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Article ; Online: Digital interventions to improve safety and quality of inpatient diabetes management: A systematic review.

Sly, Benjamin / Russell, Anthony W / Sullivan, Clair

International journal of medical informatics

2021 Volume 157, Page(s) 104596

Abstract: Importance: Diabetes is common amongst hospitalised patients and contributes to increased length of stay and poorer outcomes. Digital transformation, particularly the implementation of electronic medical records (EMRs), is rapidly occurring across the ... ...

Abstract	Importance: Diabetes is common amongst hospitalised patients and contributes to increased length of stay and poorer outcomes. Digital transformation, particularly the implementation of electronic medical records (EMRs), is rapidly occurring across the healthcare sector and provides an opportunity to improve the safety and quality of inpatient diabetes care. Alongside this revolution has been a considerable and ongoing evolution of digital interventions to optimise care of inpatients with diabetes including optimisation of EMRs, digital clinical decision support systems (CDSS) and solutions utilising data visibility to allow targeted patient review. Objective: To systematically appraise the recent literature to determine which digitally-enabled interventions including EMR, CDSS and data visibility solutions improve the safety and quality of non-critical care inpatient diabetes management. Methods: Pubmed, Embase and Cochrane databases were searched for suitable articles. Selected articles underwent quality assessment and analysis with results grouped by intervention type. Results: 1202 articles were identified with 42 meeting inclusion criteria. Four key interventions were identified; computerised physician order entry (n = 4), clinician decision support systems (n = 21), EMR driven active case finding (data visibility solutions) and targeted patient review (n = 10) and multicomponent system interventions (n = 7). Studies reported on glucometric outcomes, evidence-based medication ordering including medication errors, and patient and user outcomes. An improvement in glucometric measures particularly mean blood glucose and proportion of target range blood glucose levels and rates of evidence-based insulin prescribing were consistently demonstrated. Conclusion: Digitally-enabled interventions utilised to improve quality and safety of inpatient diabetes care were heterogenous in design. The majority of studies across all intervention types reported positive effects for evidence-based prescribing and glucometric outcomes. There was less evidence for digital interventions reducing diabetes medication administration errors or impacting patient outcomes (length of stay).
MeSH term(s)	Decision Support Systems, Clinical ; Diabetes Mellitus/drug therapy ; Electronic Health Records ; Humans ; Inpatients ; Medical Order Entry Systems
Language	English
Publishing date	2021-10-02
Publishing country	Ireland
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review ; Systematic Review
ZDB-ID	1466296-6
ISSN	1872-8243 ; 1386-5056
ISSN (online)	1872-8243
ISSN	1386-5056
DOI	10.1016/j.ijmedinf.2021.104596
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Article: Clinician Perspectives of Barriers and Enablers to Implementing the Mediterranean Dietary Pattern in Routine Care for Coronary Heart Disease and Type 2 Diabetes: A Qualitative Interview Study.

Mayr, Hannah L / Kelly, Jaimon T / Macdonald, Graeme A / Russell, Anthony W / Hickman, Ingrid J

Journal of the Academy of Nutrition and Dietetics

2022 Volume 122, Issue 7, Page(s) 1263–1282

Abstract: Background: Practice guidelines for coronary heart disease and type 2 diabetes recommend promoting the Mediterranean dietary pattern (MDP), which improves cardiometabolic risk markers and may prevent disease progression and complications. It is unknown ... ...

