The confidence in diabetes self-care scale: psychometric properties of a new measure of diabetes-specific self-efficacy in Dutch and US patients with type 1 diabetes

OBJECTIVE: To examine psychometric properties of the Confidence in Diabetes Self-Care (CIDS) scale, a newly developed instrument assessing diabetes-specific self-efficacy in Dutch and U.S. patients with type 1 diabetes. RESEARCH DESIGN AND METHODS: Reliability and validity of the CIDS scale were evaluated in Dutch (n = 151) and U.S. (n = 190) outpatients with type 1 diabetes. In addition to the CIDS scale, assessment included HbA(1c), emotional distress, fear of hypoglycemia, self-esteem, anxiety, depression, and self-care behavior. The Dutch sample completed additional measures on perceived burden and importance of self-care. Test-retest reliability was established in a second Dutch sample (n = 62). RESULTS: Internal consistency (Cronbach's alpha = 0.86 for Dutch patients and 0.90 U.S. patients) and test-retest reliability (Spearman's r = 0.85, P < 0.0001) of the CIDS scale were high. Exploratory factor analysis showed one strong general factor. Spearman's correlations between the CIDS scale and other measures were moderate and in the expected directions, and high HbA(1c) levels were associated with low CIDS scores in the U.S. sample only. Low CIDS scores were positively associated with self-care but not with glycemic control in the original samples. CIDS scores in the U.S. and Dutch samples did not show any statistically significant differences. U.S. men had higher CIDS scores than U.S. women. CONCLUSIONS: The CIDS scale is a reliable and valid measure of diabetes-specific self-efficacy for use in patients with type 1 diabetes. High psychometric similarity allows for cross-cultural comparisons.     

Development of a needs assessment system in rehabilitation

The aim of this project was to develop a standardized, valid and reliable instrument for determining needs of patients and quality of care as perceived by patients. A questionnaire was constructed based upon the Service Quality Model. This model, patient expectations and experiences all play an important role in the questionnaire. The questionnaire contains a general part which includes ten determinants of care, the information the patient got and the perceived quality of care in general. The questionnaire also contains a specific part which includes questions about the actual care for diagnosis related problems. Twenty-four spinal cord injured patients, staying at a Dutch rehabilitation centre, participated in this study. It is concluded that with the developed questionnaire the perceived quality of care according to the Service Quality Model can be assessed. Major contributions of the questionnaire to rehabilitation care will be its ability to highlight patient needs related to identified symptoms, and to provide a tool to signal aspects in the organization that can be improved. Thus it becomes a tool for quality management. Recommendations have been made for further research to make future use of the questionnaire in other settings and populations possible.     

Clinical evaluation of rebonded acid-etch retained bridges

Acid-etch retained bridges are relatively easy to rebond after dislodgement. However, retention rates for rebonded bridges reported in other studies are conflicting. This study showed a significantly lower retention rate for rebonded bridges than for originally placed acid-etch retained bridges. In most cases failure occurred as a cohesive fracture of the luting resin.     

Outpatient metrizamide myelography: prospective evaluation of safety and cost effectiveness

A group of 228 consecutive patients undergoing metrizamide myelography was prospectively evaluated for postprocedure symptoms. The observed prevalence of these symptoms concurs with previously reported inpatient studies, with the most common sequelae being exacerbation or onset of spine or extremity pain, headache, nausea, and paresthesia. Limitation of administered dose of metrizamide in lumbar myelography may slightly reduce the occurrence of common symptoms, but withdrawal of contrast medium at the completion of examination had no impact on their occurrence. There was a higher occurrence of paresthesia in cervical myelography, but otherwise there was no significant difference in symptoms between cervical and lumbar studies. Outpatient metrizamide myelography can be performed with relative safety with the potential for significant cost savings.     

Low-speed rotational angioplasty in chronic peripheral artery occlusions: experience in 83 patients. Work in progress

Between December 1986 and October 1988, 83 patients with chronic peripheral artery occlusions were treated with a new technique. In 56 patients, the superficial femoral artery was completely occluded; in 21 patients, the popliteal artery; and in six patients, the iliac artery. The length of occlusion ranged from 5 to 35 cm (mean, 12.5 cm). The duration, estimated by history, was 5-48 months (mean, 16.5 months). In seven patients, durations of 6-36 months were documented angiographically. A flexible, blunt, motor-driven rotating catheter was introduced through an 8-F sheath, and rotational angioplasty was performed at low speed (up to 200 rpm). In 49 of 60 (82%) patients in whom this new technique was used as the primary intervention, the occlusions were successfully reopened. In 23 patients in whom conventional methods had failed more than 4 weeks earlier, the success rate for rotational angioplasty was 67% (12 of 18 patients); when the time interval was less than 4 weeks, only one of five patients was treated successfully. In none of the 83 patients did a perforation occur. This new technique can reopen chronic artery occlusions with a high degree of success and without the danger of vessel-wall perforation, even after failure of conventional techniques.     

The relative validity of reports of food intake of Dutch and Finnish boys aged 8 and 9 years

Two studies were carried out to assess the relative validity of the techniques used in measuring the food intake during school lunch or home dinner of 30 Finnish and 68 Dutch boys aged 8 and 9 years. For each of the 30 Finnish boys, duplicate portions of three lunches provided to the boys were collected by a non-participating observer. Nutrient intakes were calculated with the use of a food composition table, and the results were compared with those from the records that were kept by the boys' mothers. For each of the 68 Dutch boys, duplicate portions of the hot meal, taken at home, were collected and analyzed chemically. The results were compared with those from the records that were kept by the boys' mothers. The mean values for the absolute intakes of energy and nutrients for the boys from both Finland and The Netherlands as reported by the boys themselves or their mothers were generally higher (15% to 35%) than those measured by chemical analysis of a duplicate portion or calculated from a weighed portion as collected by a non-participating observer. However, the results for the relative proportions of energy generally showed closer agreement (range of difference, +11% to -15%). The authors found in this study that collection of duplicate portions of food resulted in lower (3% to 15%) recorded food intakes in comparison with measurements recorded for meals consumed on other days.     

有机锗化物对豚鼠和家兔心脏电机械效应的影响

有机锗化物(二羧乙基锗三氧化物,dicarboxyethenylgermanium sesquioxide简称DCG)系一人工合成的新型化合物,分子式(GeCH_2CH_2COOH)_2O_3,分子量339.18,其中含纯锗42.8%。锗是生物体内非必需微量元素,在自然界及生物体内分布相当广泛。最近Ninomiya