Self-Efficacy, Problem Solving, and Social-Environmental Support Are Associated With Diabetes Self-Management Behaviors

OBJECTIVE — To evaluate associations between psychosocial and social-environmental variables and diabetes self-management, and diabetes control. RESEARCH DESIGN AND METHODS — Baseline data from a type 2 diabetes self-management randomized trial with 463 adults having elevated BMI (M 34.8 kg/m2) were used to investigate relations among demographic, psychosocial, and social-environmental variables; dietary, exercise, and medication-taking behaviors; and biologic outcomes. RESULTS — Self-efficacy, problem solving, and social-environmental support were indepen-dently associated with diet and exercise, increasing the variance accounted for by 23 and 19%, respectively. Only diet contributed to explained variance in BMI ( 0.17, P 0.0003) and self-rated health status ( 0.25, P 0.0001); and only medication-taking behaviors contrib-uted to lipid ratio (total–to–HDL) (0.20, P 0.0001) and A1C (0.21, P 0.0001). CONCLUSIONS — Interventions should focus on enhancing self-efficacy, problem solving, and social-environmental support to improve self-management of diabetes. Diabetes Care 33:751–753, 2010 D iabetes management requires coor-dination between the patient andthe primary care team. Given the lifestyle changes required for self-management success, patient, social, and environmental factors, including health care (1) and community support (2), are increasingly recognized as important. Un-derstanding relations among demo-graphic, psychosocial, and social-environmental variables, and multiple health risk behaviors is critical to devel-oping interventions that will sustain health behavior changes. RESEARCH DESIGN AND METHODS — Baseline data were col-lected as part of a patient randomized trial to evaluate the impact of an interactive, multimedia diabetes self-management program relative to “enhanced ” usual car

First Experience with the LHC Cryogenic Instrumentation

The LHC under commissioning at CERN will be the world's largest superconducting accelerator and therefore makes extensive use of cryogenic instruments. These instruments are installed in the tunnel and therefore have to withstand the LHC environment that imposes radiation-tolerant design and construction. Most of the instruments require individual calibration; some of them exhibit several variants as concerns measuring span; all relevant data are therefore stored in an Oracle® database. Those data are used for the various quality assurance procedures defined for installation and commissioning, as well as for generating tables used by the control system to configure automatically the input/output channels. This paper describes the commissioning of the sensors and the corresponding electronics, the first measurement results during the cool-down of one machine sector; it discusses the different encountered problems and their corresponding solutions

Reception Tests of the Cryogenic Distribution line for the Large Hadron Collider

The paper describes the thermo-mechanical validation of the first sector of cryogenic distribution line (QRL) [1]. The design of the line is recalled and the test methodology presented together with the main results of the reception test at cryogenic temperature

Conservation genetics of the pond bat (Myotis dasycneme) with special focus on the populations in northwestern Germany and in Jutland, Denmark

Conservation genetics is important in the management of endangered species, helping to understand their connectivity and long‐term viability, thus identifying populations of importance for conservation. The pond bat (Myotis dasycneme) is a rare species classified as “Near Threatened” with a wide but patchy Palearctic distribution. A total of 277 samples representing populations in Denmark, Germany, Latvia, Hungary, and Russia were used in the genetic analyses; 224 samples representing Denmark, Germany, and Russia were analyzed at 10 microsatellite loci; 241 samples representing all areas were analyzed using mitochondrial D‐loop and cytochrome B sequences. A Bayesian clustering approach revealed two poorly resolved clusters, one representing the Danish and German groups and the other the Russian group. However, significantly different pairwise FST and DEST estimates were observed between the Danish and German groups and between the Danish and Russian groups suggesting a recent population structure. These conflicting results might be attributed to the effect of migration or low resolution due to the number of microsatellite markers used. After concatenating the two mitochondrial sequences, analysis detected significant genetic differentiation between all populations, probably due to genetic drift combined with a founder event. The phylogenetic tree suggested a closer relationship between the Russian and Northern European populations compared to the Hungarian population, implying that the latter belongs to an older ancestral population. This was supported by the observed haplotype network and higher nucleotide diversity in this population. The genetic structuring observed in the Danish/German pond bat stresses the need for a cross‐border management between the two countries. Further, the pronounced mtDNA structuring, together with the indicated migration between nearby populations suggest philopatric female behavior but male migration, emphasizes the importance of protecting suitable habitat mosaics to maintain a continuum of patches with dense pond bat populations across the species' distribution range

Wake up, wake up! It's me! It's my life! patient narratives on person-centeredness in the integrated care context: a qualitative study

Person-centered care emphasizes a holistic, humanistic approach that puts patients first, at the center of medical care. Person-centeredness is also considered a core element of integrated care. Yet typologies of integrated care mainly describe how patients fit within integrated services, rather than how services fit into the patient's world. Patient-centeredness has been commonly defined through physician's behaviors aimed at delivering patient-centered care. Yet, it is unclear how 'person-centeredness' is realized in integrated care through the patient voice. We aimed to explore patient narratives of person-centeredness in the integrated care context

The influence of multi-morbidity and self-reported socio-economic standing on the prevalence of depression in an elderly Hong Kong population

<b>Background</b> There has been an increasing prevalence of both depression and chronic medical conditions globally but the relationship between depression and multi-morbidity is not well understood. The aim of the present study was to investigate the relationship between depression, multi-morbidity (number of chronic medical conditions, and measures of socioeconomic standing (SES) in an elderly Hong Kong population.<p></p> <b>Methods</b> Cross sectional study. Information on clinically relevant depressive symptoms, measured by the Geriatric Depression Scale (GDS), and demographic and chronic medical conditions were collected using standardized questionnaires. Information collected on SES included educational status (ES), maximum ever income (MEI), and self-perceived social standing in local community (SES-COM) and in Hong Kong generally (SES-HK). Analysis was conducted using multiple logistic regression.<p></p> <b>Results</b> Depression rates were similar in men and women (GDS caseness 8.1% vs 8.4%). Multi-morbidity of chronic medical conditions was common (40% of men and 46% of women had three or more). In the overall sample, the prevalence of depression was associated with the number of chronic medical conditions (OR 1.27; CI: 1.16–1.39). In addition, SES-HK and SES-COM were significant independent variables.<p></p> <b>Conclusion</b> In this elderly Hong Kong population, depression prevalence rose markedly with number of chronic medical conditions and SES-HK and SES-COM