ABSTRACT
AIM: To report on the development and psychometric testing of the Adolescent Diabetes Needs Assessment Tool. BACKGROUND: The UK has the fifth largest paediatric diabetes population in the world, but one of the poorest levels of diabetes control, highlighting the need for intervention development. DESIGN: Mixed methods following recommendations for questionnaire design and validation. METHODS: A total of 171 young people (12-18 years) participated between 2008- 2011. Methods included item selection using secondary framework analysis, item review, pre-testing, piloting and online transfer. Statistical tests assessed reliability using item-total correlations, interitem consistency and test-retest reliability; and validity using blood glucose (HbA1c) levels and the Self-Management of type 1 Diabetes in Adolescence questionnaire. RESULTS: The Adolescent Diabetes Needs Assessment Tool consists of 117 questions divided between six domains of educational and psychosocial support needs. It combines reflective questioning with needs assessment to raise self-awareness to support adolescent decision-making in relation to diabetes self-care. Thirty-six of the questions provide self-care and psychosocial health assessment scores. Face and content validity of the scoring items were all positively evaluated in terms of appropriateness and readability and tests for validity found significant correlations with Self-Management of type 1 Diabetes in Adolescence and weak correlation with HbA1c , which compared favourably with Self-Management of type 1 Diabetes in Adolescence, the only comparable (USA) tool. Item response analysis validated the use of simple additive scores. CONCLUSIONS: The Adolescent Diabetes Needs Assessment Tool combines reflective learning with needs assessment to support patient-centred clinical consultations.
Subject(s)
Diabetes Mellitus, Type 1/prevention & control , Needs Assessment , Adaptation, Psychological , Adolescent , Age of Onset , Attitude to Health , Child , Diabetes Mellitus, Type 1/psychology , Diet , Exercise , Female , Humans , Hypoglycemic Agents/therapeutic use , Internet , Male , Patient-Centered Care , Pilot Projects , Psychometrics , Reproducibility of Results , Surveys and Questionnaires/standardsABSTRACT
OBJECTIVE: Zidovudine (AZT) is a primary drug therapy used to treat HIV-infected individuals. While AZT inhibits replication of HIV, it also induces a drug-specific myopathy resulting in altered muscle mitochondria, increased oxidative stress and muscle contractile dysfunction. The purpose of this study was to assess the impact of an antioxidant diet (high in vitamins C and E) on AZT-mediated diaphragmatic contractile dysfunction in rodents. METHODOLOGY: Adult, Sprague-Dawley rats were assigned to feeding groups: control (CON, n = 9), AZT-treatment (AZT, n = 8), antioxidant diet only (Anti-Ox, n = 6), and AZT + antioxidant diet (AZT + Anti, n = 9). Two costal diaphragm strips were removed from each animal (under surgical anaesthesia) and evaluated for force-frequency relationship, maximal specific tension, and fatigue resistance using an in vitro preparation. RESULTS: Results indicate significant reductions in normalized force production (20-200 Hz), including maximal specific tension, between AZT animals and all other groups. While AZT reduced diaphragm contractility, the addition of an antioxidant diet eliminated this decrease. CONCLUSION: These data suggest that an increase in oxidative stress mediated by AZT may contribute to AZT-induced muscle contractile dysfunction, and that antioxidant vitamin supplementation may help ameliorate this effect.