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Bonfrate L, Di Ciaula A, Khalil M, Farella I, Chirico R, Vilahur G, Portincasa P. Gender-dependent impact of COVID-19 lockdown on metabolic and psychological aspects. Intern Emerg Med 2023; 18:385-395. [PMID: 36703077 PMCID: PMC9879743 DOI: 10.1007/s11739-022-03173-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/06/2022] [Indexed: 01/28/2023]
Abstract
The first COVID-19 lockdown resulted in enforced quarantine of heavily affected areas with social isolation and related measures by several governments to slow the spread of the disease. The general population experienced several mental and lifestyle changes. Herein, we aimed to evaluate the metabolic and psychological effects induced by lifestyle changes during COVID-19 self-isolation among an Apulian overweight/obese cohort with metabolic disturbances. The study assessed anthropometric data (weight, abdominal circumferences), dietary habits (adherence to the Mediterranean diet, junk food score), lifestyle habits (i.e., smoking, and physical activity), levels of stress and anxiety, and depression. Subjects underwent bioumoral exams before and after self-isolation to monitor glycemic and lipid profiles. A total of 245 subjects (M:F = 118:127) have been included in the study. After lockdown, the number of obese subjects significantly increased in both sexes, and was higher in females than in males (P < 0.0001). Glycemic and lipid profiles worsened, with higher levels of insulinemia, lower levels of HDL cholesterol, and higher levels of triglycerides in females than in males. Adherence to the Mediterranean diet and consumption of junk foods were altered in both groups, especially in females. Psychological aspects were significantly higher in females than in males. Finally, work activities and familial status strongly affected the metabolic and psychological profile. In conclusion, COVID-19 self-isolation induced changes in lifestyle and dietary habits with psychological distress and detrimental effects on metabolic patterns, which were more pronounced in female gender.
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Affiliation(s)
- Leonilde Bonfrate
- Department of Biomedical Sciences and Human Oncology, Clinica Medica A. Murri, University of Bari Aldo Moro, 70124, Bari, Italy.
| | - Agostino Di Ciaula
- Department of Biomedical Sciences and Human Oncology, Clinica Medica A. Murri, University of Bari Aldo Moro, 70124, Bari, Italy
| | - Mohamad Khalil
- Department of Biomedical Sciences and Human Oncology, Clinica Medica A. Murri, University of Bari Aldo Moro, 70124, Bari, Italy
| | - Ilaria Farella
- Department of Biomedical Sciences and Human Oncology, Clinica Medica A. Murri, University of Bari Aldo Moro, 70124, Bari, Italy
| | - Roberta Chirico
- Department of Biomedical Sciences and Human Oncology, Clinica Medica A. Murri, University of Bari Aldo Moro, 70124, Bari, Italy
| | - Gemma Vilahur
- Research Institute, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
- CiberCV, Instituto Salud Carlos III, Barcelona, Spain
| | - Piero Portincasa
- Department of Biomedical Sciences and Human Oncology, Clinica Medica A. Murri, University of Bari Aldo Moro, 70124, Bari, Italy
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Korolchuk O, Vasiuk N, Klymkova I, Shvets D, Piddubnyi O. Current aspects of vaccination against Covid-19 under conditions of war in Ukraine: Problems and prospects. J Immunol Regen Med 2023:100072. [PMID: 36855659 PMCID: PMC9949896 DOI: 10.1016/j.regen.2023.100072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 02/25/2023]
Abstract
The pandemic of the coronavirus infection Covid-19, which spread around the world in 2020, changed the lives of millions of people and negatively affected the life and functioning conditions of all countries, people and nations without exception. With the emergence of the opportunity to be vaccinated against Covid-19, the problem of making a decision about vaccination also appeared. But recently, it has become increasingly clear that the coronavirus disease in the world is moving into the group of annual viral epidemic diseases that occur every year in different countries during the seasonal wave of acute respiratory viral infections. The ongoing Covid-19 pandemic against the background of the adoption of serious quarantine measures indicates the need for large-scale vaccination of the population as the most effective way to protect against Covid-19. In this article, we pay special attention to vaccination, as the main factor in ensuring health, reducing the morbidity and severity of the course of the Covid-19 disease, and an important task of the state and modern public administration. Plans regarding vaccination, under the conditions of the war in Ukraine, will not be implemented in full - this all the more requires attention to this issue.
