Chinese Health Improvement Profile for people with severe mental illness: A cluster-randomized, controlled trial

© 2017 Australian College of Mental Health Nurses Inc. The aim of the present study was to establish the feasibility of conducting a full-scale trial and to estimate the preliminary effect of a Chinese Health Improvement Profile (CHIP) intervention on self-reported physical well-being of people with severe mental illness (SMI). The study used a parallel-group, open-label, cluster-randomized, controlled trial (RCT) design. Twelve community psychiatric nurses (CPN) and their corresponding 137 patients with SMI were randomized into the CHIP or treatment-as-usual (TAU) groups. After training, the CPN completed the CHIP at baseline and 12 months, and the findings were used to devise an individualized care plan to promote health behaviour change. Patients were assessed at baseline and 6 and 12 months after starting the intervention. There was an observed positive trend of improvement on the physical component subscale of SF12v2 in the CHIP group compared to the TAU group after 12 months, but the difference did not reach statistical significance (P = 0.138). The mental component subscale showed a similar positive trend (P = 0.077). CHIP participants were more satisfied with their physical health care than TAU patients (P = 0.009), and the CPN were positive about the usefulness/acceptability of the intervention. There were significant within-group improvements in the total numbers of physical health risks, as indicated by the CHIP items (P = 0.005). The findings suggest that it is feasible to conduct a full-scale RCT of the CHIP in future. The CHIP is an intervention that can be used within routine CPN practice, and could result in small–modest improvements in the physical well-being of people with SMI

Representaciones cognitivas de la diabetes y su papel en el control metabólico y la salud: cuando la visión positiva de la enfermedad protege

A positive cognitive illness representation (CIR) of diabetes is associated with better metabolic control and health. The aims of this research were to assess CIR with a newly developed Spanish scale – the ERCE – and to predict metabolic control, health outcomes, and psychological distress. One hundred and fifty-two Type 1 diabetic patients were all administered the ERCE, the MOS SF-36, the PANAS, and the HADS scales. Data on glycated hemoglobin (HbA1c) were also collected. Scores on the ERCE led to the creation of two profiles (+/- CIR) by clustering the scores. After patients were grouped, multiple hierarchical regressions were performed. A negative view of diabetes (negative CIR) was associated with poor health outcomes. The ERCE scale demonstrated acceptable psychometric guarantees and validity evidences for being used in clinical contexts. This new instrument allows educators to adjust treatment to each individual, which leads to a more efficient and better support for people with diabetes in Spain.Una representación cognitiva de la enfermedad (RCE) positiva se asocia con mejor control metabólico y mayor salud en diabetes. Los objetivos fueron evaluar la RCE con una nueva escala –la ERCE– y predecir el control metabólico, los indicadores de salud y el malestar psicológico en 152 pacientes diabéticos tipo 1. Se administraron la escala ERCE, la MOS SF-36, la PANAS y la HADS. Se recogió también la hemoglobina glicosilada (HbA1c). Mediante un análisis de clusters con las puntuaciones de la ERCE, se crearon dos perfiles (+/-RCE). El análisis de regresión jerárquico mostró que una visión negativa de la diabetes (RCE negativa) se asoció con peor estado de salud. La ERCE demostró garantías psicométricas y evidencias de validez aceptables, que justifican su uso en contextos clínicos. Este instrumento permite a los educadores evaluar la RCE y ajustar el tratamiento, lo que conduce a una asistencia más eficiente para las personas con diabetes en España

Navigating Challenges in the Endovascular Treatment of Asymptomatic Aortoiliac Aneurysms: A 10-Year Comparative Analysis

Background: Treating an abdominal aortoiliac aneurysm (AAIA) with endovascular methods can be challenging when the internal iliac artery (IIA) is involved. Embolizing the IIA and extending the limb to the external iliac artery (IIAE + EE) to prevent a type 2 endoleak may lead to pelvic ischemic complications. To avoid these complications, strategies that preserve the IIA, such as the bell-bottom technique (BBT) and the iliac branch device (IBD), have been proposed. This study aims to compare the outcomes of these three endovascular approaches for AAIA. Methods: Between January 2010 and December 2019, 174 patients with asymptomatic AAIA were enrolled in this retrospective analysis. They were divided into two groups: 81 patients underwent non-IIAE procedures, and 93 patients underwent IIAE procedures. The iliac limb study group consisted of 106 limbs treated with the BBT, 113 limbs treated with the IIAE + EE, and 32 limbs treated with the IBD. The primary outcomes included the 30-day mortality rate and intraoperative limb complications. The secondary outcomes included postoperative pelvic ischemia, freedom from reintervention, and the overall 10-year survival rate. Results: There was no significant difference in the perioperative mortality rate between the non-IIAE group (0%) and the IIAE group (2.1%), p = 0.500. The intraoperative limb complications did not differ significantly between the BBT limbs (7.5%), the IIAE + EE limbs (3.5%), and the IBD limbs (3.1%) groups, p = 0.349. The incidence of buttock claudication was significantly greater in the bilateral IIAE + EE group compared to the unilateral IIAE + EE and non-IIAE groups (25%, 11%, and 2.5%, p-value p p = 0.016). There was no significant difference in the overall 10-year survival rate between the non-IIAE and IIAE groups (51.4% vs. 55.9%, p = 0.703). Conclusions: The early and late mortality rates were similar between the non-IIAE and IIAE groups. Preserving the IIA is recommended to avoid pelvic ischemic complications. Considering the higher rate of reintervention in the BBT group, the IBD strategy may be preferred for AAIA