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Dealing with bureaucracy: measuring citizens’ bureaucratic self-efficacy
Mette Bisgaard 한국행정학회 2023 International Review of Public Administration Vol.28 No.1
As subjects of the policy and rules enforced by the state, citizens play a key role in the implementation of public policies. However, our knowledge about the role of the citizen is limited in Public Administration research. This article conceptualizes and develops a measurement scale for citizens’ subjective perception of their competence to handle interaction with bureaucracy, namely citi-zens’ bureaucratic self-efficacy. Bureaucratic self-efficacy consists of two dimensions: citizens’ self-efficacy in (1) understanding rules and processes and (2) communicative abilities related to interactions with bureaucracy. The author tested the dimensionality of the concept using exploratory and confirmatory factor analysis, which confirmed the concept’s two dimensions. Through additional valid-ity tests, the concept demonstrated good psychometric properties. The scales correlate with citizens’ decision outcomes and their perceived substantive and procedural justice. This indicates that the measurement is able to predict citizens’ outcomes when inter-acting with bureaucracy.
( Mette W Klinge ),( Nanna Sutter ),( Esben B Mark ),( Anne-mette Haase ),( Per Borghammer ),( Vincent Schlageter ),( Sten Lund ),( Jesper Fleischer ),( Karoline Knudsen ),( Asbjørn M Drewes ),( Klaus 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2021 Journal of Neurogastroenterology and Motility (JNM Vol.27 No.3
Background/Aims Patients with diabetes mellitus (DM) often suffer from gastrointestinal (GI) symptoms, but these correlate poorly to established objective GI motility measures. Our aim is to perform a detailed evaluation of potential measures of gastric and small intestinal motility in patients with DM type 1 and severe GI symptoms. Methods Twenty patients with DM and 20 healthy controls (HCs) were included. GI motility was examined with a 3-dimensional-Transit capsule, while organ volumes were determined by CT scans. Results Patients with DM and HCs did not differ with regard to median gastric contraction frequency (DM: 3.0 contractions/minute [interquartile range {IQR}, 2.9-3.0]; HCs: 2.9 [IQR, 2.8-3.1]; P = 0.725), amplitude of gastric contractions (DM: 9 mm [IQR, 8-11]; HCs: 11 mm (IQR, 9-12); P = 0.151) or fasting volume of the stomach wall (DM: 149 ㎤ [IQR, 112-187]; HCs: 132 ㎤ [IQR, 107-154]; P = 0.121). Median gastric emptying time was prolonged in patients (DM: 3.3 hours [IQR, 2.6-4.6]; HCs: 2.4 hours [IQR, 1.8-2.7]; P = 0.002). No difference was found in small intestinal transit time (DM: 5 hours [IQR, 3.7-5.6]; HCs: 4.8 hours [IQR, 3.9-6.0]; P = 0.883). However, patients with DM had significantly larger volume of the small intestinal wall (DM: 623 ㎤ [IQR, 487-766]; HCs: 478 ㎤ [IQR, 393-589]; P = 0.003). Among patients, 13 (68%) had small intestinal wall volume and 9 (50%) had gastric emptying time above the upper 95% percentile of HCs. Conclusion In our study, gastric emptying time and volume of the small intestinal wall appeared to be the best objective measures in patients with DM type 1 and symptoms and gastroenteropathy. (J Neurogastroenterol Motil 2021;27:390-399)
( Mette W Klinge ),( Peter Rask ),( Lene S Mortensen ),( Kathrine Lassen ),( Niels Ejskjaer ),( Lars H Ehlers ),( Klaus Krogh ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2017 Journal of Neurogastroenterology and Motility (JNM Vol.23 No.4