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Affiliation(s)
- Olena Korolchuk
- Department of Health Sciences, Faculty of Health and Physical Education, Uzhhorod National Unіversity, 88000, 27 Mytna Str., Uzhhorod, Ukraine
| | - Nataliia Vasiuk
- Department of National Economy and Public Administration, Faculty of Economics and Management, Kyiv National Economic University Named After Vadym Hetman, 03057, 54/1 Peremogy Ave., Kyiv, Ukraine
| | - Iryna Klymkova
- Department of Philosophy and Social Diciplines, Interregional Academy of Personnel Management, 03039, 2 Frometivska Str., Kyiv, Ukraine
| | - Dmytro Shvets
- Odesa State University of Internal Affairs, 65014, 1 Uspenska Str., Odesa, Ukraine
| | - Oleksii Piddubnyi
- Department of Civil and Economic Law, National University of Life and Environmental Sciences of Ukraine, 03041, 15 Heroiv Oborony Str., Kyiv, Ukraine
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Machado EDM, Secchi LLB, Camargo PR, Mendonça LDM. Influence of quarantine during the coronavirus disease 2019 (COVID-19) pandemic on physical and psychosocial aspects: perceptions of 214 Brazilian athletes. Glob Health J 2023; 7:49-54. [PMID: 36643776 PMCID: PMC9831665 DOI: 10.1016/j.glohj.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/25/2022] [Accepted: 12/27/2022] [Indexed: 01/12/2023] Open
Abstract
Background Social distancing may affect athletes' training, causing negative effects on mental and physical health. Objective This study therefore aimed to characterize the perception of Brazilian athletes about their physical and psychosocial aspects, sleep quality and coping strategies during the quarantine of the coronavirus disease 2019 (COVID-19) pandemic. Methods This was a cross-sectional study with online survey, performed with Brazilian athletes (amateur and professional) over 18 years. The main outcomes measures assessed were physical and psychosocial aspects, sleep quality and coping strategies. Results A total of 214 athletes were included. The average weekly hours of training during the quarantine was 4.71 ± 3.71 h, of which 64.5% athletes (138/214) were oriented by medical staff during training. For 52.8% (113/214) of athletes, training intensity during the quarantine was different/very different from the intensity before the quarantine. 79.4% athletes (170/214) reported moderate to extreme difficulties in keeping the same level of training during the quarantine. 77.1% athletes (165/214) had moderate to extreme anxiety and each of the athletes had concern about his or her athletic career future, including return to the sport. 72.9% athletes (156/214) reported change in sleep schedule during the quarantine period. Conclusion The quarantine period during COVID-19 pandemic negatively affected the athlete's perception about training routine, since athletes reported reduction in training hours and training intensity. Overall, the athletes reported that they were moderately to extremely anxious. They also had concerns about their career in the future, as well as concerns regarding return to sport.
