Do Intervention Strategies of Women Healthy Heart Project (WHHP) Impact on Differently on Working and Housewives?

<p class="abstract"><strong>BACKGROUND:</strong> The purpose of this study is to evaluate the possible difference of the impact of Women Healthy Heart Project on lifestyle, as well as physical/biochemical parameters of working women and housewives.</p> <p><strong>&nbsp;&nbsp; METHODS:</strong><strong> </strong>This was a community-based intervention study conducted over 5 years (2002-2007) in the counties of Isfahan and Najafabad (intervention areas) and Arak (control). Pre-study situation analysis of women was followed by 5 years of wide-ranging interventions (educational/environmental) conducted by various organizations using different methodologies. The interventions were aimed at modifying/improving lifestyle by increasing physical activity, encouraging healthy eating, and tobacco use cessation. The organizations involved in performing the interventions included the local radio and television authority, health/treatment centers, the Red Crescent Society, Municipalities, the Relief Committee, the Center for Retirees&rsquo; Welfare, and the Literacy Campaign Organization. After 5 years, final phase same as first phase was planed. The subjects studied in all phases` the pre- and post-intervention phases consisted of 10586 women aged above 18 years. Demographic data, obesity index, smoking, physical activity and eating habit were assessed before and after the study. Data were analyzed using SPSS-15 using Student&rsquo;s t-test, chi-square test, the general linear model of ANOVA, and logistic regression.</p> <p class="abstract"><strong>&nbsp;&nbsp; RESULTS:</strong> We studied 10586 women (6105 and 4481 women, pre- and post-intervention, respectively). Mean age of working women was 34.14 &plusmn; 10.09 and 34.08 &plusmn; 9.35 years before and after the study, respectively. Mean age of housewives before and after the study was 40.05 &plusmn; 14.61 and 40.36 &plusmn; 15.32 years, respectively. Interventions conducted during 5 years improved eating habits and decreased tobacco use in working women and housewives. In every phase of the study, there was a significant age difference between housewives and working women (P &lt; 0.001). Hence data were adjusted according to age in each phase. Overall physical activity of housewives and working women increased, but the percentage of passive smokers among housewives remained unchanged. Waist circumference and waist-to-hip ratio changed significantly in housewives following interventions (P &lt; 0.001). The parameter which improved significantly in working women was waist circumference (P &lt; 0.05). However, after adjusting for age, no significant difference was seen between working women and housewives following interventions.<strong></strong></p> <p class="abstract"><strong>&nbsp;&nbsp; </strong><strong>CONCLUSION:</strong> Community-based interventions, especially those directed at housewives, can lead to significant improvements in lifestyle and cardiovascular risk reduction. It seems that working women require tailored interventions to suit their conditions. Although short-term outcomes may seem insignificant, persistence and continuity of lifestyle changes may lead to reduced prevalence of cardiovascular diseases. Then longer-term studies are warranted.</p><p class="abstract"><strong>Keywords:</strong> Women, housewives, working, risk factors, lifestyle modification.</p

A multi-domain group-based intervention to promote physical activity, healthy nutrition and psychological wellbeing in older people with losses in intrinsic capacity: AMICOPE development study

The World Health Organization has developed the Integrated Care of Older People (ICOPE) strategy, a program based on the measurement of intrinsic capacity (IC) as 'the composite of all physical and mental attributes on which an individual can draw'. Multicomponent interventions appear to be the most effective approach to enhance IC and to prevent frailty and disability since adapted physical activity is the preventive intervention that has shown the most evidence in the treatment of frailty and risk of falls. Our paper describes the development of a multi-domain group-based intervention addressed to older people living in the community, aimed at improving and/or maintaining intrinsic capacity by means of promoting physical activity, healthy nutrition, and psychological wellbeing in older people. The process of intervention development is described following the Guidance for reporting intervention development studies in health research (GUIDED). The result of this study is the AMICOPE intervention (Aptitude Multi-domain group-based intervention to improve and/or maintain IC in Older PEople) built upon the ICOPE framework and described following the Template for Intervention Description and Replication (TIDieR) guidelines. The intervention consists of 12 face-to-face sessions held weekly for 2.5 h over three months and facilitated by a pair of health and social care professionals. This study represents the first stage of the UK Medical Research Council framework for developing and evaluating a complex intervention. The next step should be carrying out a feasibility study for the AMICOPE intervention and, at a later stage, assessing the effectiveness in a randomized controlled trial.This research was funded by the program POCTEFA (European Union) in the context of the APTITUDE project, reference EFA232/16. Nicolás Martínez-Velilla received funding from La Caixa Foundation (ID 100010434), under agreement LCF/PR/PR15/51100006

