242 research outputs found
No negative effects of a multi-factorial, intensified treatment on self-reported health status, treatment satisfaction, and diabetes-related distress in screen-detected type 2 diabetes patients. The ADDITION-Netherlands study
Сатира в публицистике. Специфика и жанровые особенности фельетона как предмет многочисленных споров исследователей
Анализируются спорные вопросы теории жанра фельетон в контексте специфики сатирической публицистики: с точки зрения меры художественного вымысла в фельетоне, наличия сатирического начала в нем и др. Формулируются
факторы различия фельетона и сатирического рассказа.Аналізуються спірні питання теорії жанру фельєтона в контексті специфіки
сатиричної публіцистики: з точки зору виміру художнього вимислу в фельєтоні,
присутності сатиричного початку у ньому і т.д. Формулюються фактори
розрізняння фельєтона та сатиричної оповіді
Effectiveness of diabetes self-management education via a smartphone application in insulin treated type 2 diabetes patients - design of a randomised controlled trial ('TRIGGER study').
Health care providers aim to stimulate self-management in type 2 diabetes (T2DM) patients. However, they have a limited number of patient contacts to do this. With the growing number of T2DM patients, innovative and cost-effective interventions to promote self-management are needed. We aim to evaluate the effectiveness of diabetes self-management education via a smartphone app in T2DM patients on insulin therapy
Динамика объемов промышленного производства в период кризиса и ее прогнозирование
Целью статьи является определение факторов, влияющих на деятельность предприятия и, выявление антикризисных мер для улучшения их состояния. Ведь проблема состоит в том, что не существует такого метода, который бы стопроцентно истребил кризис, многие научные исследования посвящены именно этой проблеме, в них присутствуют попытки выявления причин возникновения кризиса и факторов, влияющих на деятельность предприятий
Концепт «девушка» в национально-языковых картинах мира (на материале фразеологических единиц русского, украинского, польского, болгарского языков)
Данная статья является попыткой сопоставительного анализа концепта
"девушка" в национально-языковых картинах мира на материале фразеологии
и паремиологии некоторых славянских языков. Выделяются наиболее характерные, идентичные для разных этнокультур качества молодой девушки. Делается вывод о разной степени языковой андроцентричности в экспликации
рассматриваемого концепта.Дана стаття є спробою зіставного аналізу концепту "дівчина" в національномовних картинах світу на матеріалі фразеології та пареміології деяких
слов'янських мов. Виділяються найбільш характерні, ідентичні для різних етнокультур риси молодої дівчини. Авторка приходить до висновку щодо різної міри
мовної андроцентричності в експлікації розглянутого концепту.The given article is an attempt to analyze the concept "Girl" in the nationallanguage
world pictures based on phraseology of some Slavonic languages. The
most typical features of a young girl identified for different ethnical cultures are elicited.
The author finds that the androcentrical verbal expression of this concept is different,
to some extent
Lifetime health effects and costs of diabetes treatment
BACKGROUND: This article presents cost-effectiveness analyses of the major
diabetes interventions as formulated in the revised Dutch guidelines for
diabetes type 2 patients in primary and secondary care. The analyses
consider two types of care: diabetes control and the treatment of
complications, each at current care level and according to the guidelines.
METHODS: A validated probabilistic diabetes model describes diabetes and
its complications over a lifetime in the Dutch population, computing
quality-adjusted life years and medical costs. Effectiveness data and
costs of diabetes interventions are from observational current care
studies and intensive care experiments. Lifetime consequences of in total
sixteen intervention mixes are compared with a baseline glycaemic control
of 10% HBA1C. RESULTS: The interventions may reduce the cumulative
incidence of blindness, lower-extremity amputation, and end-stage renal
disease by >70% in primary care and >60% in secondary care. All primary
care guidelines together add 0.8 quality-adjusted life years per lifetime.