Abstract	Background: Practice guidelines for coronary heart disease and type 2 diabetes recommend promoting the Mediterranean dietary pattern (MDP), which improves cardiometabolic risk markers and may prevent disease progression and complications. It is unknown to what extent the MDP is recommended in routine care for patients with these conditions, particularly in multiethnic settings. Objective: The study aim was to explore multidisciplinary health care professionals' perspectives on recommending the MDP in routine care for patients with coronary heart disease or type 2 diabetes and barriers and enablers to its implementation. Design: A qualitative description design was employed, utilizing semistructured individual interviews to collect data. Participants and setting: Fifty-seven clinicians (21 nurses, 19 doctors, 13 dietitians, and 4 physiotherapists) routinely managing relevant patients across hospital and community settings in a metropolitan health service in Australia participated in interviews between November 2019 and March 2020. Statistical analysis performed: Interviews were audiorecorded, transcribed verbatim, and analyzed using thematic analysis. Results: Four overarching themes were identified highlighting that the MDP was not routinely recommended: current dietary practices (all clinicians perceived they had a role in dietary care but prioritization varied. There was a legacy of single nutrient-based strategies and disease silos); clinician-centered barriers to recommending MDP (limited MDP knowledge and practice skills and variable understanding and acceptance of evidence supporting its use. This was related to lack of education and training about the diet and personal interest/experience); organizational culture and resources influence dietary care (MDP not embedded in service culture or current clinic tools and resources, with limited dietary knowledge exchange within and across multidisciplinary teams); and perceived patient-centered barriers to implementation of MDP (socioeconomic challenges in a multicultural setting, and a lack of belief in patient capabilities to improve diet adherence). Conclusions: Clinician and organizational factors, compounded by perceptions about patient acceptance, influence recommendations of the MDP for patients with coronary heart disease or type 2 diabetes. These factors should be addressed to improve translation of MDP evidence into practice.
MeSH term(s)	Coronary Disease/prevention & control ; Diabetes Mellitus, Type 2 ; Diet ; Health Personnel ; Humans ; Qualitative Research
Language	English
Publishing date	2022-01-31
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2646718-5
ISSN	2212-2672
ISSN	2212-2672
DOI	10.1016/j.jand.2022.01.012
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Article: Clinician Perspectives of Barriers and Enablers to Implementing the Mediterranean Dietary Pattern in Routine Care for Coronary Heart Disease and Type 2 Diabetes: A Qualitative Interview Study

Mayr, Hannah L. / Kelly, Jaimon T. / Macdonald, Graeme A. / Russell, Anthony W. / Hickman, Ingrid J.

Academy of Nutrition and Dietetics Journal of the Academy of Nutrition and Dietetics. 2022 Jan. 24,

2022

Abstract: Practice guidelines for coronary heart disease and type 2 diabetes recommend promoting the Mediterranean dietary pattern (MDP), which improves cardiometabolic risk markers and may prevent disease progression and complications. It is unknown to what ... ...

Abstract	Practice guidelines for coronary heart disease and type 2 diabetes recommend promoting the Mediterranean dietary pattern (MDP), which improves cardiometabolic risk markers and may prevent disease progression and complications. It is unknown to what extent the MDP is recommended in routine care for patients with these conditions, particularly in multiethnic settings. The study aim was to explore multidisciplinary health care professionals’ perspectives on recommending the MDP in routine care for patients with coronary heart disease or type 2 diabetes and barriers and enablers to its implementation. A qualitative description design was employed, utilizing semistructured individual interviews to collect data. Fifty-seven clinicians (21 nurses, 19 doctors, 13 dietitians, and 4 physiotherapists) routinely managing relevant patients across hospital and community settings in a metropolitan health service in Australia participated in interviews between November 2019 and March 2020. Interviews were audiorecorded, transcribed verbatim, and analyzed using thematic analysis. Four overarching themes were identified highlighting that the MDP was not routinely recommended: current dietary practices (all clinicians perceived they had a role in dietary care but prioritization varied. There was a legacy of single nutrient-based strategies and disease silos); clinician-centered barriers to recommending MDP (limited MDP knowledge and practice skills and variable understanding and acceptance of evidence supporting its use. This was related to lack of education and training about the diet and personal interest/experience); organizational culture and resources influence dietary care (MDP not embedded in service culture or current clinic tools and resources, with limited dietary knowledge exchange within and across multidisciplinary teams); and perceived patient-centered barriers to implementation of MDP (socioeconomic challenges in a multicultural setting, and a lack of belief in patient capabilities to improve diet adherence). Clinician and organizational factors, compounded by perceptions about patient acceptance, influence recommendations of the MDP for patients with coronary heart disease or type 2 diabetes. These factors should be addressed to improve translation of MDP evidence into practice.
Keywords	coronary disease ; diet ; dietetics ; disease progression ; eating habits ; education ; health services ; hospitals ; information exchange ; nationalities and ethnic groups ; noninsulin-dependent diabetes mellitus ; nutrition knowledge ; patients ; prioritization ; Australia
Language	English
Dates of publication	2022-0124
Publishing place	Elsevier Inc.
Document type	Article
Note	Pre-press version
ZDB-ID	2646718-5
ISSN	2212-2672
ISSN	2212-2672
DOI	10.1016/j.jand.2022.01.012
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Article ; Online: Community-based integrated care versus hospital outpatient care for managing patients with complex type 2 diabetes: costing analysis.