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Affiliation(s)
- Eliane de Morais Machado
- Physical Therapy Department, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, CEP 13565-905, Brazil
| | | | - Paula Rezende Camargo
- Physical Therapy Department, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, CEP 13565-905, Brazil
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, CEP 13565-905, Brazil
| | - Luciana De Michelis Mendonça
- Physical Therapy Department, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, CEP 13565-905, Brazil
- Physical Therapy Department, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, CEP 31270-901, Brazil
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Mortilla S, Pruneti C, Masellis G, Guidotti S, Caramuscio C. Clinical- Psychological Aspects Involved in Gynecological Surgery: Description of Peri-Operative Psychopathological Symptoms and Illness Behavior. Int J Psychol Res (Medellin) 2023; 16:56-66. [PMID: 37547867 PMCID: PMC10402648 DOI: 10.21500/20112084.5981] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/24/2022] [Accepted: 02/13/2023] [Indexed: 08/08/2023] Open
Abstract
Background Within the current literature concerning the gynecological surgery, there are only a few studies that focus on the psychological aspects that characterize the peri-operative period. In this research, the psychopathological symptoms and the illness behavior were assessed in order to confirm previous results about clinical variables such as the type and method of intervention, as well as psychological aspects regarding the positive anamnesis for mental disorders. Moreover, other factors including the desire for maternity and previous surgical interventions and pregnancies were also investigated. Methods In this observational research, 58 women (age = 41.5±8.8), that undergone gynecological surgery (conservative and non-conservative) for benign pathologies, were consecutively recruited. Information on psychopathological symptoms was collected 15 days (T0) and one day before surgery (T1), and at the time of discharge (T2) through the Symptom Questionnaire (SQ). At T2, the Illness Behavior Questionnaire (IBQ) was also administered. Results The descriptive analyzes conducted on the total sample demonstrated that while anxious activation and irritable mood decrease from T0 to T1, somatizations and depression mood increase between T1 and T2. Moreover, the comparisons between groups, dividing the sample according to the clinical-medical and psychological variables, highlighted that the type and modality of the intervention, as well as a positive history for the presence of psychological disorders, the desire for maternity, and previous surgical interventions and pregnancies, can influence the course of psychopathological symptoms. Conclusion This study highlights the need to include a clinical-psychological evaluation and to pay attention to specific clinical variables regarding women that are undergoing a conservative or non-conservative gynecological surgery. Considering the psychological impact of these type of interventions, the clinical history of these women, as well as their fears and desires, could facilitate a better management of the patients in terms of well-being, adherence to treatment, and recovery.
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Affiliation(s)
- Simona Mortilla
- Obstetrics and Gynecology Unit, Carpi Hospital, Modena, Italy.Carpi HospitalModenaItaly
- Clinical Psychology, Clinical Psychophysiology and Clinical Neuropsychology Labs., Dept. of Medicine and Surgery, University of Parma, Italy.Università degli Studi di ParmaUniversity of ParmaItaly
| | - Carlo Pruneti
- Clinical Psychology, Clinical Psychophysiology and Clinical Neuropsychology Labs., Dept. of Medicine and Surgery, University of Parma, Italy.Università degli Studi di ParmaUniversity of ParmaItaly
| | - Giuseppe Masellis
- Obstetrics and Gynecology Unit, Carpi Hospital, Modena, Italy.Carpi HospitalModenaItaly
| | - Sara Guidotti
- Clinical Psychology, Clinical Psychophysiology and Clinical Neuropsychology Labs., Dept. of Medicine and Surgery, University of Parma, Italy.Università degli Studi di ParmaUniversity of ParmaItaly
| | - Chiara Caramuscio
- Clinical Psychology, Clinical Psychophysiology and Clinical Neuropsychology Labs., Dept. of Medicine and Surgery, University of Parma, Italy.Università degli Studi di ParmaUniversity of ParmaItaly
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Ganesapillai M, Mondal B, Sarkar I, Sinha A, Ray SS, Kwon YN, Nakamura K, Govardhan K. The face behind the Covid-19 mask - A comprehensive review. Environ Technol Innov 2022; 28:102837. [PMID: 35879973 PMCID: PMC9299984 DOI: 10.1016/j.eti.2022.102837] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/16/2022] [Accepted: 07/16/2022] [Indexed: 05/07/2023]
Abstract
The threat of epidemic outbreaks like SARS-CoV-2 is growing owing to the exponential growth of the global population and the continual increase in human mobility. Personal protection against viral infections was enforced using ambient air filters, face masks, and other respiratory protective equipment. Available facemasks feature considerable variation in efficacy, materials usage and characteristic properties. Despite their widespread use and importance, face masks pose major potential threats due to the uncontrolled manufacture and disposal techniques. Improper solid waste management enables viral propagation and increases the volume of associated biomedical waste at an alarming rate. Polymers used in single-use face masks include a spectrum of chemical constituents: plasticisers and flame retardants leading to health-related issues over time. Despite ample research in this field, the efficacy of personal protective equipment and its impact post-disposal is yet to be explored satisfactorily. The following review assimilates information on the different forms of personal protective equipment currently in use. Proper waste management techniques pertaining to such special wastes have also been discussed. The study features a holistic overview of innovations made in face masks and their corresponding impact on human health and environment. Strategies with SDG3 and SDG12, outlining safe and proper disposal of solid waste, have also been discussed. Furthermore, employing the CFD paradigm, a 3D model of a face mask was created based on fluid flow during breathing techniques. Lastly, the review concludes with possible future advancements and promising research avenues in personal protective equipment.
