Analysis of Effectiveness and Psychological Techniques Implemented in mHealth Solutions for Middle-Aged and Elderly Adults with Type 2 Diabetes : A Narrative Review of the Literature

Background: in diabetes, multiple mHealth solutions were produced and implemented for self-management behaviors. However, little research on the effectiveness of psychological techniques implemented within these mHealth solutions was carried out, and even less with the elderly population where technological barriers might exist. Reliable evidence generated through a comprehensive evaluation of mHealth interventions may accelerate its growth for successful long-term implementation and to help to experience mHealth benefits in an enhanced way in all ages. Objective: this study aimed to review mHealth solutions for diabetes self-management in older adults (adherence to treatments and glycemic control) by analyzing the effectiveness of specific psychological techniques implemented. Methods: a narrative review was conducted following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. PubMed (Medline) and American Psychological Association (APA) PsycInfo databases were searched for published papers that addressed eHealth solutions' effectiveness for diabetes self-management. Studies in English, Spanish, and/or German of any design were screened, with no time constraints regarding the year of publication. A qualitative analysis of the selected papers was conducted in several steps. Results: this review found 38 studies setting up and analyzing mHealth solutions for older adults. Most research showed improvements in HbA1c, self-management behaviors, and medication adherence in T2DM patients post intervention. However, different mid-to-long term effects were found across studies, specifically concerning the maintenance and adherence to healthy behaviors. The most employed psychological framework was CBT, including techniques such as self-monitoring of outcome behaviors (mostly targeting glycemia measurements and healthy habits as physical activity and/or diet), tailored motivational feedback from medical staff, and psychoeducation or health coaches. The most successful mHealth intervention combined the feature of tailored feedback messages, interactive communication with healthcare professionals, and multifaceted functions. Conclusions: there is a lack of elaborate and detailed information in the literature regarding the factors considered in the design and development of mHealth solutions used as interventions for T2DM self-management in the elderly. Documentation and inclusion of such vital information will foster a transparent and shared decision-making process that will ultimately lead to the development of useful and user-friendly self-management apps that can enhance the quality of life for diabetes patients. Further research adapting mHealth solutions to older adults' sensory deficits is necessary

Virtual self-conversation using motivational interviewing techniques to promote healthy eating and physical activity : A usability study

We aim to examine the usability of a Virtual Reality (VR) platform, called ConVRSelf, which has been designed to address the needs of People Living With Obesity (PLWO). Fourteen participants with a desire to eat healthier and exercise more (6 normal weight and 8 PLWO; Mean age = 41.86, SD = 13.89) were assigned to the experimental group (EG) or the control group (CG). EG participants, after being trained on motivational interviewing skills, engaged in a virtual self-conversation using embodiment and body swapping techniques, which aimed to normalize and resolve their ambivalence to change lifestyle habits. CG participants, embodied in their virtual bodies, participated in a pre-established discourse with a virtual counselor giving them psychoeducational advice about how to change lifestyle habits. A mixed-methods design was used, involving a semi-structured interview and self-report questionnaires, including readiness to change habits (Readiness Rulers), body ownership (Body Ownership Questionnaire, BOQ), and system usability (System Evaluation Questionnaire, SEQ). Thematic content analysis was carried out for qualitative data while statistical data analysis was carried out using SPSS 20.0. Participants from both groups showed high readiness to change lifestyle (Readiness Rulers) before engaging with the virtual experiences, which was maintained at the same level after the interventions and their scores on the SEQ and BOQ were satisfactory. Regarding qualitative information obtained from the interviews, almost all participants found the VR experience to be novel, interesting, and enjoyable. A higher acceptability was observed among PLWO from the EG than normal weight participants from the same group, a promising finding for the ConVRSelf platform, which had been specifically designed to address the needs of PLWO. The ConVRSelf system is well-accepted by participants and is ready to be tested with PLWO in a clinical setting

The Gaze Fixation Assessed by Microperimetry: A Useful Tool for the Monitoring of the Cognitive Function in Patients with Type 2 Diabetes

Cognitive impairment; Retinal microperimetry; Type 2 diabetesDeterioro cognitivo; Microperimetría retiniana; Diabetes tipo 2Deteriorament cognitiu; Microperimetria retiniana; Diabetis tipus 2Current guidelines recommend annual screening for cognitive impairment in patients > 65 years with type 2 diabetes (T2D). The most used tool is the mini-mental state evaluation (MMSE). Retinal microperimetry is useful for detecting cognitive impairment in these patients, but there is no information regarding its usefulness as a monitoring tool. We aimed to explore the role of retinal microperimetry in the annual follow-up of the cognitive function of patients with T2D older than 65 years. Materials and Methods: Prospective observational study, comprising patients > 65 years with T2D, attended at our center between March–October 2019. A complete neuropsychological evaluation assessed the baseline cognitive status (mild cognitive impairment, MCI, or normal, NC). Retinal microperimetry (sensitivity, gaze fixation) and MMSE were performed at baseline and after 12 months. Results: Fifty-nine patients with MCI and 22 NC were identified. A significant decline in the MMSE score was observed after 12 months in the MCI group (25.74 ± 0.9 vs. 24.71 ± 1.4; p = 0.001). While no significant changes in retinal sensitivity were seen, all gaze-fixation parameters worsened at 12 months and significantly correlated with a decrease in the MMSE scores. Conclusion: Retinal microperimetry is useful for the monitoring of cognitive decline in patients > 65 years with T2D. Gaze fixation seems a more sensitive parameter for follow-up after 12 months than retinal sensitivity.This study was supported by grants from the Instituto de Salud Carlos III (Fondo de Investigación Sanitaria, PI20/01703). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

