9 research outputs found
How to perform better intervention to prevent and control diabetic retinopathy among patients with type 2 diabetes
This meta-analysis of randomized controlled trials (RCTs) aims to investigate how to perform better interventions targeting modifiable risk factors of diabetic retinopathy (DR) to
prevent and control DR in patients with type 2 diabetes by comparing different intervention
types and follow-up intervals. Literature published before June 1st, 2019 were searched on
Pubmed, Embase and ScienceDirect. RCTs targeting modifiable risk factors of DR (including
blood glucose, blood pressure, lipid, dietary, physical activity and smoking) were selected
by two reviewers and double checked for accuracy. Random effects models were estimated
to calculate pooled Odds Ratios (OR). Twenty-two RCTs (n = 22,511) were included. In general, interventions targeting modifiable risk factor of DR reduced the risk of developing DR
(I
2 = 26.7%; OR = 0.60; 95% CI 0.45 to 0.79) and DR worsening (I
2 = 0.0%; OR = 0.62; 95% CI 0.47
to 0.80; P < 0.001). Multifactorial interventions had better effect on reducing the risk of
development and progression of DR in comparison with other interventions, while only
blood-pressure-control interventions showed significant effect on slowing down DR worsening. Additionally, interventions with follow-up >5 years had better effect on reduction of
DR development, and interventions with follow-up >2 years had better effect on reducing
the risk of DR worsenin
Processes and coastal dynamics in the Ensenada de Marbella: recent morphosedimentary evolution
La Ensenada de Marbella ha experimentado en las últimas décadas cambios físicos y socio-económicos
sustanciales debidos fundamentalmente a una transformación en el modelo económico y un desarrollo acusado del
turismo residencial y todos los impactos en los usos del suelo relacionado con ello. Sin embargo, las causas de la
alteración de la dinámica litoral también hay que buscarlas en cambios en la morfología del nearshore y en la dinámica
sedimentaria. Para analizar la morfodinámica de la ensenada en varios escenarios temporales, simulaciones de oleaje
sobre batimetrías del 1888 y actuales revelan cambios importantes en los patrones dispersión de la energía y el
funcionamiento de la bahía a través de complejas células litorales de transporte. El análisis de los procesos dinámicos en
la zona del nearshore y el estudio volumétrico a través de modelos de batimetrías secuenciales muestran como dichos
cambios morfológicos de los fondos costeros pueden o no estar relacionados con cambios a largo plazo en la línea de
costa, y por tanto ser co-responsables de los procesos de erosión y acreción acelerados evidentes a lo largo de la
Ensenada
Longitudinal Association Between Physical Activity and Frailty Among Community-Dwelling Older Adults
OBJECTIVES: To examine the longitudinal association between frequency of moderate physical activity (PA) and overall, physical, psychological, and social frailty among community-dwelling older adults older than 70 years. Second, we assessed the association between a 12-month change in frequency of moderate PA and frailty. DESIGN: Longitudinal cohort study. SETTING: Community settings in Spain, Greece, Croatia, the Netherlands, and the United Kingdom. PARTICIPANTS: A total of 1735 participants (61.1% female; mean age = 79.6 years; SD = 5.5 years). MEASUREMENTS: The frequency of self-reported moderate PA was measured and classified into two categories: “regular frequency” and “low frequency.” The 12-month change in frequency of moderate PA between baseline and follow-up was classified into four categories: “continued regular frequency,” “decreased frequency,” “continued low frequency,” and “increased frequency.” The 15-item Tilburg Frailty Indicato
Evaluation design of the Social Engagement Framework for Addressing the Chronic-disease-challenge (SEFAC)
Background: The Social Engagement Framework for Addressing the Chronic-disease-challenge (SEFAC) project
intends to empower citizens at risk of or with type 2 diabetes (T2DM) and/or cardiovascular disease (CVD) to selfmanage their chronic conditions through the SEFAC intervention. The intervention combines the concepts of
mindfulness, social engagement and information and communication technology support, in order to reduce the
burden of citizens with chronic conditions and to increase the sustainability of the health system in four European
countries.
Methods: A prospective cohort study with a 6-month pre-post design will be conducted in four European countries:
Croatia, Italy, the Netherlands and the United Kingdom. A total of 360 community-dwelling citizens ≥50 years of age
will be recruited; 200 citizens at risk of T2DM and/or CVD in the next 10 years (50 participants in each country) and 160
citizens with T2DM and/or CVD (40 participants in each country). Effects of the intervention in terms of selfmanagement, healthy lifestyle behavior, social support, stress, depression, sleep and fatigue, adherence to
medications and health-related quality of life will be assessed. In addition, a preliminary cost-effectiveness
analysis will be performed from a societal and healthcare perspective.