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Affiliation(s)
- Mahesh Ganesapillai
- Mass Transfer Group, School of Chemical Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Bidisha Mondal
- Mass Transfer Group, School of Chemical Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Ishita Sarkar
- Mass Transfer Group, School of Chemical Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Aritro Sinha
- Mass Transfer Group, School of Chemical Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Saikat Sinha Ray
- Department of Urban and Environmental Engineering, Ulsan National Institute of Science and Technology, Republic of Korea
| | - Young-Nam Kwon
- Department of Urban and Environmental Engineering, Ulsan National Institute of Science and Technology, Republic of Korea
| | - Kazuho Nakamura
- Faculty of Engineering, Division of Material Science and Chemical Engineering, Yokohama National University, Tokiwadai, Yokohama, Kanagawa 240-8501, Japan
| | - K Govardhan
- Department of Micro and Nano-Electronics, School of Electronics Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
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Tausch A, Peifer C, Kirchhoff BM, Kluge A. Human-robot interaction: how worker influence in task allocation improves autonomy. Ergonomics 2022; 65:1230-1244. [PMID: 35099354 DOI: 10.1080/00140139.2022.2025912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 01/01/2022] [Indexed: 06/14/2023]
Abstract
Task allocation research is often efficiency-focussed, but procedural and work-psychological perspectives are required to enable human-centred human-robot interaction (HRI). Hence, the motivational and cognitive outcomes of the degree of worker influence over task allocation are relevant to research objects for allocation process design. In a laboratory experiment, 87 participants manufactured goods in collaboration with a robot under three conditions: (1) a support system decided the allocation, (2) a support-system allocation could be revised, (3) the participant determined the allocation. Conditions affected mental effort, process control and autonomy, resulting in higher values when participants allocated tasks themselves. Satisfaction with the process appears lower with no worker influence. Trust in the support-system moderates the condition effect, with higher satisfaction depending on trust when a system is involved in allocation. An allocation made by the workers and adaptability is preferred. Results show the importance of worker influence over task allocation in HRI. Practitioner Summary: Our experiment on allocation processes seeks to satisfy the gap in human-centred psychological research on task allocation in human-robot interaction (HRI). For successful, ergonomic HRI, it is found that workers should be provided with influence over task allocation.
