrine studies unless the height velocity(More)
OBJECTIVE To examine the relationship between peer victimization and child and parent reports of psychosocial adjustment and physical activity in a clinical sample of at-risk-for-overweight and overweight children and adolescents. METHODS The Schwartz Peer Victimization Scale, Children's Depression Inventory-Short Form, Multidimensional Anxiety Scale for(More)