Sixty-nine individuals with diabetes (23 with type I, 15 with pregestational, and 31 with gestational) used specially modified reflectance meters containing memory chips enabling the instruments to store 440 individual blood glucose values with corresponding time and date. These data were organized into 14-day periods and then collapsed into a graphic depiction, the Ambulatory Glucose Profile (AGP), which was represented as the pattern of the 25th, 50th, and 75th percentiles of blood glucose values. These three curves illustrate the median level of control and provide an index of variability in control at each hour of a "typical day." We observed distinctive AGPs related to the variability in metabolic control and the type of diabetes. Comparisons between diagnostic groups showed consistent differences between groups, independent of level of glycemic control. Review of serial AGPs obtained for sequential 2-wk periods for 23 non-pregnant individuals with type I diabetes and 10 women with gestational diabetes revealed changes in AGP corresponding to alterations in regimen. The AGP provides a new approach to the evaluation of glycemic control, with applications to patient and physician education, clinical investigation, and individual patient care.
The purposes of this study were to (a) develop and implement an effective program of psychosocial intervention for adult cancer patients, (b) evaluate the impact of this program in ameliorating the psychosocial problems of cancer patients, and (c) develop procedures for documenting the intervention process. Three cancer sites were investigated: breast, lung, and melanoma. Half of the patients (n = 157) received psychosocial evaluation and a systematic program of psychosocial rehabilitation (intervention group), and the remaining half (n = 151) received only the evaluation (control group). There were no significant demographic or medical (e.g., prognosis, staging of disease, etc.) differences between the control and intervention groups. Data analysis indicated that (a) the evaluation instruments were sensitive to the course of psychosocial treatment of the cancer patient; (b) intervention effectively ameliorated some of the psychosocial problems reported by patients; and (c) patients in the intervention group evidenced a more rapid decline of negative affect (i.e., anxiety, hostility, depression), a more realistic outlook on life, a greater proportion of return to previous vocational status, and a more active pattern of time usage than patients in the control group.The psychosocial impact of cancer on the (1977) indicated that 25% to 30% of the patient has been well described in both mastectomy patients that they interviewed the professional (Craig & Abeloff, 1974; remained emotionally upset 1 year follow-
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