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Affiliation(s)
- Alina Tausch
- Chair Work and Organisational Psychology, Ruhr University Bochum, Bochum, Germany
- Federal Institute for Occupational Safety and Health, Dortmund, Germany
| | - Corinna Peifer
- Institute for Psychology, Universität zu Lübeck, Lübeck, Germany
| | | | - Annette Kluge
- Chair Work and Organisational Psychology, Ruhr University Bochum, Bochum, Germany
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Boscari F, Ferretto S, Cavallin F, Fadini GP, Avogaro A, Bruttomesso D. Effectiveness of adding alarms to flash glucose monitoring in adults with type 1 diabetes under routine care. Acta Diabetol 2022; 59:921-928. [PMID: 35416537 PMCID: PMC9156464 DOI: 10.1007/s00592-022-01884-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/17/2022] [Indexed: 11/26/2022]
Abstract
AIM Whether glucose sensor alarms improve metabolic control and are accepted by individuals with diabetes is unclear. Here, we investigated whether switching from a standard flash glucose monitoring system (FGM1) to a system equipped with hypo- and hyperglycemia alarms (FGM2) improves glycemic control and psychological outcomes in adults with type 1 diabetes (T1D). METHODS Subjects with T1D and > 4% of time in hypoglycemia or > 40% of time in hyperglycemia were studied while wearing FGM1 (4 weeks) and after switching to FGM2 for 8 weeks. The primary endpoint was the change in time in range (TIR 70-180 mg/dl [3.9-10.0 mmol/L]) after 4 weeks of FGM2 use. Time below range (TBR), time above range (TAR), mean glucose, coefficient of variation (CV), sensor scans, treatment satisfaction, and hypoglycemia fear were secondary outcomes. RESULTS We included 38 subjects aged 33.7 ± 12.6 year. During 4 weeks of FGM2 use, TIR increased from 52.8 to 57.0% (p = 0.001), TBR decreased from 6.2 to 3.4% (p < 0.0001) as did time < 54 mg/dl (from 1.4 to 0.3%, p < 0.0001) and CV (from 39.6% to 36.1%, p < 0.0001). These changes were confirmed after 8 weeks of FGM2 use. Treatment satisfaction improved and fear of hypoglycemia decreased. Subjects who had > 4% of time in hypoglycemia at baseline showed the greatest improvements in glucose control and treatment satisfaction. CONCLUSION Switching from FGM1 to FGM2 improved TIR and treatment satisfaction and reduced fear of hypoglycemia. Participants who benefited most from switching from FGM1 to FGM2 were those prone to hypoglycemia.
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Affiliation(s)
- Federico Boscari
- Department of Medicine (DIMED), University of Padova, Via Giustiniani 2, 35128, Padova, Italy
- Division of Metabolic Diseases, University Hospital of Padova, 36020, Solagna, Italy
| | - Sara Ferretto
- Division of Metabolic Diseases, University Hospital of Padova, 36020, Solagna, Italy
| | | | - Gian Paolo Fadini
- Department of Medicine (DIMED), University of Padova, Via Giustiniani 2, 35128, Padova, Italy
- Division of Metabolic Diseases, University Hospital of Padova, 36020, Solagna, Italy
| | - Angelo Avogaro
- Department of Medicine (DIMED), University of Padova, Via Giustiniani 2, 35128, Padova, Italy
- Division of Metabolic Diseases, University Hospital of Padova, 36020, Solagna, Italy
| | - Daniela Bruttomesso
- Department of Medicine (DIMED), University of Padova, Via Giustiniani 2, 35128, Padova, Italy.
- Division of Metabolic Diseases, University Hospital of Padova, 36020, Solagna, Italy.
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Boscari F, Ferretto S, Cavallin F, Bruttomesso D. Switching from predictive low glucose suspend to advanced hybrid closed loop control: Effects on glucose control and patient reported outcomes. Diabetes Res Clin Pract 2022; 185:109784. [PMID: 35183648 DOI: 10.1016/j.diabres.2022.109784] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/09/2022] [Accepted: 02/13/2022] [Indexed: 11/25/2022]
Abstract
AIMS Automated insulin delivery improves glucose control. Aim of this study was to compare in real life the effects on glucose control and patient reported outcomes of an advanced hybrid closed loop system (Control-IQ), versus a simpler system with predictive low glucose suspend function (Basal-IQ). METHODS Thirty-one type 1 diabetic subjects were studied during Basal-IQ and after switching to Control-IQ. Variables analyzed were time spent in range (70-180 mg/dL), in tight range (70-140 mg/dL), above range (>180 mg/dL), below range (<70 mg/dL), mean glucose, coefficient of variation and glycated hemoglobin. Questionnaires were administered regarding therapy satisfaction (Diabetes Treatment Satisfaction Questionnaire in status/change form), fear of hypoglycemia (Hypoglycemia Fear Survey), quality of sleep (Pittsburgh Sleep Quality Index). RESULTS After 12 weeks of Control-IQ, time in range increased from 62.7 to 74.0%, p < 0.0001, time in tight range increased from 37.1 to 44.6 %, p < 0.001, time above range decreased from 35.6 to 24.4% p < 0.0001. Improvements were observed in mean glucose and glucose variability. Glycated hemoglobin decreased from 7.0% (53 mmol/mol) to 6.6% (49 mmol/mol), p < 0.0001. Subjects using Control-IQ manifested greater satisfaction and less fear of hypoglycemia. CONCLUSION Compared to Basal-IQ, Control-IQ improves glucose control and therapy satisfaction.
