Calcium Handling Defects and Cardiac Arrhythmia Syndromes

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Effectiveness of a family-, school- and community-based intervention on physical activity and its correlates in Belgian families with an increased risk for type 2 diabetes mellitus: the Feel4Diabetes-study

BACKGROUND: The study aimed to investigate the effectiveness of the European Feel4Diabetes intervention, promoting a healthy lifestyle, on physical activity and its correlates among families at risk for type 2 diabetes mellitus (based on the Finnish Diabetes Risk Score) in Belgium. METHODS: The Feel4Diabetes intervention involved three components: family, school and community component, with the family component consisting of 6 counseling sessions for families at risk. Main outcomes were objectively measured physical activity levels and its subjectively measured correlates. The final sample consisted of 454 parents (mean age 39.4¿years; 72.0% women) and 444 children (mean age 8.0¿years; 50.1% girls). Multilevel repeated measures analyses were performed to assess intervention effectiveness after 1 year. RESULTS: In parents, there was no significant intervention effect. In children, there were only significant negative effects for moderate to vigorous physical activity (p¿=¿0.05; ¿p2¿=¿0.008) and steps (p¿=¿0.03; ¿p2¿=¿0.006%) on weekdays, with physical activity decreasing (more) in the intervention group. CONCLUSIONS: The F4D-intervention lacks effectiveness on high-risk families'' physical activity and its correlates in Belgium. This could partially be explained by low attendance rates and a large drop-out. To reach vulnerable populations, future interventions should invest in more appropriate recruitment (e.g. more face-to-face contact) and more bottom-up development of the intervention (i.e. co-creation of the intervention with the target group)

The effect of a cluster-randomized controlled trial on lifestyle behaviors among families at risk for developing type 2 diabetes across Europe: the Feel4Diabetes-study

Background: This study investigated the effect of the Feel4Diabetes-intervention, a 2-year multilevel intervention, on energy balance-related behaviors among European families at risk for developing type 2 diabetes. Intervention effects on self-reported physical activity, sedentary behavior and eating behaviors were investigated across and within the participating countries: Belgium, Finland, Greece, Spain, Hungary and Bulgaria. Methods: Families were recruited through schools, located in low socio-economic status areas. In total, 4484 families at risk for developing type 2 diabetes were selected using the FINDRISC-questionnaire. Parents’ and children’s energy balance-related behaviors data were collected by questionnaires at three time points (baseline, mid- and post intervention). Families assigned to the intervention group were invited to participate in a 2-year school-, community-, and family-based intervention to promote a healthier lifestyle, including counseling sessions (first intervention year) and text messages (second intervention year). Families assigned to the control group received standard care, including medical check-up results and recommendations and tips regarding a healthy lifestyle. To assess the intervention-effects, Mixed Models were conducted using the R-Package “lmer “with R v3.2. Results: Significant intervention effects were found on a certain number of families’ lifestyle behaviors. Significant favorable intervention effects were detected on parents’ water consumption and consumption of fruit and vegetables, and on children’s consumption of sweets and moderate-to-vigorous physical activity. Analyses by country revealed significant favorable intervention effects on water consumption and on moderate-to-vigorous physical activity in Belgian parents and on fruit and vegetable consumption among Belgian children, on sweets consumption among Spanish parents and children, and on moderate-to-vigorous physical activity among Finnish children. Unfavorable intervention effects were found on the consumption of soft drinks and sugar-containing juices among Hungarian children and parents, while when examining the intervention effects for the overall population and per country, 10 from the 112 investigated outcome variables were improved in the intervention group compared to the control group (9%). Conclusions: The Feel4Diabetes-intervention managed to improve a certain number of targeted lifestyle behaviors while the intervention was not effective on a large number of targeted lifestyle behaviors. The findings of the current study are encouraging, but further research is needed on how we can further improve effectiveness of lifestyle interventions to prevent type 2 diabetes in families at risk. Trial registration: The Feel4Diabetes-study is registered with the clinical trials registry http://clinicaltrials.gov, ID: 643708. © 2021, The Author(s)

Do physical activity and screen time mediate the association between European fathers' and their children's weight status? Cross-sectional data from the Feel4Diabetes-study