Donald, Maria / Jackson, Claire L / Byrnes, Joshua / Vaikuntam, Bharat Phani / Russell, Anthony W / Hollingworth, Samantha A

Australian health review : a publication of the Australian Hospital Association

2021 Volume 45, Issue 1, Page(s) 42–50

Abstract: Objective This study compared the cost of an integrated primary-secondary care general practitioner (GP)-based Beacon model with usual care at hospital outpatient departments (OPDs) for patients with complex type 2 diabetes. Methods A costing analysis ... ...

Abstract	Objective This study compared the cost of an integrated primary-secondary care general practitioner (GP)-based Beacon model with usual care at hospital outpatient departments (OPDs) for patients with complex type 2 diabetes. Methods A costing analysis was completed alongside a non-inferiority randomised control trial. Costs were calculated using information from accounting data and interviews with clinic managers. Two OPDs and three GP-based Beacon practices participated. In the Beacon practices, GPs with a special interest in advanced diabetes care worked with an endocrinologist and diabetes nurse educator to care for referred patients. The main outcome was incremental cost saving per patient course of treatment from a health system perspective. Uncertainty was characterised with probabilistic sensitivity analysis using Monte Carlo simulation. Results The Beacon model is cost saving: the incremental cost saving per patient was A$365 (95% confidence interval -A$901, A$55) and was cost saving in 93.7% of simulations. The key contributors to the variance in the cost saving per patient course of treatment were the mean number of patients seen per site and the number of additional presentations per course of treatment associated with the Beacon model. Conclusions Beacon clinics were less costly per patient course of treatment than usual care in hospital OPDs for equivalent clinical outcomes. Local contractual arrangements and potential variation in the operational cost structure are of significant consideration in determining the cost-efficiency of Beacon models. What is known about this topic? Despite the growing importance of achieving care quality within constrained budgets, there are few costing studies comparing clinically-equivalent hospital and community-based care models. What does this paper add? Costing analyses comparing hospital-based to GP-based health services require considerable effort and are complex. We show that GP-based Beacon clinics for patients with complex chronic disease can be less costly per patient course of treatment than usual care offered in hospital OPDs. What are the implications for practitioners? In addition to improving access and convenience for patients, transferring care from hospital to the community can reduce health system costs.
MeSH term(s)	Ambulatory Care ; Cost-Benefit Analysis ; Delivery of Health Care, Integrated ; Diabetes Mellitus, Type 2/therapy ; Hospitals ; Humans ; Outpatients
Language	English
Publishing date	2021-02-09
Publishing country	Australia
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	639155-2
ISSN	1449-8944 ; 0159-5709 ; 0156-5788
ISSN (online)	1449-8944
ISSN	0159-5709 ; 0156-5788
DOI	10.1071/AH19226
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Article ; Online: Electronic consultations (eConsults): a proof of concept trial in Australia.

Russell, Anthony W / Adkins, Peter / Hayes, Lisa / Prior, Erin / McCormack, Christine / DiGregorio, John

Internal medicine journal

2022 Volume 52, Issue 12, Page(s) 2150–2156

Abstract: Background: Electronic consultations (eConsults) allow general practitioners (GP) to seek the advice of a specialist via secure asynchronous digital communication.: Aims: To report the outcomes of a proof of concept (POC) trial of eConsults for ... ...