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Affiliation(s)
- Federico Boscari
- Department of Medicine, Unit of Metabolic Disease, University of Padova, 35128 Padova, Italy
| | - Sara Ferretto
- Department of Medicine, Unit of Metabolic Disease, University of Padova, 35128 Padova, Italy
| | | | - Daniela Bruttomesso
- Department of Medicine, Unit of Metabolic Disease, University of Padova, 35128 Padova, Italy.
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Messina R, Iommi M, Rucci P, Reno C, Fantini MP, Lunghi C, Altini M, Bravi F, Rosa S, Nicolucci A, Di Bartolo P. Is it time to consider depression as a major complication of type 2 diabetes? Evidence from a large population-based cohort study. Acta Diabetol 2022; 59:95-104. [PMID: 34495396 PMCID: PMC8758621 DOI: 10.1007/s00592-021-01791-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/19/2021] [Indexed: 12/26/2022]
Abstract
AIMS Depression in type 2 diabetes may heavily affect the course of the disease. In this study, we investigated, among new cases with type 2 diabetes, the incidence and clinical predictors of depression and determined the extent to which depression constitutes a risk factor for acute and long-term diabetes complications and mortality. METHODS In this population-based retrospective cohort study, incident cases of type 2 diabetes without a prior history of depression were identified from the administrative databases of the Emilia-Romagna Region, Italy, between 2008 and 2017 and followed up until 2020. Logistic regression models were used to identify the predictors of depression. Cox regression models were used to estimate the risk of acute complications over three years, and the risk of long-term complications and mortality over ten years. RESULTS Incident cases with type 2 diabetes were 30,815, of whom 5146 (16.7%) developed depression. The predictors of depression onset were as follows: female sex, age > 65 years, living in rural areas and comorbid diseases. Depression in type 2 diabetes was associated with a 2.3-fold risk of developing acute complications, 1.6-fold risk of developing long-term complications and 2.8-fold mortality risk. CONCLUSIONS Our findings highlight that depression is associated with an increased risk for complications in type 2 diabetes and mortality and should not be neglected. Therefore, it is important to promote screening activities and introduce targeted and personalized treatment for depression in order to reduce the risk of poor short- and long-term outcomes of diabetes.
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Affiliation(s)
- Rossella Messina
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum-University of Bologna, Via San Giacomo, 12, 40126, Bologna, BO, Italy
| | - Marica Iommi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum-University of Bologna, Via San Giacomo, 12, 40126, Bologna, BO, Italy.