The Gaze Fixation Assessed by Microperimetry : A Useful Tool for the Monitoring of the Cognitive Function in Patients with Type 2 Diabetes

Current guidelines recommend annual screening for cognitive impairment in patients > 65 years with type 2 diabetes (T2D). The most used tool is the mini-mental state evaluation (MMSE). Retinal microperimetry is useful for detecting cognitive impairment in these patients, but there is no information regarding its usefulness as a monitoring tool. We aimed to explore the role of retinal microperimetry in the annual follow-up of the cognitive function of patients with T2D older than 65 years. Materials and Methods: Prospective observational study, comprising patients > 65 years with T2D, attended at our center between March-October 2019. A complete neuropsychological evaluation assessed the baseline cognitive status (mild cognitive impairment, MCI, or normal, NC). Retinal microperimetry (sensitivity, gaze fixation) and MMSE were performed at baseline and after 12 months. Results: Fifty-nine patients with MCI and 22 NC were identified. A significant decline in the MMSE score was observed after 12 months in the MCI group (25.74 ± 0.9 vs. 24.71 ± 1.4; p = 0.001). While no significant changes in retinal sensitivity were seen, all gaze-fixation parameters worsened at 12 months and significantly correlated with a decrease in the MMSE scores. Conclusion: Retinal microperimetry is useful for the monitoring of cognitive decline in patients > 65 years with T2D. Gaze fixation seems a more sensitive parameter for follow-up after 12 months than retinal sensitivity

Relación entre déficits lingüísticos y atencionales en personas con afasia post-ictus: el papel de la modulación colinérgica

Objetivos: (1) Estudiar la prevalencia de déficits atencionales en personas con afasia crónica post-ictus (PACPI); (2) evaluar si la modulación del sistema colinérgico, con donepecilo, tiene efectos favorables sobre los déficits atencionales y de lenguaje en PACPI; (3) comparar estos efectos con los producidos por la modulación glutamatérgica con memantina; (4) estudiar los correlatos neurales de estas intervenciones. Método: 3 sub-estudios: (1) Comparamos el rendimiento de 55 PACPI con 25 controles sanos en tareas atencionales. (2) Ensayo clínico (20 semanas) aleatorizado, doble ciego y controlado con placebo de 13 PACPI tratados con donepezilo (10mg/día). (3) Ensayo clínico abierto de 10 PACPI tratados con donepezilo (10 mg/día; 8 semanas) y 14 PACPI tratados con memantina (20 mg/día; 16 semanas). Evaluación del lenguaje: Cociente de Afasia de la Western Aphasia Battery, Denominación por Frecuencia de la Evaluación del Procesamiento Psicolingüístico de la Afasia (EPLA 52). Medida de atención: California Computerized Assessment Package (CalCAP). Neuroimagen: 18FDG-PET y RMN funcional con un paradigma de denominación. Resultados (1) Los PACPI tienen peor rendimiento en tareas atencionales (CalCAP; t-test, p<0.05) que los controles. (2) La modulación del sistema colinérgico tiene efectos positivos en medidas de atención, y éstas correlacionan con mejor rendimiento en tareas de denominación (EPLA 52; Pearson's r, p<0.01). 3) Las PACPI que responden al tratamiento con donepecilo mejoran más que las que responden al tratamiento con memantina. La mejoría en denominación correlacionó (Pearson's r, p<0.01) con cambios en el metabolismo (18FDG-PET) y activación (fMRI) de áreas cerebrales inervadas por el sistema colinérgico. Conclusiones (1)Los déficits atencionales son frecuentes entre las PACPI, y éstos se relacionan con peor rendimiento en denominación. (2) El donepecilo tiene efectos positivos sobre los déficits atencionales y de denominación en PACPI.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

One-year longitudinal association between changes in dietary choline or betaine intake and cardiometabolic variables in the PREvención con DIeta MEDiterránea-Plus (PREDIMED-Plus) trial