Abstract	Background: Electronic consultations (eConsults) allow general practitioners (GP) to seek the advice of a specialist via secure asynchronous digital communication. Aims: To report the outcomes of a proof of concept (POC) trial of eConsults for patients with diabetes and endocrine disorders. Methods: A prospective observational study conducted from November 2020 to May 2021. eConsults were provided by endocrinologists from the Princess Alexandra Hospital, Brisbane. The requests for advice were from GP in Brisbane South. An online questionnaire was completed by the GP and endocrinologist after each eConsult. Results: Forty eConsults were performed over 7 months. The majority were in relation to type 2 diabetes (30%) or thyroid conditions (30%). All eConsult responses were performed within the target of 72 h with 92.5% responses provided within 24 h. The average time taken for the endocrinologist to perform the eConsult was 14.2 ± 4.4 min. The GP rated the value of eConsults as excellent 97% of the time. The eConsult resulted in a new or additional course of action 68% (19/28) of the time and confirmed a course of action 32% (9/28) of the time. The eConsult avoided the need for referral of the patient for a face-to-face specialist review in 55% of the eConsults. Conclusion: An eConsult service was able to be delivered by endocrinologists from a tertiary hospital to GP in Brisbane South. With an appropriate funding model, the broader implementation and adoption of eConsults has the potential to address specialist waiting lists and facilitate models of integrated care.
MeSH term(s)	Humans ; Remote Consultation ; Diabetes Mellitus, Type 2/therapy ; Primary Health Care/methods ; Referral and Consultation ; Tertiary Care Centers ; Australia ; Health Services Accessibility
Language	English
Publishing date	2022-06-29
Publishing country	Australia
Document type	Observational Study ; Journal Article
ZDB-ID	2045436-3
ISSN	1445-5994 ; 1444-0903
ISSN (online)	1445-5994
ISSN	1444-0903
DOI	10.1111/imj.15495
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Article ; Online: Mobile Health (mHealth) for Diabetes Care: Opportunities and Challenges.

Fatehi, Farhad / Gray, Leonard C / Russell, Anthony W

Diabetes technology & therapeutics

2017 Volume 19, Issue 1, Page(s) 1–3

MeSH term(s)	Combined Modality Therapy/trends ; Diabetes Complications/prevention & control ; Diabetes Mellitus/therapy ; Global Health ; Health Transition ; Humans ; Middle Aged ; Mobile Applications ; Patient Compliance ; Self-Management/trends ; Telemedicine/trends
Language	English
Publishing date	2017
Publishing country	United States
Document type	Introductory Journal Article
ZDB-ID	1452816-2
ISSN	1557-8593 ; 1520-9156
ISSN (online)	1557-8593
ISSN	1520-9156
DOI	10.1089/dia.2016.0430
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Article ; Online: Toilet Paper, Minced Meat and Diabetes Medicines: Australian Panic Buying Induced by COVID-19.

Engstrom, Teyl / Baliunas, Dolly O / Sly, Benjamin P / Russell, Anthony W / Donovan, Peter J / Krausse, Heike K / Sullivan, Clair M / Pole, Jason D

International journal of environmental research and public health

2021 Volume 18, Issue 13

Abstract: The COVID-19 pandemic has impacted the management of non-communicable diseases in health systems around the world. This study aimed to understand the impact of COVID-19 on diabetes medicines dispensed in Australia. Publicly available data from Australia' ... ...

Abstract	The COVID-19 pandemic has impacted the management of non-communicable diseases in health systems around the world. This study aimed to understand the impact of COVID-19 on diabetes medicines dispensed in Australia. Publicly available data from Australia's government subsidised medicines program (Pharmaceutical Benefits Scheme), detailing prescriptions by month dispensed to patients, drug item code and patient category, was obtained from January 2016 to November 2020. This study focused on medicines used in diabetes care (Anatomical Therapeutical Chemical code level 2 = A10). Number of prescriptions dispensed were plotted by month at a total level, by insulins and non-insulins, and by patient category (general, concessional). Total number of prescriptions dispensed between January and November of each year were compared. A peak in prescriptions dispensed in March 2020 was identified, an increase of 35% on March 2019, compared to average growth of 7.2% in previous years. Prescriptions dispensed subsequently fell in April and May 2020 to levels below the corresponding months in 2019. These trends were observed across insulins, non-insulins, general and concessional patient categories. The peak and subsequent dip in demand have resulted in a small unexpected overall increase for the period January to November 2020, compared to declining growth for the same months in prior years. The observed change in consumer behaviour prompted by COVID-19 and the resulting public health measures is important to understand in order to improve management of medicines supply during potential future waves of COVID-19 and other pandemics.
MeSH term(s)	Australia/epidemiology ; Bathroom Equipment ; COVID-19 ; Consumer Behavior ; Diabetes Mellitus/drug therapy ; Diabetes Mellitus/epidemiology ; Humans ; Meat ; Pandemics ; SARS-CoV-2
Language	English
Publishing date	2021-06-29
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph18136954
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Article ; Online: Urea treatment in fluid restriction-refractory hyponatraemia.