| | - Paola Rucci
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum-University of Bologna, Via San Giacomo, 12, 40126, Bologna, BO, Italy
| | - Chiara Reno
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum-University of Bologna, Via San Giacomo, 12, 40126, Bologna, BO, Italy
| | - Maria Pia Fantini
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum-University of Bologna, Via San Giacomo, 12, 40126, Bologna, BO, Italy
| | - Carlotta Lunghi
- Department of Health Sciences, Université du Québec À Rimouski, Rimouski, Canada
- Santé Des Populations Et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec, Québec, Canada
| | - Mattia Altini
- Health Directorate, Romagna Local Health Authority, Bologna, Emilia-Romagna Region, Italy
| | - Francesca Bravi
- Health Directorate, Romagna Local Health Authority, Bologna, Emilia-Romagna Region, Italy
| | - Simona Rosa
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum-University of Bologna, Via San Giacomo, 12, 40126, Bologna, BO, Italy
| | - Antonio Nicolucci
- Center for Outcomes Research and Clinical Epidemiology (CORESEARCH), Pescara, Italy
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Naito A, Nwokolo M, Smith EL, de Zoysa N, Garrett C, Choudhary P, Amiel SA. Personality traits of alexithymia and perfectionism in impaired awareness of hypoglycemia in adults with type 1 diabetes - An exploratory study. J Psychosom Res 2021; 150:110634. [PMID: 34610494 PMCID: PMC8530191 DOI: 10.1016/j.jpsychores.2021.110634] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 09/26/2021] [Accepted: 09/26/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Severe hypoglycemia complicates insulin therapy for type 1 diabetes, with impaired awareness of hypoglycemia (IAH) being a major risk factor. We explored associations between the personality traits, alexithymia and perfectionism, and cognitive barriers to hypoglycemia avoidance described in IAH, and evaluated their prevalence in people with and without IAH. METHODS Cross-sectional exploratory study. Ninety adults with type 1 diabetes, 54 hypoglycemia aware and 36 with IAH, completed validated questionnaires exploring alexithymia (Total Alexithymia Scale [TAS-20]) and perfectionism (Frost Multidimensional Perfectionism Scale [FMPS]); and cognitive barriers related to hypoglycemia avoidance (Attitudes to Awareness Questionnaire [A2A]. RESULTS Alexithymia and perfectionism scores correlated positively with cognitive barriers associated with IAH. Specifically, alexthymia scores correlated with the 'Hyperglycaemia Avoidance Prioritised' factor (r = 0.265; p = .02, n = 77) and the 'Asymptomatic Hypoglycemia Normalised' factor (r = 0.252-0.255; p = .03, n = 77). Perfectionism scores correlated with the 'Hyperglycaemia Avoidance Prioritised' factor (r = 0.525; p < .001, n = 66). Overall, IAH participants were significantly more likely to score at the high end for alexithymia (17.6% vs. 1.9%, p = .008, n = 87) and at the extreme ends (high and low) for perfectionism (69.0% vs. 40.0%, χ2 (1) = 6.24, p = .01, n = 77). CONCLUSION These novel data showing associations between alexithymia and perfectionism scores and maladaptive health beliefs in IAH suggest the intriguing possibility that personality traits may contribute to the risk of IAH, perhaps through their influence on incentives to avoid hypoglycemia. If confirmed, measuring such traits may help tailor early adjunctive psychological intervention to reduce hypoglycemia burden for people with IAH.
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Affiliation(s)
- Anna Naito
- Diabetes Research Group, Faculty of Life Sciences & Medicine, King's College London, London, UK,Diabetes Department, King's College Hospital NHS Foundation Trust, London, UK
| | - Munachiso Nwokolo
- Diabetes Research Group, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Emma L. Smith
- Diabetes Department, King's College Hospital NHS Foundation Trust, London, UK
| | - Nicole de Zoysa
- Diabetes Department, King's College Hospital NHS Foundation Trust, London, UK
| | - Christopher Garrett
- Diabetes and Psychiatry Research Group, Department of Psychological Medicine, King's College London, London, UK,Diabetes and Metabolism Department, Bart's Health NHS Trust, London, UK
| | - Pratik Choudhary
- Diabetes Research Group, Faculty of Life Sciences & Medicine, King's College London, London, UK,Diabetes Department, King's College Hospital NHS Foundation Trust, London, UK
| | - Stephanie A. Amiel
- Diabetes Research Group, Faculty of Life Sciences & Medicine, King's College London, London, UK,Diabetes Department, King's College Hospital NHS Foundation Trust, London, UK,Corresponding author at: Diabetes Research Group, Weston Education Centre, 10 Cutcombe Road, London SE5 9RJ, UK.