Nouvelles méthodes de mesure du risque médicamenteux en pharmacovigilance

TOULOUSE3-BU Sciences (315552104) / SudocPARIS-BIUP (751062107) / SudocSudocFranceF

Devenir à 30 jours suivant un passage aux urgences des patients âgés de plus de 75 ans, autonomes en provenance du domicile, selon qu'ils étaient repérés fragiles ou robustes

TOULOUSE3-BU Santé-Centrale (315552105) / SudocSudocFranceF

Hyperglycémies d’origine médicamenteuse : étude dans la Base Nationale Française de PharmacoVigilance (BNPV)

Objectifs. Analyser les médicaments à l’origine d’hyperglycémie en utilisant les notifications spontanées enregistrées dans la Base Nationale Française de PharmacoVigilance (BNPV). Méthodes. Nous avons inclus toutes les notifications d’hyperglycémie et/ou de diabète enregistrées dans la BNPV entre le 1er janvier 1985 et le 31 décembre 2008. Nous avons estimé le risque d’hyperglycémie associé aux médicaments selon la méthode de cas-non cas, les cas étant les notifications d’hyperglycémie et les non-cas toutes les autres observations d’effets indésirables hors hyperglycémie. Le risque a été estimé par le calcul du rapport de cote de notification : reporting odds ratio (ROR). Résultats. Durant cette période, 1219 notifications incluant l’effet indésirable «hyperglycémie et/ou diabète» ont été enregistrées dans la BNPV (0,34 % du total des notifications de la BNPV). Cet effet indésirable survient une fois sur quatre chez les diabétiques ou dans le cadre d’une infection à VIH. L’effet est «grave» dans près de 50 % des cas. Les médicaments associés à la plus forte augmentation du risque d’hyperglycémie ont été la méthylprednisolone [ROR = 43,5; IC 95 % (37,3–50,8)], le tacrolimus [ROR = 25; IC 95 % (17,9–34,8)], l’olanzapine [ROR = 19,9; IC 95 % (14,9–26,5)], la prednisone [ROR = 18,9; IC 95 % (15,7–22,8)] ou la pentamidine (ROR = 15,4; IC 95 % (8,2–28,3)]. Conclusion. Les classes médicamenteuses les plus fréquemment retrouvées dans la BNPV [selon la classification ATC (Anatomique-Thérapeutique-Chimique)] à l’origine d’hyperglycémie sont les antirétroviraux, les anti-inflammatoires stéroïdiens, les neuroleptiques de seconde génération, les immunosuppresseurs et les diurétiques

Impact of a personalised care plan for the elderly calling emergency medical services after a fall at home: The RISING-DOM multi-centre randomised controlled trial protocol

International audienceBackground: A growing number of emergency calls are made each year for elderly people who fall. Many of them are not taken to hospital or are rapidly discharged from the Emergency Department (ED). Evidence shows that, with no further support, this vulnerable population is particularly at risk of injuries, dependency and death. This study aims to determine the effectiveness of a comprehensive geriatric assessment and a tailored intervention in the elderly calling on an Emergency Medical Service (EMS) for a fall at home, but not conveyed to the ED or rapidly discharged from it (less than 24 h from hospitalisation), to the time to institutionalisation or death. Methods: Rising-Dom is a two-arm randomised (ratio 1:1), interventional, multi-centre and open study. Communitydwelling elderly people (≥ 70 years) who call an EMS for a fall at home are recruited. The intervention group receives home visits by a nurse with a comprehensive fall risk assessment and a personalised intervention care plan with a planned follow-up (six nurse home visits and five nurse phone calls). Subjects enrolled in the usual care-control group continue to receive their routine care for the prevention or treatment of diseases. Primary (time to institutionalisation or death) and secondary (unscheduled hospitalisations, additional EMS calls relating to falls, functional decline and quality of life) outcome data will be collected for both groups through five phone calls made by Clinical Research Associates (CRA) blind to the participants' group during the follow-up period (24-months). Twelve hospital centres in the SouthWest of France are participating in the study as study sites. The inclusion period started in October 2019 and will end in March 2022. By the end of this period, 1,190 subjects are expected to be enrolled. Discussion: Studies on elderly home falls have rarely concerned people who were not taken to hospital. The Rising-Dom intervention scheme should enhance understanding of features related to this vulnerable population and investigate the impact of a nurse care at home on delaying death and institutionalisation