Lockett, Jack / Berkman, Kathryn E / Dimeski, Goce / Russell, Anthony W / Inder, Warrick J

Clinical endocrinology

2019 Volume 90, Issue 4, Page(s) 630–636

Abstract: Objective: Hyponatraemia in hospitalized patients is common and associated with increased mortality. International guidelines give conflicting advice regarding the role of urea in the treatment of SIADH. We hypothesized that urea is a safe, effective ... ...

Abstract	Objective: Hyponatraemia in hospitalized patients is common and associated with increased mortality. International guidelines give conflicting advice regarding the role of urea in the treatment of SIADH. We hypothesized that urea is a safe, effective treatment for fluid restriction-refractory hyponatraemia. Design: Review of urea for the treatment of hyponatraemia in patients admitted to a tertiary hospital during 2016-2017. Primary end-point: proportion of patients achieving a serum sodium ≥130 mmol/L at 72 hours. Patients: Urea was used on 78 occasions in 69 patients. The median age was 67 (IQR 52-76), 41% were female. Seventy (89.7%) had hyponatraemia due to SIADH-CNS pathology (64.3%) was the most common cause. The duration was acute in 32 (41%), chronic in 35 (44.9%) and unknown in the rest. Results: The median nadir serum sodium was 122 mmol/L (IQR 118-126). Fluid restriction was first-line treatment in 65.4%. Urea was used first line in 21.8% and second line in 78.2%. Fifty treatment episodes (64.1%) resulted in serum sodium ≥130 mmol/L at 72 hours. In 56 patients who received other prior treatment, the mean sodium change at 72 hours (6.9 ± 4.8 mmol/L) was greater than with the preceding treatments (-1.0 ± 4.7 mmol/L; P < 0.001). Seventeen patients (22.7%) had side effects (principally distaste), none were severe. No patients developed hypernatraemia, overcorrection (>10 mmol/L in 24 hours or >18 mmol/L in 48 hours), or died. Conclusions: Urea is safe and effective in fluid restriction-refractory hyponatraemia. We recommend urea with a starting dose of ≥30 g/d, in patients with SIADH and moderate to profound hyponatraemia who are unable to undergo, or have failed fluid restriction.
MeSH term(s)	Aged ; Female ; Humans ; Hyponatremia/blood ; Hyponatremia/drug therapy ; Hyponatremia/mortality ; Male ; Middle Aged ; Sodium/blood ; Tertiary Care Centers/statistics & numerical data ; Treatment Outcome ; Urea/therapeutic use
Chemical Substances	Urea (8W8T17847W) ; Sodium (9NEZ333N27)
Language	English
Publishing date	2019-01-25
Publishing country	England
Document type	Journal Article
ZDB-ID	121745-8
ISSN	1365-2265 ; 0300-0664
ISSN (online)	1365-2265
ISSN	0300-0664
DOI	10.1111/cen.13930
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Article ; Online: A clinimetric study of outpatient diabetes consultations: the potential for telemedicine substitution.

Fatehi, Farhad / Gray, Leonard C / Russell, Anthony W

Diabetes technology & therapeutics

2014 Volume 16, Issue 1, Page(s) 8–14

Abstract: Background: The purpose of this study was to identify the clinimetric characteristics of specialist outpatient consultations for people with diabetes and to evaluate the possibility of providing such consultations remotely using telemedicine.: ... ...