BACKGROUND: Most research on parenting and childhood obesity and obesity-related behaviours has focused on mothers while fathers have been underrepresented. Yet, recent literature has suggested that fathers uniquely influence their children''s lifestyle behaviours, and hence could also affect their weight status, but this has not yet been scientifically proven. Therefore, the present study aimed to determine whether the association between fathers'' weight status and their children''s weight status is mediated by fathers'' and children''s movement behaviours (i.e. physical activity (PA) and screen time (ST)). METHODS: Cross-sectional data of 899 European fathers and their children were analyzed. Fathers/male caregivers (mean age =¿43.79¿±¿5.92¿years, mean BMI =¿27.08¿±¿3.95) completed a questionnaire assessing their own and their children''s (mean age =¿8.19¿±¿0.99¿years, 50.90% boys, mean BMIzscore =¿0.44¿±¿1.07) movement behaviours. Body Mass Index (BMI, in kg/m2) was calculated based on self-reported (fathers) and objectively measured (children) height and weight. For children, BMI z-scores (SD scores) were calculated to obtain an optimal measure for their weight status. Serial mediation analyses were performed using IBM SPSS 25.0 Statistics for Windows to test whether the association between fathers'' BMI and children''s BMI is mediated by fathers'' PA and children''s PA (model 1) and fathers'' ST and children''s ST (model 2), respectively. RESULTS: The present study showed a (partial) mediation effect of fathers'' PA and children''s PA (but not father''s ST and children''s ST) on the association between fathers'' BMI and children''s BMI (model for PA; coefficient: 0.001, 95% CI: [0.0001, 0.002]; model for ST; coefficient: 0.001, 95% CI: [0.000, 0.002]). Furthermore, fathers'' movement behaviours (PA and ST) were positively associated with their children''s movement behaviours (PA and ST) (model for PA, coefficient: 0.281, SE: 0.023, p <¿0.001; model for ST, coefficient: 0.345, SE: 0.025, p¿<¿0.001). CONCLUSIONS: These findings indicate that the influence of fathers on their children''s weight status partially occurs through the association between fathers'' PA and children''s PA (but not their ST). As such, intervening by focusing on PA of fathers but preferably of both members of the father-child dyad (e.g. engaging fathers and their children in co-PA) might be a novel and potentially effective strategy for interventions aiming to prevent childhood overweight and obesity. Longitudinal studies or intervention studies confirming these findings are however warranted to make meaningful recommendations for health intervention and policy. TRIAL REGISTRATION: The Feel4Diabetes-study is registered with the clinical trials registry http://clinicaltrials.gov , ID: 643708

Effectiveness of a family-, school- and community-based intervention on physical activity and its correlates in Belgian families with an increased risk for type 2 diabetes mellitus : the Feel4Diabetes-study

BackgroundThe study aimed to investigate the effectiveness of the European Feel4Diabetes intervention, promoting a healthy lifestyle, on physical activity and its correlates among families at risk for type 2 diabetes mellitus (based on the Finnish Diabetes Risk Score) in Belgium.MethodsThe Feel4Diabetes intervention involved three components: family, school and community component, with the family component consisting of 6 counseling sessions for families at risk. Main outcomes were objectively measured physical activity levels and its subjectively measured correlates. The final sample consisted of 454 parents (mean age 39.4years; 72.0% women) and 444 children (mean age 8.0years; 50.1% girls). Multilevel repeated measures analyses were performed to assess intervention effectiveness after 1 year.ResultsIn parents, there was no significant intervention effect. In children, there were only significant negative effects for moderate to vigorous physical activity (p=0.05; eta (2)(p)=0.008) and steps (p=0.03; eta (2)(p)=0.006%) on weekdays, with physical activity decreasing (more) in the intervention group.ConclusionsThe F4D-intervention lacks effectiveness on high-risk families' physical activity and its correlates in Belgium. This could partially be explained by low attendance rates and a large drop-out. To reach vulnerable populations, future interventions should invest in more appropriate recruitment (e.g. more face-to-face contact) and more bottom-up development of the intervention (i.e. co-creation of the intervention with the target group).Trial registrationThe Feel4Diabetes-study was prospectively registered at clinicaltrials.gov as NCT02393872 on 20 March 2015

Effect of the intracellular calcium concentration chelator BAPTA acetoxy-methylester on action potential duration in canine ventricular myocytes

Intracellular calcium concentration ([Ca(2+)]i) is often buffered by using the cell-permeant acetoxy-methylester form of the Ca(2+) chelator BAPTA (BAPTA-AM) under experimental conditions. This study was designed to investigate the time-dependent actions of extracellularly applied BAPTA-AM on action potential duration (APD) in cardiac cells. Action potentials were recorded from enzymatically isolated canine ventricular myocytes with conventional sharp microelectrodes. The effect of BAPTA-AM on the rapid delayed rectifier K(+) current (IKr) was studied using conventional voltage clamp and action potential voltage clamp techniques. APD was lengthened by 5 muM BAPTA-AM - but not by BAPTA - and shortened by the Ca(2+) ionophore A23187 in a time-dependent manner. The APD-lengthening effect of BAPTA-AM was strongly suppressed in the presence of nisoldipine, and enhanced in the presence of BAY K8644, suggesting that a shift in the [Ca(2+)]i-dependent inactivation of L-type Ca(2+) current may be an important underlying mechanism. However, in the presence of the IKr-blocker dofetilide or E-4031 APD was shortened rather than lengthened by BAPTA-AM. Similarly, the APD-lengthening effect of 100 nM dofetilide was halved by the pretreatment with BAPTA-AM. In line with these results, IKr was significantly reduced by extracellularly applied BAPTA-AM under both conventional voltage clamp and action potential voltage clamp conditions. This inhibition of IKr was partially reversible and was not related to the Ca(2+) chelator effect BAPTA-AM. The possible mechanisms involved in the APD-modifying effects of BAPTA-AM are discussed. It is concluded that BAPTA-AM has to be applied carefully to control [Ca(2+)]i in whole cell systems because of its direct inhibitory action on IKr

