BackgroundThe purpose of this study is to develop and test reliability, validity, and utility of the Goal-Setting Evaluation Tool for Diabetes (GET-D). The effectiveness of diabetes self-management is predicated on goal-setting and action planning strategies. Evaluation of self-management interventions is hampered by the absence of tools to assess quality of goals and action plans. To address this gap, we developed the GET-D, a criteria-based, observer rating scale that measures the quality of patients’ diabetes goals and action plans.MethodsWe conducted 3-stage development of GET-D, including identification of criteria for observer ratings of goals and action plans, rater training and pilot testing; and then performed psychometric testing of the GET-D.ResultsTrained raters could effectively rate the quality of patient-generated goals and action plans using the GET-D. Ratings performed by trained evaluators demonstrated good raw agreement (94.4%) and inter-rater reliability (Kappa = 0.66). Scores on the GET-D correlated well with measures theoretically associated with goal-setting, including patient activation (r=.252, P<.05), diabetes specific self-efficacy (r=.376, P<.001) and inverse relationship with depression (r= −.376, P<.01). Significant between group differences (P<.01) in GET-D scores between goal-setting intervention (mean = 7.33, standard deviation = 4.4) and education groups (mean = 4.93, standard deviation = 3.9) confirmed construct validity of the GET-D.ConclusionsThe GET-D can reliably and validly rate the quality of goals and action plans. It holds promise as a measure of intervention fidelity for clinical interventions that promote diabetes self-management behaviors to improve clinical outcomes.Trial registrationClinicaltrials.gov Identifier: NCT00481286

Objective A prior knee osteoarthritis (OA) trial found that provider conveyed expectations for treatment success were associated with pain improvement. We hypothesized this relationship was mediated by patient self-efficacy since expectations of improvement may enhance one’s ability to control health behaviors, and therefore health. Our aim was to examine whether self-efficacy was a mediator of the relationship observed in this trial. Methods A secondary analysis of a three arm (traditional acupuncture, sham acupuncture, and wait list) trial for knee OA was conducted. Those in the acupuncture groups were equally randomized to acupuncturists trained to communicate a high or neutral expectation of treatment success (e.g. used language conveying high or unclear likelihood that acupuncture would reduce knee pain). A modified Arthritis Self-Efficacy Questionnaire and the Western Ontario McMasters (WOMAC) pain subscale were administered. Linear regression analyses were used to examine whether patient self-efficacy mediated the relationship between provider communication style and knee pain at 3 months. Results High expectation provider communication was associated with patient self-efficacy, β coefficient of 0.14 (95%CI: 0.01, 0.28). Self-efficacy was associated with WOMAC pain, β coefficient of −9.29 (95%CI: −11.11, −7.47), while controlling for the provider communication style. The indirect effect a*b of −1.36 for high versus neutral expectation, (bootstrap 95% CI: −2.80, −0.15, does not include 0), supports that patient self-efficacy mediates the relationship between provider-communicated expectations of treatment effects and knee pain. Conclusion Our findings suggest that clinician-conveyed expectations can enhance the benefit of treatments targeting knee OA symptoms, mediated by improved patient self-efficacy.

Bovine mastitis is the predominant cause for antimicrobial use on dairy farms and is a major source of economic losses in the dairy industry. In this study, the antimicrobial susceptibility profiles of common mastitis-causing pathogens, Staphylococcus aureus (n = 62), Streptococcus agalactiae (n = 46), and Escherichia coli (n = 129), were determined for dairy cattle with mastitis across 142 Ukrainian farms. The results showed that there were more gentamicin resistant S. aureus isolates (16.95%) identified in this study than previously reported for Ukrainian dairy cattle. Moreover, low levels of amoxicillin susceptibly (13.51%) were observed for St. agalactiae, which contrasted a previous study showing susceptibility levels of >50%. St. agalactiae resistance to tetracycline was observed in 80% of the isolates. Cephalosporin use was most ineffective against E. coli, with 43.27–56% of the isolates exhibiting this resistant trait. Overall, this study performed a preliminary analysis of antimicrobial resistance on mastitis isolates from Ukrainian farms. However, given the limited numbers of the isolates tested in this study and that the publications on antimicrobial resistance in animal husbandry of Ukraine are very few, more extensive investigations are needed to comprehensively examine susceptibility patterns of mastitis-causing pathogens in dairy cattle in Ukraine.