Abstract	Background: The purpose of this study was to identify the clinimetric characteristics of specialist outpatient consultations for people with diabetes and to evaluate the possibility of providing such consultations remotely using telemedicine. Materials and methods: The process of care was analyzed during the specialist consultations provided by five endocrinologists in a tertiary hospital diabetes outpatient clinic. The specialists' opinion of the possibility of providing each consultation remotely was also sought. Results: In total, 50 consultations were analyzed. The patients had type 1 and type 2 diabetes in 28% and 64% of the cases, respectively; 68% had at least one diabetes complication. Diabetic neuropathy was the most prevalent (42%) complication. Physical examination was not performed by the specialists in 34% of cases. General foot inspection, the most frequent examination, was performed in 54% of the consultations. After "general advice," ordering laboratory tests was the most frequent recommendation (80%), followed by adjustment of an insulin regimen (52%). In 86% of consultations, the specialists believed that it would have been possible to provide that consultation remotely via videoconferencing to a patient with the general practitioner present. In their opinion, communicating with the patients through e-mail was the least possible alternative means of providing the consultations. Conclusions: Endocrinologists with little telemedicine experience believe that a considerable proportion of outpatient specialty consultations for people with diabetes can be provided remotely via videoconferencing. The clinimetric analysis of 50 consultations supports this opinion.
MeSH term(s)	Ambulatory Care ; Communication ; Cost-Benefit Analysis ; Diabetes Complications/diagnosis ; Diabetes Mellitus, Type 1/complications ; Diabetes Mellitus, Type 1/therapy ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/therapy ; Feasibility Studies ; Female ; Humans ; Male ; Outpatients ; Patient Satisfaction ; Physician-Patient Relations ; Referral and Consultation ; Remote Consultation ; Telemedicine
Language	English
Publishing date	2014-01
Publishing country	United States
Document type	Evaluation Studies ; Journal Article
ZDB-ID	1452816-2
ISSN	1557-8593 ; 1520-9156
ISSN (online)	1557-8593
ISSN	1520-9156
DOI	10.1089/dia.2013.0213
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Article ; Online: Validity Study of Video Teleconsultation for the Management of Diabetes: A Pilot Randomized Controlled Trial.

Fatehi, Farhad / Gray, Leonard C / Russell, Anthony W / Paul, Sanjoy K

Diabetes technology & therapeutics

2015 Volume 17, Issue 10, Page(s) 717–725

Abstract: Background: A large proportion of diabetes patients do not receive a basic minimum of standard care. Telemedicine holds the promise of improving access to health care. However, the validity of remote consultation for diabetes has not been well ... ...

Abstract	Background: A large proportion of diabetes patients do not receive a basic minimum of standard care. Telemedicine holds the promise of improving access to health care. However, the validity of remote consultation for diabetes has not been well researched. This pilot randomized control trial was designed to evaluate the agreement on prescription decisions of endocrinologists between two consultation formats: videoconferencing and face-to-face (in-person) consultation. Patients and methods: Seventy-three patients were randomized to telemedicine (n=36) and reference group (n=37). Each study patient in the telemedicine group received one face-to-face consultation and one video consultation. The reference group received two face-to-face consultations. The paired consultations for each patient were performed by two different endocrinologists. The level of agreement between endocrinologists was evaluated by comparing their recommendations on antidiabetes and cardioprotective medications. Results: The level of agreement between two endocrinologists on changing antidiabetes drugs was 64% in the telemedicine group and 78% in the reference group. Although the level of agreement was lower when one of the consultations was provided via videoconference, the difference was not significant. The level of agreement on changing cardiovascular drugs was 78% in the telemedicine group and 76% in the reference group, again not significantly different. Conclusions: The results of this study demonstrate the preliminary evidence on the validity of recommendations made by endocrinologists via video consultation. Known limitations of videoconferencing for clinical purposes did not have remarkable impact on the outcome of consultation in terms of adjustment of patient's medications. Video teleconsultation can substitute for a considerable proportion of conventional outpatient specialty consultations for people with diabetes.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Diabetes Mellitus/therapy ; Disease Management ; Female ; Humans ; Male ; Middle Aged ; Patient Satisfaction ; Pilot Projects ; Remote Consultation/methods ; Videoconferencing ; Young Adult
Language	English
Publishing date	2015-10
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	1452816-2
ISSN	1557-8593 ; 1520-9156
ISSN (online)	1557-8593
ISSN	1520-9156
DOI	10.1089/dia.2014.0416
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