Eenzaamheid en zelfmanagementvaardigheden bij visueel beperkte ouderen

 0,001). De multivariate hiërarchische regressieanalyse toont aan dat de zelfmanagementvaardigheid self-efficacy, partner status en zelfwaardering samenhangen met eenzaamheid. Visus-gerelateerde variabelen, zoals de ernst en de duur van de visuele beperking, zijn niet geassocieerd met eenzaamheid. Discussie. Visueel beperkte ouderen zijn een risicogroep als het gaat om eenzaamheid. De samenhang met zelfmanagementvaardigheden biedt mogelijkheden aangezien deze vaardigheden aangeleerd kunnen worden en daarmee eenzaamheidsgevoelens bij visueel beperkte ouderen kunnen verminderen. Een aangepaste versie van dit paper is verschenen in Journal of Aging and Health, doi:10.1177/0898264311399758

Reduced costs with bisoprolol treatment for heart failure - An economic analysis of the second Cardiac Insufficiency Bisoprolol Study (CIBIS-II)

Background Beta-blockers, used as an adjunctive to diuretics, digoxin and angiotensin converting enzyme inhibitors, improve survival in chronic heart failure. We report a prospectively planned economic analysis of the cost of adjunctive beta-blocker therapy in the second Cardiac Insufficiency BIsoprolol Study (CIBIS II). Methods Resource utilization data (drug therapy, number of hospital admissions, length of hospital stay, ward type) were collected prospectively in all patients in CIBIS . These data were used to determine the additional direct costs incurred, and savings made, with bisoprolol therapy. As well as the cost of the drug, additional costs related to bisoprolol therapy were added to cover the supervision of treatment initiation and titration (four outpatient clinic/office visits). Per them (hospital bed day) costings were carried out for France, Germany and the U.K. Diagnosis related group costings were performed for France and the U.K. Our analyses took the perspective of a third party payer in France and Germany and the National Health Service in the U.K. Results Overall, fewer patients were hospitalized in the bisoprolol group, there were fewer hospital admissions perpatient hospitalized, fewer hospital admissions overall, fewer days spent in hospital and fewer days spent in the most expensive type of ward. As a consequence the cost of care in the bisoprolol group was 5-10% less in all three countries, in the per them analysis, even taking into account the cost of bisoprolol and the extra initiation/up-titration visits. The cost per patient treated in the placebo and bisoprolol groups was FF35 009 vs FF31 762 in France, DM11 563 vs DM10 784 in Germany and pound 4987 vs pound 4722 in the U.K. The diagnosis related group analysis gave similar results. Interpretation Not only did bisoprolol increase survival and reduce hospital admissions in CIBIS II, it also cut the cost of care in so doing. This `win-win' situation of positive health benefits associated with cost savings is Favourable from the point of view of both the patient and health care systems. These findings add further support for the use of beta-blockers in chronic heart failure

The importance of honeydew as food for larvae of Chrysoperla carnea in the presence of aphids.

Larvae of the common green lacewing Chrysoperla carnea are predacious and feed on a wide range of small, soft-bodied arthropods. In addition to their feeding on prey arthropods to cover their nutritional requirements for growth and development, the consumption of non-prey foods such as honeydew has been reported. It is commonly believed that these food supplements are primarily exploited by the larvae when prey is scarce or of low nutritional quality. Here, we assess whether C. carnea larvae also use honeydew when high-quality aphid prey are readily available. In a choice experiment, the feeding behaviour of C. carnea larvae was observed in the presence of both aphids and honeydew. The larvae were starved, aphid-fed, or honeydew-fed prior to the experiment. The time spent feeding on honeydew compared with feeding on aphids was highest for starved larvae and lowest for honeydew-fed larvae. Among the three treatments, the aphid-fed larvae spent the most time resting and the least time searching. In an additional experiment food intake was assessed in terms of weight change when larvae were provided with an ad libitum supply of either aphids or honeydew. Larvae yielded a significant lower relative weight increase on honeydew compared with aphids. The reduced weight increase on honeydew was compensated when larvae were subsequently provided with aphids, but not when honeydew was provided again. This study showed that (i) prior honeydew feeding reduces overall aphid consumption, and (ii) larvae do consume honeydew even after they have been given ad libitum access to aphids. The fact that larvae of C. carnea still use honeydew as a food source in the presence of suitable prey underlines the importance of carbohydrates as foods

Prevalence and causes of visual impairment in a Brazilian population: The Botucatu Eye Study

<p>Abstract</p> <p>Background</p> <p>This paper reports population-based data on the prevalence and causes of visual impairment among children and adults in Botucatu, Brazil.</p> <p>Methods</p> <p>A population-based cross-sectional study was conducted involving a random start point and then systematic sampling of an urban Brazilian population in the city of Botucatu. There were approximately 3 300 individuals aged 1 to 91 years who were eligible to participate in the study. Of this sample, 2485 (75.3%) underwent ophthalmic examination. The ophthalmic examination included uncorrected (presenting) and best corrected distance visual acuity using standardized protocols. The primary cause of decreased visual acuity was identified for all patients with visual impairment.</p> <p>Results</p> <p>Presenting low vision and presenting blindness were found in 5.2% (95% CI: 4.3–6.1) and 2.2% (95% CI: 1.6–2.8) of the population, respectively. Unilateral presenting low vision and unilateral presenting blindness were found in 8.3% (95% CI: 7.2–9.5) and 3.7% (95% CI: 2.9–4.4) of the population respectively. Best corrected low vision was found in 1.3% of the population (95% CI: 0.9–1.7) and best corrected blindness was discovered in 0.4% of people (95% CI: 0.2–0.7). The main cause of presenting low vision was refractive error (72.3%) and cataract was the most prevalent cause of blindness (50%).</p> <p>Conclusion</p> <p>The main causes of low vision and blindness in this Brazilian city were uncorrected refractive errors, cataract, and retinal diseases. Programs to further reduce the burden of visual impairment need to be targeted toward the correction of refractive error and surgery for cataracts.</p