Choline and betaine intakes have been related to cardiovascular health. We aimed to explore the relation between 1-y changes in dietary intake of choline or betaine and 1-y changes in cardiometabolic and renal function traits within the frame of the PREDIMED (PREvención con DIeta MEDiterránea)-Plus trial. We used baseline and 1-y follow-up data from 5613 participants (48.2% female and 51.8% male; mean ± SD age: 65.01 ± 4.91 y) to assess cardiometabolic traits, and 3367 participants to assess renal function, of the Spanish PREDIMED-Plus trial. Participants met ≥3 criteria of metabolic syndrome and had overweight or obesity [BMI (in kg/m 2) ≥27 and ≤40]. These criteria were similar to those of the PREDIMED parent study. Dietary intakes of choline and betaine were estimated from the FFQ. The greatest 1-y increase in dietary choline or betaine intake (quartile 4) was associated with improved serum glucose concentrations (−3.39 and −2.72 mg/dL for choline and betaine, respectively) and HbA1c levels (−0.10% for quartile 4 of either choline or betaine intake increase). Other significant changes associated with the greatest increase in choline or betaine intake were reduced body weight (−2.93 and −2.78 kg, respectively), BMI (−1.05 and −0.99, respectively), waist circumference (−3.37 and −3.26 cm, respectively), total cholesterol (−4.74 and −4.52 mg/dL, respectively), and LDL cholesterol (−4.30 and −4.16 mg/dL, respectively). Urine creatinine was reduced in quartile 4 of 1-y increase in choline or betaine intake (−5.42 and −5.74 mg/dL, respectively). Increases in dietary choline or betaine intakes were longitudinally related to improvements in cardiometabolic parameters. Markers of renal function were also slightly improved, and they require further investigation. This trial was registered at as ISRCTN89898870

The Fifteenth Data Release of the Sloan Digital Sky Surveys: First Release of MaNGA-derived Quantities, Data Visualization Tools, and Stellar Library

Twenty years have passed since first light for the Sloan Digital Sky Survey (SDSS). Here, we release data taken by the fourth phase of SDSS (SDSS-IV) across its first three years of operation (2014 July–2017 July). This is the third data release for SDSS-IV, and the 15th from SDSS (Data Release Fifteen; DR15). New data come from MaNGA—we release 4824 data cubes, as well as the first stellar spectra in the MaNGA Stellar Library (MaStar), the first set of survey-supported analysis products (e.g., stellar and gas kinematics, emission-line and other maps) from the MaNGA Data Analysis Pipeline, and a new data visualization and access tool we call "Marvin." The next data release, DR16, will include new data from both APOGEE-2 and eBOSS; those surveys release no new data here, but we document updates and corrections to their data processing pipelines. The release is cumulative; it also includes the most recent reductions and calibrations of all data taken by SDSS since first light. In this paper, we describe the location and format of the data and tools and cite technical references describing how it was obtained and processed. The SDSS website (www.sdss.org) has also been updated, providing links to data downloads, tutorials, and examples of data use. Although SDSS-IV will continue to collect astronomical data until 2020, and will be followed by SDSS-V (2020–2025), we end this paper by describing plans to ensure the sustainability of the SDSS data archive for many years beyond the collection of data

The Fifteenth Data Release of the Sloan Digital Sky Surveys: First Release of MaNGA-derived Quantities, Data Visualization Tools, and Stellar Library

Twenty years have passed since first light for the Sloan Digital Sky Survey (SDSS). Here, we release data taken by the fourth phase of SDSS (SDSS-IV) across its first three years of operation (2014 July–2017 July). This is the third data release for SDSS-IV, and the 15th from SDSS (Data Release Fifteen; DR15). New data come from MaNGA—we release 4824 data cubes, as well as the first stellar spectra in the MaNGA Stellar Library (MaStar), the first set of survey-supported analysis products (e.g., stellar and gas kinematics, emission-line and other maps) from the MaNGA Data Analysis Pipeline, and a new data visualization and access tool we call "Marvin." The next data release, DR16, will include new data from both APOGEE-2 and eBOSS; those surveys release no new data here, but we document updates and corrections to their data processing pipelines. The release is cumulative; it also includes the most recent reductions and calibrations of all data taken by SDSS since first light. In this paper, we describe the location and format of the data and tools and cite technical references describing how it was obtained and processed. The SDSS website (www.sdss.org) has also been updated, providing links to data downloads, tutorials, and examples of data use. Although SDSS-IV will continue to collect astronomical data until 2020, and will be followed by SDSS-V (2020–2025), we end this paper by describing plans to ensure the sustainability of the SDSS data archive for many years beyond the collection of data

Neuropsicologia del llenguatge, setembre 2016

Recurs d'aprenentatge de la Universitat Oberta de Catalunya. Material publicat amb llicència Creative Commons passats 6 semestres des de la data de publicació.Recurso de aprendizaje de la Universitat Oberta de Catalunya. Material publicado con licencia Creative Commons pasados 6 semestres desde la fecha de publicación.Learning material of the Universitat Oberta de Catalunya. Material published under a Creative Commons license after 6 semesters from the date of publication