CONCLUSION: In case of few resources, treating complications according to
guidelines yields the most health benefits. Current care of diabetes
complications is inefficient. If there are sufficient resources, countries
may implement all guidelines, also on diabetes control, and improve
efficiency in diabetes care
Diabetes quality management in Dutch care groups and outpatient clinics:A cross-sectional study
BACKGROUND: In recent years, most Dutch general practitioners started working under the umbrella of diabetes care groups, responsible for the organisation and coordination of diabetes care. The quality management of these new organisations receives growing interest, although its association with quality of diabetes care is yet unclear. The best way to measure quality management is unknown and it has not yet been studied at the level of outpatient clinics or care groups. We aimed to assess quality management of type 2 diabetes care in care groups and outpatient clinics. RESULTS: Quality management was measured with online questionnaires, containing six domains (see below). They were divided into 28 subdomains, with 59 (care groups) and 57 (outpatient clinics) questions respectively. The mean score of the domains reflects the overall score (0-100%) of an organisation. Two quality managers of all Dutch care groups and outpatient clinics were invited to fill out the questionnaire. Sixty care groups (response rate 61.9%) showed a mean score of 59.6% (CI 57.1-62.1%). The average score in 52 outpatient clinics (response rate 50.0%) was 61.9% (CI 57.5-66.8%). Mean scores on the six domains for care groups and outpatient clinics respectively were: ‘organisation of care’ 71.9% (CI 68.8-74.9%), 76.8% (CI 72.8-80.7%); ‘multidisciplinary teamwork’ 67.1% (CI 62.4-71.9%), 71.5% (CI 65.3-77.8%); ‘patient centeredness’ 46.7% (CI 42.6-50.7%), 62.5% (CI 57.7-67.2%); ‘performance management’ 63.3% (CI 61.2-65.3%), 50.9% (CI 44.2-57.5%); ‘quality improvement policy’ 52.6% (CI 49.2-56.1%), 50.9% (CI 44.6-57.3%); and ‘management strategies’ 56.0% (CI 51.4-60.7%), 59.0% (CI 52.8-65.2%). On subdomains, care groups scored highest on ‘care program’ (83.3%) and ‘measured outcomes’ (98.3%) and lowest on ‘patient safety’ (15.1%) and ‘patient involvement’ (17.7%). Outpatient clinics scored high on the presence of a ‘diabetic foot team’ (81.6%) and the support in ‘self-management’ (81.0%) and low on ‘patient involvement’ (26.8%) and ‘inspection of medical file’ (28.0%). CONCLUSIONS: This nationwide assessment reveals that the level of quality management in diabetes care varies between several subdomains in both diabetes care groups and outpatient clinics
Population-based screen-detected type 2 diabetes mellitus is associated with less need for insulin therapy after 10 years
INTRODUCTION: With increased duration of type 2 diabetes, most people have a growing need of glucose-lowering medication and eventually might require insulin. Presumptive evidence is reported that early detection (eg, by population-based screening) and treatment of hyperglycemia will postpone the indication for insulin treatment. A treatment legacy effect of population-based screening for type 2 diabetes of about 3 years is estimated. Therefore, we aim to compare insulin prescription and glycemic control in people with screen-detected type 2 diabetes after 10 years with data from people diagnosed with type 2 diabetes seven (treatment legacy effect) and 10 years before during care-as-usual. RESEARCH DESIGN AND METHODS: Three cohorts were compared: one screen-detected cohort with 10 years diabetes duration (Anglo-Danish-Dutch study of Intensive Treatment in People with Screen-Detected Diabetes in Primary care (ADDITION-NL): n=391) and two care-as-usual cohorts, one with 7-year diabetes duration (Groningen Initiative to Analyze Type 2 Diabetes Treatment (GIANTT) and Zwolle Outpatient Diabetes project Integrating Available Care (ZODIAC): n=4473) and one with 10-year diabetes duration (GIANTT and ZODIAC: n=2660). Insulin prescription (primary outcome) and hemoglobin A1c (HbA1c) of people with a known diabetes duration of 7 years or 10 years at the index year 2014 were compared using regression analyses. RESULTS: Insulin was prescribed in 10.5% (10-year screen detection), 14.7% (7-year care-as-usual) and 19.0% (10-year care-as-usual). People in the 7-year and 10-year care-as-usual groups had a 1.5 (95% CI 1.0 to 2.1) and 1.8 (95% CI 1.3 to 2.7) higher adjusted odds for getting insulin prescribed than those after screen detection. Lower HbA1c values were found 10 years after screen detection (mean 50.1 mmol/mol (6.7%) vs 51.8 mmol/mol (6.9%) and 52.8 mmol/mol (7.0%)), compared with 7 years and 10 years after care-as-usual (MDadjusted: 1.6 mmol/mol (95% CI 0.6 to 2.6); 0.1% (95% CI 0.1 to 0.2) and 1.8 mmol/mol (95% CI 0.7 to 2.9); and 0.2% (95% CI 0.1 to 0.3)). CONCLUSION: Population-based screen-detected type 2 diabetes is associated with less need for insulin after 10 years compared with people diagnosed during care-as-usual. Glycemic control was better after screen detection but on average good in all groups
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