Real-life dosage and clinical efficacy of biphasic insulin preparations in patients with type 2 diabetes.

Introduction: This retrospective study used data from a primary care database to compare two insulin products in routine clinical practice for the treatment of type 2 diabetes in the UK.

Patients And Methods: Records were analyzed for patients with type 2 diabetes who had been initiated on biphasic insulin aspart 30 (BIAsp30) (n=632) or biphasic isophane human insulin 30 (BHI30) (n=762) and who had a glycated hemoglobin (HbA₁(c)) measurement at baseline (up to 6 months before the index date) and end of study (6-12 months after index date). Regression analyses were used to test for a statistically significant interaction between reduction in HbA₁(c) from baseline to end of study and the log-transformed average daily dose (logADD) of insulin.

A meta-analysis of placebo-controlled clinical trials assessing the efficacy and safety of incretin-based medications in patients with type 2 diabetes.

Aims: A systematic review of the literature, in combination with a meta-analysis of randomized controlled trials comparing treatments with placebo, was conducted to provide an update on the clinical efficacy and safety of incretin-based medications in adult patients with type 2 diabetes.

Methods: A literature search (2000-2009) identified 38 placebo-controlled trials (phase II or later - parallel design) comparing exenatide (n = 8), liraglutide (n = 7), vildagliptin (n = 11) and sitagliptin (n = 12) with placebo. Outcomes were change from baseline in HbA(1c) and in weight, and the number of patient-reported hypoglycemic episodes.

Functional incapacity and physical and psychological symptoms: how they interconnect in chronic fatigue syndrome.

Background: It has been argued that perceived functional incapacity might be a primary characteristic of chronic fatigue syndrome (CFS) and could be explained by physical symptoms. If so, it could be expected to be closely associated with physical, but not psychological symptoms. The study tests this hypothesis.

Indirect comparison of once daily insulin detemir and glargine in reducing weight gain and hypoglycaemic episodes when administered in addition to conventional oral anti-diabetic therapy in patients with type-2 diabetes.

Aims: Basal insulin administered to type-2 diabetic patients with poor glycaemic control when managed with oral anti-diabetics (OADs) alone can lead to an increased risk of weight gain and hypoglycaemia. In the absence of head-to-head trials, an indirect comparison of the once-daily insulin detemir with insulin glargine was conducted on the following outcomes: weight gain, hypoglycaemic episodes, and HbA(1c).

Methods: Parallel-group randomised controlled trials of at least 20 weeks duration that compared once-daily evening glargine or detemir with a common comparator, neutral protamine Hagedorn insulin (evening), were selected.

Therapy conversion to biphasic insulin aspart 30 improves long-term outcomes and reduces the costs of type 2 diabetes in Saudi Arabia.

Objective: An observational study in Saudi Arabia indicated that conversion to biphasic insulin aspart 30 (BIAsp 30) from human insulin (HI) was associated with improvement of glycaemic control.

Methods: A validated computer simulation model of diabetes was used to project long-term outcomes (such as quality-adjusted life expectancy and direct medical costs) based on patient characteristics and treatment effects observed in the Saudi Arabian PRESENT subgroup (n=598). Baseline prevalence of comorbidities was obtained from published sources.

Be good to your patient: how the therapeutic relationship in the treatment of patients admitted to assertive outreach affects rehospitalization.

We investigated whether the quality of the therapeutic relationship (TR) between patient and clinician predicts rehospitalization in patients in assertive outreach treatment. Analyses were conducted on 332 "established" (equal to in care for > or =3 months) and 150 "new" (equal to in care for <3 months) patients with severe mental illness sampled from 24 assertive outreach teams in London, England. TR was assessed at baseline using the clinician version of the Helping Alliance Scale.

Goals of new long-stay patients in supported housing: a UK study.

Aim: This study assessed the goals 'new' long-stay clients aim to achieve by being in supported housing (SH), compared the goals stated by clients and staff, and tested whether subgroups of clients can be identified on the basis of their goals, quality of life and psychopathology.

Method: Interviews were conducted with 41 clients and 39 staff of supported houses in London and Essex, UK. Descriptive, content and cluster analyses were used to analyse the results.

Morale and job perception of community mental health professionals in Berlin and London.

Introduction: Morale and job perception of staff in community mental health care may influence feasibility and quality of care, and some research has suggested particularly high burnout of staff in the community. The aims of this study were to: a) assess morale, i. e.

Subjective quality of life and posttraumatic stress disorder.

Subjective quality of life (SQOL) and its predictors were assessed in 117 patients with posttraumatic stress disorder (PTSD) in a specialized clinic. Scores were compared with other samples. PTSD patients had lower SQOL than the comparison groups.

Morale of mental health professionals in Community Mental Health Services of a Northern Italian Province.

Aims: To explore morale of psychiatrists and psychiatric nurses working in Community Mental Health Centres (CMHC) in an Italian Province, and identify influential factors.

Methods: Thirty psychiatrists and 30 nurses working in CMHCs in Modena completed questionnaires on burnout, team identity and job satisfaction. They also answered open questions about different aspects of their work.

Characteristics of teams, staff and patients: associations with outcomes of patients in assertive outreach.

Background: Little is known about what characteristics of teams, staff and patients are associated with a favourable outcome of severe mental illness managed by assertive outreach.

Aims: To identify predictors of voluntary and compulsory admissions in routine assertive outreach services in the UK.

Method: Nine features of team organisation and policy, five variables assessing staff satisfaction and burn-out and eleven patient characteristics taken from the baseline data of the Pan-London Assertive Outreach Study were tested as predictors of voluntary and compulsory admissions within a 9-month follow-up period.

Assertive outreach teams in London: patient characteristics and outcomes. Pan-London Assertive Outreach Study, part 3.

Background: Although the model of assertive outreach has been widely adopted, it is unclear who receives assertive outreach in practice and what outcomes can be expected under routine conditions.

Aims: To assess patient characteristics and outcome in routine assertive outreach services in the UK.

Method: Patients (n=580) were sampled from 24 assertive outreach teams in London.

Subjective evaluation: is there more than one criterion?

Previous cross-sectional investigations have shown that subjective evaluation criteria (criteria that are used in psychiatric research for evaluating care based on patients' statements) do overlap and that there exists a single general factor underlying all these criteria. In this study, we tested longitudinally and in two different samples of schizophrenia patients the distinctness and covariation at baseline and at followup of three common subjective evaluation criteria (subjective quality of life, self-rated needs, and self-reported symptoms). Scores were intercorrelated at both baseline and followup and showed some intercorrelations over time, suggesting temporal covariation.

Research in supported housing.

Background: De-institutionalization has led to the provision of various forms of housing with or without support for people with mental illness in the community. In this paper, we review the conceptual issues related to the provision of supported housing schemes, the characteristics of residents, research methods and outcomes, and the factors influencing the quality of care provided.

Methods: A Medline and hand search of published literature was complemented by information derived from contacting expert researchers in the field.