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- Anderbro, Therese, et al.
(författare)
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Fear of hypoglycemia : relationship to hypoglycemic risk and psychological factors
- 2014
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Ingår i: Acta Diabetologica. - : Springer Science and Business Media LLC. - 0940-5429 .- 1432-5233.
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The major aims of this study were to examine (1) the association between fear of hypoglycemia (FOH) in adults with type 1 diabetes with demographic, psychological (anxiety and depression), and disease-specific clinical factors (hypoglycemia history and unawareness, A1c), including severe hypoglycemia (SH), and (2) differences in patient subgroups categorized by level of FOH and risk of SH.RESEARCH DESIGN AND METHODS: Questionnaires were mailed to 764 patients with type 1 diabetes including the Swedish translation of the Hypoglycemia Fear Survey (HFS) and other psychological measures including the Perceived Stress Scale, Hospital Anxiety and Depression Scale, Anxiety Sensitivity Index, Social Phobia Scale, and Fear of Complications Scale. A questionnaire to assess hypoglycemia history was also included and A1c measures were obtained from medical records. Statistical analyses included univariate approaches, multiple stepwise linear regressions, Chi-square t tests, and ANOVAs.RESULTS: Regressions showed that several clinical factors (SH history, frequency of nocturnal hypoglycemia, self-monitoring) were significantly associated with FOH but R (2) increased from 16.25 to 39.2 % when anxiety measures were added to the model. When patients were categorized by level of FOH (low, high) and SH risk (low, high), subgroups showed significant differences in non-diabetes-related anxiety, hypoglycemia history, self-monitoring, and glycemic control.CONCLUSION: There is a strong link between FOH and non-diabetes-related anxiety, as well as hypoglycemia history. Comparison of patient subgroups categorized according to level of FOH and SH risk demonstrated the complexity of FOH and identified important differences in psychological and clinical variables, which have implications for clinical interventions.
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| 3. |
- Galaz, Victor, et al.
(författare)
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Institutional and Political Leadership Dimensions of Cascading Ecological Crises
- 2011
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Ingår i: Public Administration. - : Wiley. - 0033-3298 .- 1467-9299. ; 89:2, s. 361-380
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Tidskriftsartikel (refereegranskat)abstract
- While some of the future impacts of global environmental change such as some aspects of climate change can be projected and prepared for in advance, other effects are likely to surface as surprises - that is situations in which the behaviour in a system, or across systems, differs qualitatively from expectations. Here we analyse a set of institutional and political leadership challenges posed by 'cascading' ecological crises: abrupt ecological changes that propagate into societal crises that move through systems and spatial scales. We illustrate their underlying social and ecological drivers, and a range of institutional and political leadership challenges, which have been insufficiently elaborated by either crisis management researchers or institutional scholars. We conclude that even though these sorts of crises have parallels to other contingencies, there are a number of major differences resulting from the combination of a lack of early warnings, abrupt ecological change, and the mismatch between decision-making capabilities and the cross-scale dynamics of social-ecological change.
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