1] The International Bathymetric Chart of the Arctic Ocean (IBCAO) released its first gridded bathymetric compilation in 1999. The IBCAO bathymetric portrayals have since supported a wide range of Arctic science activities, for example, by providing constraint for ocean circulation models and the means to define and formulate hypotheses about the geologic origin of Arctic undersea features. IBCAO Version 3.0 represents the largest improvement since 1999 taking advantage of new data sets collected by the circum-Arctic nations, opportunistic data collected from fishing vessels, data acquired from US Navy submarines and from research ships of various nations. Built using an improved gridding algorithm, this new grid is on a 500 meter spacing, revealing much greater details of the Arctic seafloor than IBCAO Version 1.0 (2.5 km) and Version 2.0 (2.0 km). The area covered by multibeam surveys has increased from $6% in Version 2.0 to $11% in Version 3.0.

This study indicated that patient empowerment is an effective approach to developing educational interventions for addressing the psychosocial aspects of living with diabetes. Furthermore, patient empowerment is conducive to improving blood glucose control. In an ideal setting, patient education would address equally blood glucose management and the psychosocial challenges of living with diabetes.

Objective-The purpose of this article is to clarify the concept of empowerment and to correct common misconceptions about its use in diabetes care and education.Methods-The patient empowerment approach is well suited to helping patients make self-selected changes related to weight, nutrition, and physical activity. Although the concept of patient empowerment has become an integral part of diabetes education, an accurate understanding and authentic application of empowerment has not occurred as readily. The empowerment approach is clarified and common misconceptions have been corrected. Results-Embracing empowerment means making a paradigm shift that is often difficult because the traditional approach to care is embedded in the training and socialization of most health care professionals (HCP).Conclusion-Unlike the traditional approach, empowerment is not something one does to patients. Rather, empowerment begins when HCPs acknowledge that patient are in control of their daily diabetes care.Empowerment occurs when the HCPs goal is to increase the capacity of patients to think critically and make autonomous, informed decisions. Empowerment also occurs when patients are actually making autonomous, informed decisions about their diabetes self-management.Practice Implications-Clarity about all aspects of the empowerment approach is essential if it is to be used effectively.

IN BRIEF A gap currently exists between the promise and the reality of diabetes care. Practical interventions that facilitate collaborative relationships and foster patient-centered practices are the key to closing this gap.

Although the samples differed demographically, the reliability and validity of the test were supported in both the community and the health department samples. This suggests that the test is appropriate for a variety of settings and patient populations.

739 Patients with diabetes must make a series of daily decisions involving nutrition, physical activity, medication, blood glucose monitoring, and stress management. Patients must also interact effectively with the health care system, their family members, friends, and employers to obtain the support necessary to manage their diabetes (1). Thus, enhancing the perceived self-efficacy of patients to self-manage their diabetes is an important goal of diabetes care and education.Perceived self-efficacy has become an important and useful construct in psychology (2-4) because it is related to the willingness and the ability of people to engage in various behavioral challenges including preventive and disease management behaviors (5-15). Studies in diabetes have demonstrated the effect of perceived self-efficacy on the adherence behavior of adolescents (16,17), African-American women with diabetes (18), adults with complex insulin regimens (18,19), and adults with type 1 or type 2 diabetes (20-22). However, in these studies, self-efficacy has been defined primarily as the perceived ability to engage in various situation-specific self-management tasks such as blood glucose monitoring and ordering meals in a restaurant, or the studies have focused on the needs of particular group of patients (e.g., adolescents).In 1991, we conducted a randomized controlled trial to evaluate the effectiveness of a patient empowerment program for adults that focused entirely on psychosocial issues such as managing stress, obtaining family support, negotiating with health care professionals and employers, and dealing with uncomfortable emotions (23). Because we were unable to identify a measure of diabetes-related self-efficacy for adults that focused on these important psychosocial areas, we developed the Diabetes Empowerment Scale (DES), which is a 37-item Likert-type questionnaire (24), and we used it in that study. The study showed that the program resulted in both psychosocial and blood glucose level improvements. RESEARCH DESIGN AND METHODS Instrument developmentThe pilot version of the DES had 8 subscales that were keyed to the major content areas of the patient empowerment and education program (23,24). The structure of the DES and the patient empowerment program were based on our earlier work in patient empowerment (25)(26)(27). In an earlier study (25), we defined the purpose of the empowerment approach to diabetes education as helping patients make informed choices about their diabetes selfmanagement. In that study, we offered a 4-step behavior change model: 1) patient identification of problem areas, 2) exploration of the emotions associated with those problems, 3) development of a set of goals and strategies to overcome the barriers to achieving those goals, and 4) determining patients' motivation to make a commitment to the behavior change plan. That approach to facilitating behavior change in diabetic patients was adapted from earlier work in counseling psychology (28-31). Most of the patient empowerment program and DES subsc...

No abstract

A digital representation of ocean floor topography is essential for a broad variety of geological, geophysical and oceanographic analyses and modeling. In this paper we present a new version of the International Bathymetric Chart of the Arctic Ocean (IBCAO) in the form of a digital grid on a Polar Stereographic projection with grid cell spacing of 2 × 2 km. The new IBCAO, which has been derived from an accumulated database of available bathymetric data including the recent years of multibeam mapping, significantly improves our portrayal of the Arctic Ocean seafloor.