Self-care of patients with type 2 diabetes mellitus over the course of illness: implications for tailoring support.

Purpose: Type 2 diabetes requires patients to make lifestyle changes and perform daily self-care. To determine at what stages patients may need particular self-management support, we examined (1) whether patients' performance of self-care related to their diabetes duration, and (2) whether illness characteristics (treatment and complications) and diabetes-related distress influenced this relationship.

Methods: Cross-sectional data from 590 type 2 diabetes patients were analysed through linear and logistic regression analysis.

Primary health care in transition: Variations in service profiles of general practitioners in Estonia and in Finland between 1993 and 2012.

Introduction: Since the early 1990s, the Estonian and Finnish health systems have undergone various changes which are expected to have impacted the type and range of services provided by general practitioners (GPs).

Objective: To compare GP services between Estonia and Finland in 1993 and 2012 and draw a parallel with transformations occurred in the health systems of both countries during these two decades.

Methods: Data were collected through surveys among 129 and 288 GPs from Estonia and Finland in 2012 and 139 Estonian and 239 Finnish GPs in 1993.

Patient-perceived responsiveness of primary care systems across Europe and the relationship with the health expenditure and remuneration systems of primary care doctors.

Background: Health systems are expected to be responsive, that is to provide services that are user-oriented and respectful of people. Several surveys have tried to measure all or some of the dimensions of the responsiveness (e.g.

Overweight and obese adults have low intentions of seeking weight-related care: a cross-sectional survey.

Background: The prevalence of obesity is growing worldwide. Obesity guidelines recommend increasing the level of weight-related care for persons with elevated levels of weight-related health risk (WRHR). However, there seems to be a discrepancy between need for and use of weight-related care.

The sweetest pill to swallow: how patient neurobiology can be harnessed to maximise placebo effects.

The burgeoning interest in placebo effects over the last 10-15 years has fallen into two main research areas: elucidation of the neurobiological mechanisms recruited following placebo administration, and investigations into the situations and contexts in which placebo effects are evoked. There has been little attention focused on bridging these two i.e.

Terminal patients' awareness of impending death: the impact upon requesting adequate care.

In this qualitative study, 19 Dutch terminal patients and 23 relatives of deceased patients were interviewed. The interviews revealed that a timely request for care and anticipation of "what was going to happen" was determined by the degree to which patients and their relatives realize that the end of life was close, that the symptoms would get worse, and that the family would have to bear an increasing burden. When awareness of the severity of the situation dawns late, shortly before death, the patient and family may not receive the right sort of care, nor have access to the appropriate facilities.