Changing behaviors: Using norms to promote physical activity for type 2 diabetes patients

IntroductionGiven that diabetes is a major public heath issue around the world, it is vital that we find effective means to change behaviors, especially levels of physical activity among type 2 diabetes patients.ObjectiveThis study aims to provide proof of the effectiveness of programs promoting physical activity, based on cognitive dissonance and normative focus theories which are designed to produce behavioral changes in persons with type 2 diabetes.MethodNinety-six type 2 diabetes patients were assigned to one of three programs: a traditional information program, a norm-based program, and a dissonance-based program. The participants filled out a short French version of the International Physical Activity Questionnaire (IPAQ) one week before and one week after the program.ResultsThe results showed that the participants in the norm-based program made progress compared to those in the traditional information program. No significant difference was observed between the traditional information program and dissonance-based program.ConclusionsThese findings are consistent with both the focus normative theory and previous studies showing that recalling the norm increases compliance. The procedure to be used in diabetes prevention programs should focus on the normative dimensions of the desired behaviors in order to improve patients’ quality of life.     

Parental illness intrusiveness and youth glycaemic control in type 1 diabetes: intergenerational associations and processes

Objective: This study examined associations between the functioning of youth with type 1 diabetes and their parents, including parenting dimensions as intervening mechanisms. The study adds to the existing literature by focusing on (1) the concept of parental illness intrusiveness; (2) the (understudied) periods of adolescence and emerging adulthood; and (3) maternal and paternal functioning. Design: Questionnaires were completed by 317 patient-mother dyads and 277 patient-father dyads. All patients (aged 14–25) had type 1 diabetes. The hypothesised model was compared to an alternative model using structural equation modelling. Main Outcome Measures: Youth reported on depressive symptoms and treatment adherence; Physicians provided HbA_1c-values. Parents reported on illness intrusiveness, depressive symptoms, and their child’s treatment adherence. Patients and parents reported on psychological control and overprotection. Results: The hypothesised path model had a good fit to the data. Parental illness intrusiveness was positively associated with depressive symptoms and both were positively related to overprotection and psychological control. Psychological control was positively related to patients’ depressive symptoms and negatively to treatment adherence. Poorer treatment adherence was associated with worse HbA_1c-values. Conclusion: These findings underscore the relevance of parental illness intrusiveness and emphasise the importance of mothers’ and fathers’ roles throughout adolescence and emerging adulthood.     

骨髓造血干细胞移植治疗自身免疫性疾病的进展

自身免疫疾病发病机制复杂,目前尚缺少有效的治疗方法。近年来发现造血干细胞移植可以通过免疫重建显著缓解甚至治愈自身免疫病。笔者对近年来造血干细胞移植治疗自身免疫病进行了介绍和综述,就其在1型糖尿病这一领域的研究进展进行了述评,探讨造血干细胞移植用于治疗自身免疫病的前景和待解决的问题。     

关于糖尿病的几点认识

糖尿病及其并发症严重影响了人类的健康。随着科学技术的不断发展,人们对糖尿病 的认识逐步加深。目前关于糖尿病的命名、诊断分型标准和治疗原则在临床工作中逐渐显露 出其不足之处,这势必会影响人们对于糖尿病的进一步研究。本文从糖尿病的命名、诊断、 分型、治疗和糖尿病研究等方面发表了作者的看法,旨在引起大家的思考。     

糖尿病伴发脑卒中病例临床特点分析

探讨2型糖尿病患者伴发脑卒中的发生率及相关危险因素,采用头CT扫描,化验血糖、胆固醇、甘油三酯、高密度脂蛋白、纤维蛋白原。对我院自2005年7月-2007年7月间收治的2型糖尿病合并脑卒中患者与非糖尿病发生脑卒中患者进行比较分析。200例患者中糖尿病88例,患病率44％,两组患者比较糖尿病并发脑卒中发生多灶性梗死（P〈0．01）,血流变学分析（P〈0．01）其差异有统计学意义。糖尿病合并脑卒中的患者与多种危险因素有关,必须及早控制,防止脑卒中发生、发展,减少致残率。     

糖尿病患者白内障手术围手术期风险评估

白内障超声乳化手术的日趋成熟和完善为广大糖尿病患者带来了福音,但作为一个特殊高危群体,手术风险不容忽视。结合以往临床经验,就糖尿病患者白内障手术围手术期风险评估的重要性和必要性作一阐述。以期警示临床严格把握手术适应证,认真作好术前风险评估,实事求是,因人而宜,针对每一位患者的自身条件作出最优化临床决策。     

Integrating Behavior into Health Research and Health Care: One Psychologist's Journey

The author narrates a history of the development of her interest in integrating behavior into heath research and health care. Using diabetes as an exemplar, she describes some of the challenges of integrating behavior into health research and health care: (1) becoming a member of interdisciplinary research and health care teams; (2) acquiring funding for behavioral research with medical populations; (3) communicating scientific findings; and (4) acquiring reimbursement for psychological services rendered. Specific examples of how the author and other psychologists can address these challenges are provided.     

胰岛素抵抗与2型糖尿病关系的新思考

胰岛素抵抗(IR)与2型糖尿病关系密切,对IR的认识,经历了几十年反复的过程,胰岛素抵抗综合征(IRS)的提出使2型糖尿病防治观念发生了根本的转变,提出了2型糖尿病防治新策略:从以降糖治疗为主到全面防治心血管疾病.对IR的认识和IR与2型糖尿病的关系,体现了辩证唯物主义认识论和系统论的观点.     

诱导2型糖尿病的“蜜月期”——治疗糖尿病的新策略

在2型糖尿病β细胞功能早期失代偿阶段,通过短期治疗,可以逆转或改善其功能,从而获得病情的长期缓解,称为2型糖尿病的“蜜月期”。本文就2型糖尿病的“蜜月期”的病理生理基础、影响因素、诱导措施等进行分析,探索2型糖尿病治疗的新策略。     

骨髓干细胞移植治疗1型糖尿病的理论与实践

胰岛移植作为治疗1型糖尿病较理想的方法,由于其供体不足而受到限制。干细胞具有极强的自我更新能力与多向分化潜能,可成为提供1型糖尿病胰岛β细胞良好的细胞来源。造血千细胞移植通过诱导免疫耐受,修复受损胰腺组织改善胰岛功能。间充质干细胞移植可分化为胰岛β细胞,且通过免疫调节改善胰岛细胞微环境。