Methodology of the health economic evaluation of the Feel4Diabetes-study

Background: The clinical and economic burden of type 2 diabetes mellitus on society is rising. Effective and efficient preventive measures may stop the increasing prevalence, given that type 2 diabetes mellitus is mainly a lifestyle-driven disease. The Feel4Diabetes-study aimed to tackle unhealthy lifestyle (unhealthy diet, lack of physical activity, sedentary behaviour, and excess weight) of families with a child in the first grades of elementary school. These schools were located in regions with a relatively low socio-economic status in Belgium, Bulgaria, Finland, Greece, Hungary and Spain. Special attention was paid to families with a high risk of developing type 2 diabetes mellitus. Methods: The aim of this paper is to describe the detailed methodology of the intervention’s cost-effectiveness analysis. Based on the health economic evaluation of the Toybox-study, both a decision analytic part and a Markov model have been designed to assess the long-term (time horizon of 70 year with one-year cycles) intervention’s value for money. Data sources used for the calculation of health state incidences, transition probabilities between health states, health state costs, and health state utilities are listed. Intervention-related costs were collected by questionnaires and diaries, and attributed to either all families or high risk families only. Conclusions: The optimal use of limited resources is pivotal. The future results of the health economic evaluation of the Feel4Diabetes-study will contribute to the efficient use of those resources.Publication of this supplement was funded by the European Union’s Horizon 2020 research and innovation programme under grant agreement n° 643708

Development and reliability of questionnaires for the assessment of diet and physical activity behaviors in a multi-country sample in Europe the Feel4Diabetes Study

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An appraisal: How notifiable infectious diseases are reported by Hungarian family physicians

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Conducta suicida no letal en Castellón: un estudio descriptivo y comparativo.

Treball Final de Grau en Medicina. Codi: MD1158. Curs acadèmic: 2018/2019.Background: Due to the suicidal behavior variability regarding the sociocultural values of each territory, we conducted this study to define the sociodemographic and clinical features of the patients from Castellon. The objective is to obtain deeper knowledge that facilitate the detection and implementation of effective interventions. In addition, we carried out a comparative analysis between non-lethal suicide cases (our sample) and completed suicide cases. Methods: Our sample includes every person assisted for non-lethal suicidal behavior in the Psychiatric Emergency room at Castellon’s Provincial Hospital from January 19th to February 15th, performing an 8 year follow-up. Our completed suicide sample was taken from a previous study conducted in 2018.2 Results: Our sample showed an average age of 39, with a majority of women (56.1%) and psychiatric pathology diagnosis (74.2%, mainly anxiety-depressive disorders). Most of them were being followed by a health service (81.2%, generally their GP). The most frequent suicide method was drug overdose (94.4%). After the suicide episode, only 27 patients (40.9%) attended the healthcare service they were referred to, what may explain the persistance of the suicidal behavior during the follow-up (7.7% suicidal threats and 34.5% attempts) Conclusions: Non-lethal suicidal behavior in Castellon is more frequent among young, women, and those with psychiatric disorders, using as main suicidal method drug overdose. Most of them don’t attend the health care service responsible for their follow-up. Moreover, it was found that the completed suicide profile differs from the non-lethal; it is therefore required to develop different therapeutical and preventive strategies for each one.Introducción: Dada la variabilidad en la conducta suicida según los valores socioculturales de cada territorio, realizamos este estudio para definir las características sociodemográficas y clínicas de los pacientes con comportamiento suicida no letal de nuestra provincia. Pretendemos ampliar nuestro conocimiento para facilitar la detección de individuos en riesgo e implantar intervenciones efectivas. Además, realizamos una comparativa entre las características de nuestra muestra con las de suicidio consumado. Material y métodos: La muestra incluye toda conducta suicida no letal registrada en el Hospital Provincial de Castellón entre el 19 de enero y 15 de febrero de 2009, realizándose un seguimiento hasta febrero de 2017. La muestra de suicidio consumado es tomada de un proyecto previo de 2018. Resultados: La muestra la integran mayormente individuos jóvenes (media de 39 años), de sexo femenino (56.1%), con patología psiquiátrica (74.2%, principalmente trastornos ansioso-depresivos) y en seguimiento sanitario (81.2%, predominantemente MAP (77.3%)). El método de suicidio más frecuente fue la sobreingesta medicamentosa (94.4%). Sólo 27 pacientes (40.9%) acudieron tras el episodio a los servicios de salud remitidos, facilitándose así la persistencia de la conducta durante el seguimiento (7.7% amenazas, 34.5% tentativas). Conclusiones: La conducta suicida no letal de Castellón predomina entre adultos jóvenes, de sexo femenino, con trastornos psiquiátricos, que recurren como método a la sobredosis medicamentosa e incumplen el seguimiento a posteriori. Además, se comprobó que el perfil del comportamiento suicida letal difiere de los rasgos de la conducta suicida no letal, evidenciando la necesidad de desarrollar estrategias preventivas y terapéuticas distintas entre ellos