Selbstmanagementförderung bei chronischer Krankheit für Menschen mit Migrationshintergrund – ein Gruppenkurs mit Peer-Ansatz als Beitrag zu gesundheitlicher Chancengerechtigkeit

Ziel: Begrenzte Gesundheits- und Sprachkompetenz erschweren Menschen mit Migrationshintergrund (MmM) den Zugang zu Gesundheitsinformationen und -versorgung, gerade bei chronischer Krankheit. Bei der Einführung eines Peer-geleiteten Stanford Selbstmanagementkurses bei chronischer Krankheit wurde in der Schweiz großes Interesse und hohe Motivation von MmM beobachtet. Daher wurde eruiert, ob das Kursprogramm auf Deutsch bei moderaten Sprachkenntnissen umsetzbar ist.

Methodik: Dies ist der explorative Teil der Begleitstudie zur Einführung des Stanford Programms in der Schweiz und im deutschsprachigen Europa. Angelehnt an Prinzipien der Grounded Theory wurden leitfadengestützte Fokusgruppen- und Einzelinterviews mit Kursteilnehmerinnen, -leiterinnen und -koordination (n=30) geführt, die thematisch ausgewertet wurden. Im Fokus der Datenerhebung standen die Durchführbarkeit, Zufriedenheit und Kursinhalte.

Ergebnisse: Der Kurs stößt bei MmM auf positive Resonanz und scheint auf Deutsch prinzipiell durchführbar zu sein, hohe Alltagsrelevanz zu haben sowie Impulse zur Integration zu setzen.

Schlussfolgerung: Zu prüfen ist ein weiterer Anpassungsbedarf auf den Migrationskontext, um den Kurs vulnerablen Gruppen besser zugänglich zu machen.

[Correction: Chronic Disease Self-management Support for People with a Migrant Background: towards a Peer-led Group Program to Improve Equity in Health]

Zanoni S, Gabriel E, Salis Gross C, Deppeler M, Haslbeck J. Selbstmanagementförderung bei chronischer Krankheit für Menschen mit Migrationshintergrund – ein Gruppenkurs mit Peer-Ansatz als Beitrag zu gesundheitlicher Chancengerechtigkeit. Gesundheitswesen 2016;

Bei diesem Beitrag wurde der engl. Titel korrigiert. Korrekt ist: Chronic Disease Self-management Support for People with a Migrant Background: towards a Peer-led Group Program to Improve Equity in Health

Lipid risk factors among elderly with normal fasting glucose, impaired fasting glucose and type 2 diabetes mellitus. The Italian longitudinal study on aging

BACKGROUND AND AIMS

Three groups of subjects were identified within a representative sample of older Italians: subjects with normal fasting glucose (NFG), with impaired fasting glucose (IFG) or with type 2 diabetes mellitus (T2D). The aim of the present study was to evaluate the relationship among plasma lipids, lipoproteins, other metabolic factors in the three groups, and their role in predicting total fatal events.

METHODS AND RESULTS

2422 subjects, aged 65-84 years, taking part into the Italian Longitudinal Study on Aging were included in the analyses. Factor analysis was conducted separately for men and women. Factor scores were used as independent variables in Cox Proportional Hazard models, to determine factors predicting death at the follow-up in NFG, IFG and T2D subjects. Four major factors were found for men ("insulin resistance", "body size", "total cholesterol", "HDL cholesterol") and four also for women ("insulin resistance", "total cholesterol", "body size", "HDL cholesterol"). For NFG and IFG men, and for both T2D men and women, the "HDL cholesterol" was a significant protective factor for total deaths (NFG men: HR = 0.79, 95% CI 0.67-0.93; IFG men: HR = 0.59, 95% CI 0.45-0.79; T2D men: HR = 0.55, 95% CI 0.34-0.89; T2D women: HR = 0.61, 95% CI 0.44-0.86). Among NFG women, the "body size" factor was also a protective factor with respect to total deaths (HR = 0.74, 95% CI 0.57-0.95).

CONCLUSION

A factor including HDL Cholesterol and Apo A-I showed protection against all-cause mortality in older men, independently from the glycemia level, and in women only in those diagnosed with T2D.

Plasma lipids and inflammation in active inflammatory bowel diseases

BACKGROUND

Ulcerative colitis (UC) and Crohn's disease (CD) can cause metabolic and inflammatory alterations.

AIM

To evaluate the relationships between inflammatory parameters, plasma lipids and phospholipid fatty acid (FA) composition in patients with active UC and CD.

METHODS

Diet, the Harvey-Bradshaw Activity Index (HBAI), inflammatory parameters, lipoproteins and FA composition were assessed in 60 CD and 34 UC.

RESULTS

No differences in clinical parameters were observed in the two groups. Total cholesterol correlated inversely with the number of bowel movements in both groups and directly with BMI in UC. Arachidonic acid correlated inversely with HBAI in UC and total and HDL cholesterol were inversely related to C-reactive protein (CRP) in CD while HDL correlated with CRP in UC. Docosapentaenoic acid was the only polyunsaturated n-3 FA that was correlated to CRP in both groups. Total cholesterol was independently associated in the multiple regression analysis with the number of bowel movements and systemic inflammation.

CONCLUSIONS

Total and LDL cholesterol were lower in the active UC and CD than in the healthy subjects and were correlated with the systemic inflammatory status. Phospholipid FA composition was correlated to the systemic inflammatory status, but was unrelated to dietary intake and intestinal disease activity.

High-performance anion-exchange chromatography coupled with pulsed amperometric detection and capillary zone electrophoresis with indirect ultra violet detection as powerful tools to evaluate prebiotic properties of fructooligosaccharides and inulin

Fructooligosaccharides (FOS) and inulin are food grade non-digestible carbohydrates that exert beneficial nutritional effect. This paper describes the suitability of high-performance anion-exchange chromatography coupled with pulsed amperometric detection (HPAEC-PAD) and capillary zone electrophoresis (CZE) to evaluate fermentation properties of FOS and inulin in pure Bifidobacterium cultures; and to study their effects on faecal cultures (microbial population and short-chain fatty acids). Prebiotic effectiveness of FOS and inulin of different degrees of polymerization was evaluated monitoring the changes in their molecular weight distribution during the in vitro growth of selected Bifidobacterium strains. The qualitative analysis of the residual soluble oligosaccharides or polysaccharides from Raftilose Synergy, Raftiline HP and Raftilose P95 was carried out by HPAEC-PAD, using a CarboPac PA 100 column and an appositely optimized gradient elution program. Under the optimized gradient elution conditions, glucose, fructose, sucrose were resolved from each other and from fructans with a DP ranging from 3 (1-kestose) to 60. The chromatographic profiles of the spent broths pointed out that almost every strain presented a different capability to ferment fructan chains of variable DP, indicating wide strain to strain differences. To explore the prebiotic effect of FOS and inulin, related to of short chain fatty acids (SCFAs) accumulation in faecal cultures due to fermentative metabolism of intestinal microflora, analysis of SCFAs, acetic and lactic acid was achieved by co-electroosmotic capillary electrophoresis, where the electrophoretic mobility of the anionic analytes and electroosmotic flow (EOF) were similarly directed. Moreover, the use of UV detection for the analyses of our organic anions required a running electrolyte which allowed indirect detection. The optimization of the capillary electrophoretic conditions was carried out by applying a chemometric study based on the use of the experimental design, the effects of three parameters, i.e. temperature, voltage and percentage of methanol added to the background electrolyte were investigated.