How do patients with type 2 diabetes perceive their disease? Insights from the French DIABASIS survey.

AIM: The main purpose of this survey was to describe type 2 diabetes (T2DM) from the patient's standpoint in a representative French panel in 2008. METHODS: Fourteen thousand two hundred and one individuals from the general population aged 45 or older completed a self-questionnaire exploring knowledge about diabetes; 1092 replies were from patients with T2DM. RESULTS: The prevalence of T2DM in this population was 7.7%, with demographics as follows: 60% men; mean age: 66 years; mean age at diagnosis: 55 years; mean BMI: 29 kg/m(2). Eighty-five percent of T2DM patients reported that they wanted more information about at least one aspect of the disease at diagnosis; they reported feeling anxious (30%), frightened (13%), angry (4%) or that the disease was unfair (12%). Half of the patients had modified their dietary habits but 71% found it difficult to engage in regular physical activity. Most patients (90%) were treated with drugs: 81% with oral antidiabetic drugs (OAD) (44% in monotherapy) while 19% received insulin (alone or in combination with OAD). Twenty-three percent complained of weight gain since start of current therapy (average gain of 7.3 kg). Insulin initiation represented a turning point for patients who became more aware of the disease severity, more willing to follow advice and to take greater control over their disease management. The mean time from diagnosis to insulin initiation was 13.8 years. Half of the patients perceived their disease as severe especially women, patients who initially reacted with anxiety, insulin-treated patients and those actively involved in their disease management. Some gender differences emerged: women took the disease more seriously, were more engaged in self-management, and reported a higher impact on daily life. CONCLUSIONS: DIABASIS provides important information for diabetes care by highlighting patients' views of the disease, such as distress at diagnosis, lack of adequate information to cope with this distress and the important supportive role played by the family. A deeper understanding of patients' perception of the disease would help optimize customized care.

The choice of bromeliads as a microhabitat by Scinax argyreornatus (Anura, Hylidae).

The association of anurans to bromeliads presents different degrees of interaction such as: eventual, obligatory and bromeligen. The frog species Scinax argyreornatus shows a regular association with these plants. The goal of this study is to characterise the degree of association between the frog S. argyreornatus to different species of bromeliads. We identified which species of bromeliad is regularly associated with S. argyreornatus and recognised which factors interfere with this association preference. We analysed the Concentration of Relative Dominance of frogs per bromeliad species. As possible criteria for frog association preference to different bromeliads species we established the analysis of leaves number, length and width, number of leaf axils, stored water in the axils, pH and relative humidity, among other organographic components. Our observations were analyzed by ANOVA followed by the Tukey test. We also evaluated the preference for association by the constancy of Bodenheimer. The correlation matrix indicated that the relative humidity is the factor responsible for the frog-bromeliads association, except for Aechmea sp.. However Aechmea sp. was the species with greater constancy of occupation followed by Quesnelia arvensis and Neoregelia johannis. According to our statistical results, Aechmea sp. and Q. arvensis are not different regarding organographic parameters, but differ from N. johannis. Our observations suggest that the bromeliads organographic structure and the relative humidity are key conditions which influence the preferences of S. argyreornatus to bromeliad species, while the other features showed no correlation.

[Communication around the cancer diagnosis: patient satisfaction and process quality in French Comprehensive Cancer Centers]. / L'annonce de la maladie: satisfaction des patients et démarche qualité dans les Centres de lutte contre le cancer.

BACKGROUND: Our survey was designed to evaluate the satisfaction of patients treated in French Comprehensive Cancer Centers (CCC) with the communication of their cancer diagnosis and treatments, and to use the data obtained to optimize current practices. METHODS: One thousand six hundred (and) six CCC patients participated in a telephone survey. Eligible patients were attending a visit to a CCC for initial care of their disease (i.e. not a relapse). The questionnaire assessed patient satisfaction with the communication of diagnosis and treatment options, globally and with respect to potential individual determinants of satisfaction. FINDINGS: Complete satisfaction was recorded by 77% of patients with their overall care at the CCC and by 63% of patients with the initial consultation when diagnosis was communicated and/or treatment discussed. Overall, 90% of patients were satisfied with the level of their implication in discussions about their care. A model established by Partial Least Squares (PLS) regression analysis, identified four major areas and their relative contributions to patient satisfaction: patient's relationship with their physician (64%); nature of the information provided (14%; influenced strongly by information on type, duration and practical organization of planned treatment); agenda/diary issues (14%; influenced strongly by waiting room delay); accompaniment (8%; influenced equally by support from close family and patient association/self-help groups). INTERPRETATION: Overall satisfaction was high in cancer patients attending visits for initial care in French CCC. The model we devised to understand components of satisfaction could serve as a benchmark for evolution of outcomes in this field.