Comorbid diabetes and depression:Do E-health treatments achieve better diabetes control?

Research in the field of comorbid depression in diabetes shows that the optimum treatment to attain better diabetes disease control is still undecided. Although several treatment models are effective and available, interventions aimed at improving disease control, such as glycemic control, are less effective, with moderate evidence for pharmacological treatment and a lot of evidence for psychotherapy in combination with self-management techniques. New developments such as M-health and E-health are much less effective and show much less effect in terms of glycemic control than earlier developed, face-to-face psychotherapeutic treatments, and demonstrate higher mortality rates in patients with diabetes mellitus or with multimorbidity, which gives reason for caution in the evaluation, testing and implementation of E-health and M-health models in patients with diabetes and depression. Further research into blended E-health models, in which the clinical diagnostic and treatment evaluation is strongly embedded, and with a focus not only on depression treatment, but also on diabetes control and taking mortality into account as outcome, is neede

The effect of exercise on cancer-related fatigue in cancer survivors : a systematic review and meta-analysis

Objective: The objective of the study was to conduct systematic review and meta-analysis to establish the effect of exercise interventions on cancer-related fatigue (CRF) in cancer survivors, compared to non-exercise intervention controls.Methods: Trials published between January 1st 2000 and August 17th 2016 were included through PubMed database search and search of references. Eligible trials compared the effect of an exercise intervention on CRF compared to non-exercise intervention controls, with CRF as primary outcome and measured by validated self-report questionnaire, in cancer survivors not receiving palliative care. We evaluated risk of bias of individual trials following Cochrane Quality criteria. We performed a random-effects meta-analysis in the low risk of bias trials with intervention type, exercise intensity, adherence, and cancer type as moderators, and also performed meta-regression analyses and a sensitivity analysis including the high risk of bias trials.Results: Out of 274 trials, 11 met the inclusion criteria, of which six had low risk of bias. Exercise improved CRF with large effect size (Cohen’s d 0.605, 95% CI 0.235–0.975) with no significant difference between types of cancer. Aerobic exercise (Δ=1.009, CI 0.222–1.797) showed a significantly greater effect than a combination of aerobic and resistance exercises (Δ=0.341, CI 0.129–0.552). Moderator and meta-regression analyses showed high adherence yielding best improvements.Conclusion: Exercise has a large effect on CRF in cancer survivors. Aerobic interventions with high adherence have the best result