Background/Aims Recurrent nausea and/or vomiting are common complications of diabetes mellitus. The conditions severely impact the quality of life of patients and often cause repeated admissions to hospital incurring significant healthcare costs. If standard treatment fails, gastric electrical stimulation (GES) may be offered in selected cases, as a minimally invasive, but expensive, therapeutic option. Our aims are to evaluate the clinical effect and the cost-utility of GES as a treatment for severe diabetic recurrent nausea and/or vomiting. Methods Among 33 diabetes patients implanted with GES because of recurrent nausea and/or vomiting, 30 were available for evaluation. The effect of treatment was assessed prospectively using symptom-diaries and the SF-36 questionnaires at baseline, after 6 and 12 months, and thereafter yearly. The number of days in hospital due to symptoms related to gastrointestinal dysfunction was calculated using hospital records 12 months prior to and 12 months after implantation. Results The surgical procedures were performed without mortality or major complications. Six months after surgery 78% of the respondents had at least 50% reduction in time with nausea and 48% had at least 50% reduction in days with vomiting. Symptom relief persisted at follow-up after at least 4 years. Quality adjusted life years improved after GES, which was cost-effective after 24 months. Conclusions GES reduces symptoms and improves quality of life in diabetes patients with recurrent nausea and/or vomiting. The procedure is supposed as cost-effective over a 2-year time horizon. (J Neurogastroenterol Motil 2017;23:541-549)
Insulin/GLP-1 Treatment for Patients with DM
Zacho, Mette Association for Research of MPS and Rare Diseases 2016 Journal of mucopolysaccharidosis and rare disease Vol.2 No.2
Combining basal insulin therapy with a glucagon-like peptide-1 receptor agonist (GLP-1 RA) has clear clinical advantages, and is supported by the latest EASD/ADA position statement (1). IDegLira is a once-daily combination of the basal insulin, degludec, and the GLP-1RA, liraglutide, in one pen. The DUAL phase 3 clinical trial program provides important evidence about the efficacy and safety of IDegLira in three different populations of patients with type 2 diabetes (T2D): insulin naïve subjects uncontrolled on oral antidiabetic drugs (OADs), subjects uncontrolled on OAD(s) and a GLP-1 RA, and subjects uncontrolled on OAD(s) and basal insulin. Treatment with IDegLira reduced mean HbA1c to below the EASD/ADA treatment target of 7.0% in all five trials. The mean reduction of HbA1c from baseline ranged from 1.3% and 1.9%. IDegLira resulted in weight loss for subjects uncontrolled on basal insulin, was weight neutral for subjects on OADs and weight gain was minimal (2 kg) for subjects previously treated with a GLP-1 RA. Rates of hypoglycaemia were low across all the trials, particularly considering the level of glycaemic control achieved.
Joergensen, Mette Warming,Labouriau, Rodrigo,Hindkjaer, Johnny,Stougaard, Magnus,Kolevraa, Steen,Bolund, Lars,Agerholm, Inge Errebo,Sunde, Lone The Korean Society for Reproductive Medicine 2015 Clinical and Experimental Reproductive Medicine Vol.42 No.1
Objective: It has previously been suggested that embryos developing from intracytoplasmic sperm-injected (ICSI) zygotes with three pronuclei (3PN) are endowed with a mechanism for self-correction of triploidy to diploidy. 3PN are also observed in zygotes after conventional in vitro fertilization (IVF). The parental origin, however, differs between the two fertilization methods. Whereas the vast majority of 3PN IVF zygotes are of dispermic origin and thus more likely to have two centrioles, the 3PN ICSI zygotes are digynic in origin and therefore, more likely to have one centriole. In the present study, we examine whether the parental origin of 3PN embryos correlates with the karyotype. Methods: The karyotype of each nucleus was estimated using four sequential fluorescence in situ hybridizations-each with two probes-resulting in quantitative information of 8 different chromosomes. The karyotypes were then compared and correlated to the parental origin. Results: 3PN ICSI embryos displayed a significantly larger and more coordinated reduction from the assumed initial 3 sets of chromosomes than 3PN IVF embryos. Conclusion: The differences in the parental origin-and hence the number of centrioles-between the 3PN IVF and the 3PN ICSI zygotes are likely to be the cause of the differences in karyotypes.