Discussion: The SEFAC project will further elucidate whether the SEFAC intervention is feasible and (cost-)
effective among citizens at risk of and suffering from T2DM and/or CVD in different settings.
Trial registration: ISRCTN registry number is ISRCTN11248135
Healthy Ageing: Health Promotion for People with Frailty and Chronic Conditions
In dit proefschrift hebben we gezondheidsbevordering bij mensen met kwetsbare en chronische aandoeningen bestudeerd om inzicht te krijgen in en richting te geven aan het ontwikkelen van gezondheidsbevordering ter ondersteuning van gezond ouder worden van ouderen. Toekomstig onderzoek naar de ontwikkeling en effecten van interventies bevelen we aan om mensen op jongere leeftijd te includeren om kwetsbaarheid op latere leeftijd te voorkomen en om gezond ouder worden te bevorderen. Doorlopende ondersteuning kan belangrijk zijn voor de preventie en een beter beheer van kwetsbare en chronische aandoeningen. We raden aan om strategieën te ontwikkelen om de duurzaamheid van nieuw ontwikkelde (effectieve) benaderingen mogelijk te maken
Factors associated with physical, psychological and social frailty among community-dwelling older persons in Europe
Background: Frailty is an age-related condition resulting in a state of increased vulnerability regarding functioning across multiple systems. It is a multidimensional concept referring to physical, psychological and social domains. The purpose of this study is to identify factors (demographic characteristics, lifestyle factors and health indicators) associated with overall frailty and physical, psychological and social frailty in community-dwelling older p
Longitudinal association between physical activity and health-related quality of life among community-dwelling older adults
Background: Physical activity (PA) may play a key role in healthy aging and thus in promoting health-related quality of life (HRQoL). However, longitudinal studies on the association between PA and HRQoL are still scarce and have shown inconsistent results. In this study, we aimed to examine the longitudinal association between frequency of moderate PA and physical and mental HRQoL. Secondly, to assess the association between a 12-month change in frequency of moderate PA and HRQoL. Methods: A 12-month longitudinal study was conducted in Spain, Greece, Croatia, the Netherlands, and the United Kingdom with 1614 participants (61.0% female; mean age = 79.8; SD = 5.2) included in the analyses. Two categories of the self-reported frequency of moderate PA including 1) ‘regular frequency’ and 2) ‘low frequency’ were classified, and four categories of the change in frequency of moderate PA between baseline and follow-up including 1) ‘continued regular frequency’, 2) ‘decreased frequency’, 3) ‘continued low frequency’ and 4) ‘increased frequency’ were identified. Physical and mental HRQoL were assessed by the 12-Item Short-Form Health Survey (SF-12). Results: The frequency of moderate PA at baseline was positively associated with HRQoL at follow-up. Participants with a continued regular frequency had the highest HRQoL at baseline and follow-up. Participants who increased the frequency of moderate PA from low to regular had better physical and mental HRQoL at follow-up than themselves at baseline. After controlling for baseline HRQoL and covariates, compared with participants who continued a regular frequency, participants who decreased their frequency had significantly lower physical (B = -4.42; P <.001) and mental (B = -3.95; P <.001) HRQoL at follow-up; participants who continued a low frequency also had significantly lower physical (B = -5.45; P <.001) and mental (B = -4.10; P <.001) HRQoL at follow-up. The follow-up HRQoL of participants who increased their frequency was similar to those who continued a regular frequency. Conclusions: Maintaining or increasing to a regular frequency of PA are associated with maintaining or improving physical and mental HRQoL. Our findings support the development of health promotion and long-term care strategies to encourage older adults to maintain a regular frequency of PA to promote their HRQoL.</p
Longitudinal association between physical activity and frailty among community-dwelling older adults
OBJECTIVES: To examine the longitudinal association between frequency of moderate physical activity (PA) and overall, physical, psychological, and social frailty among community-dwelling older adults older than 70 years. Second, we assessed the association between a 12-month change in frequency of moderate PA and frailty. DESIGN: Longitudinal cohort study. SETTING: Community settings in Spain, Greece, Croatia, the Netherlands, and the United Kingdom. PARTICIPANTS: A total of 1735 participants (61.1% female; mean age = 79.6 years; SD = 5.5 years). MEASUREMENTS: The frequency of self-reported moderate PA was measured and classified into two categories: “regular frequency” and “low frequency.” The 12-month