Dimensions, application, and outcomes of person-centered self-management interventions for those living with type 2 diabetes: A scoping review.

OBJECTIVES: To explore which dimensions of the person-centered approach (PCA) are adopted in self-management interventions, how they are applied, and its outcomes. METHODS: A review team carried out a scoping review using the methodology of Arksey and O'Malley on diabetes mellitus type 2, person-centered care, and self-management. RESULTS: Of the 364 titles identified, 22 articles were included in this review. No study contained all five dimensions described by the person-centered framework. Some dimensions seemed difficult to assess, mainly having a sympathetic presence and engagement. The application of the five PCA dimensions are presented. Although the authors claimed their intervention to be person-centered, none used a specific tool to measure person-centered care in a holistic way. CONCLUSION: Although the guidelines recommend a PCA to professionals, there is a gap with practice, professionals having difficulty adopting and measuring this approach. PRACTICE IMPLICATIONS: Some strategies to facilitate the adoption of a PCA with people living with type 2 diabetes are proposed. These can help researchers and clinicians develop a PCA, by identifying the care delivery processes necessary to provide it. It seems important for researchers to measure whether their intervention is truly person-centered, using holistic tools and combining different methods (observation, questionnaire, interview).

Development and Implementation of a Registry of Patients Attending Multidisciplinary Pain Treatment Clinics: The Quebec Pain Registry.

The Quebec Pain Registry (QPR) is a large research database of patients suffering from various chronic pain (CP) syndromes who were referred to one of five tertiary care centres in the province of Quebec (Canada). Patients were monitored using common demographics, identical clinical descriptors, and uniform validated outcomes. This paper describes the development, implementation, and research potential of the QPR. Between 2008 and 2013, 6902 patients were enrolled in the QPR, and data were collected prior to their first visit at the pain clinic and six months later. More than 90% of them (mean age ± SD: 52.76 ± 4.60, females: 59.1%) consented that their QPR data be used for research purposes. The results suggest that, compared to patients with serious chronic medical disorders, CP patients referred to tertiary care clinics are more severely impaired in multiple domains including emotional and physical functioning. The QPR is also a powerful and comprehensive tool for conducting research in a "real-world" context with 27 observational studies and satellite research projects which have been completed or are underway. It contains data on the clinical evolution of thousands of patients and provides the opportunity of answering important research questions on various aspects of CP (or specific pain syndromes) and its management.

Discovery of a new broad resonance in 19Ne: implications for the destruction of the cosmic gamma-ray emitter 18F.

Six proton-emitting states in 19Ne were studied through the inelastic scattering reaction H(19Ne,p);{19}Ne; (p)18F. Their energies and widths were derived from the protons detected at zero degree, while proton-proton angular correlations between the detector at zero degree and a segmented annular detector were used to determine their spin value. In addition to the known states, a new broad J=1/2 resonance has been evidenced at E_{x} approximately 7.9 MeV, approximately 1.45 MeV above the proton emission threshold. By introducing this resonance, the 18F(p,alpha)15O destruction rate in novae is significantly enhanced. This reduces the chance to observe the cosmic gamma-ray emission of 18F from novae in space telescopes.

[Help-seeking behavior of women with migraines]. / La recherche d'aide de femmes atteintes de migraine.

Women who suffer from migraine headaches live in fear of the next crushing attack. Though many in number, only a few of them benefit from adequate care, thus suffering a diminishing quality of life as well. It is therefore important to understand how these women proceed to get help. Based on the Theory of Care Seeking, the purpose of this study was to describe and understand the way five adult women between the age of 25 and 45, who have had migraine for more than five years, go about seeking help. The simultaneous paradigm was used as a framework. The method used was Grounded Theory. What emerged was a process of seeking help of which the central idea is "seeking an adequate method to stop the headache". This phenomenon is preceded by the history of the illness, including its beginning, its causes and the symptoms. Seeking help takes place in a context made up of the seeker's personal characteristics and her human and social environment. Strategies used are the traditional medical route, alternative medicine, learning about the illness and insight. The person uses one or several strategies causing physical and social repercusions; searching for help may be influenced by prejudice and ignorance. The process is not all linear; the constant which appears is the history of the illness as well as the desire to see an end to the headache. A second review of the literature permitted a discussion of the originality of the identified process of seeking help.