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11
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Tachalov VV, Orekhova LY, Kudryavtseva TV, Loboda ES, Pachkoriia MG, Berezkina IV, Golubnitschaja O. Making a complex dental care tailored to the person: population health in focus of predictive, preventive and personalised (3P) medical approach. EPMA J 2021; 12:129-140. [PMID: 33897916 PMCID: PMC8053896 DOI: 10.1007/s13167-021-00240-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 02/06/2023]
Abstract
An evident underestimation of the targeted prevention of dental diseases is strongly supported by alarming epidemiologic statistics globally. For example, epidemiologists demonstrated 100% prevalence of dental caries in the Russian population followed by clinical manifestation of periodontal diseases. Inadequately provided oral health services in populations are caused by multi-factorial deficits including but not limited to low socio-economic status of affected individuals, lack of insurance in sub-populations, insufficient density of dedicated medical units. Another important aspect is the “participatory” medicine based on the active participation of population in maintaining oral health: healthcare will remain insufficient as long as the patient is not motivated and does not feel responsible for their oral health. To this end, nearly half of chronically diseased people do not comply with adequate medical services suffering from severely progressing pathologies. Noteworthy, the prominent risk factors and comorbidities linked to the severe disease course and poor outcomes in COVID-19-infected individuals, such as elderly, diabetes mellitus, hypertension and cardiovascular disease, are frequently associated with significantly altered oral microbiome profiles, systemic inflammatory processes and poor oral health. Suggested pathomechanisms consider potential preferences in the interaction between the viral particles and the host microbiota including oral cavity, the respiratory and gastrointestinal tracts. Since an aspiration of periodontopathic bacteria induces the expression of angiotensin-converting enzyme 2, the receptor for SARS-CoV-2, and production of inflammatory cytokines in the lower respiratory tract, poor oral hygiene and periodontal disease have been proposed as leading to COVID-19 aggravation. Consequently, the issue-dedicated expert recommendations are focused on the optimal oral hygiene as being crucial for improved individual outcomes and reduced morbidity under the COVID-19 pandemic condition. Current study demonstrated that age, gender, socio-economic status, quality of environment and life-style, oral hygiene quality, regularity of dental services requested, level of motivation and responsibility for own health status and corresponding behavioural patterns are the key parameters for the patient stratification considering person-tailored approach in a complex dental care in the population. Consequently, innovative screening programmes and adapted treatment schemes are crucial for the complex person-tailored dental care to improve individual outcomes and healthcare provided to the population.
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Affiliation(s)
- V. V. Tachalov
- Therapeutic Dentistry and Periodontology Department, Pavlov First Saint Petersburg State Medical University, 6/8 Lva Tolstogo Street, St. Petersburg, Russia
| | - L. Y. Orekhova
- Therapeutic Dentistry and Periodontology Department, Pavlov First Saint Petersburg State Medical University, 6/8 Lva Tolstogo Street, St. Petersburg, Russia
- City Periodontology Centre, “PAKS”, Dobrolubova prospect, 27, St. Petersburg, Russia
| | - T. V. Kudryavtseva
- Therapeutic Dentistry and Periodontology Department, Pavlov First Saint Petersburg State Medical University, 6/8 Lva Tolstogo Street, St. Petersburg, Russia
| | - E. S. Loboda
- City Periodontology Centre, “PAKS”, Dobrolubova prospect, 27, St. Petersburg, Russia
| | - M. G. Pachkoriia
- Therapeutic Dentistry and Periodontology Department, Pavlov First Saint Petersburg State Medical University, 6/8 Lva Tolstogo Street, St. Petersburg, Russia
| | - I. V. Berezkina
- Therapeutic Dentistry and Periodontology Department, Pavlov First Saint Petersburg State Medical University, 6/8 Lva Tolstogo Street, St. Petersburg, Russia
| | - O. Golubnitschaja
- Predictive, Preventive, Personalised (3P) Medicine, Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, 53127 Bonn, Germany
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12
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Ribeiro RT, Andrade R, Nascimento do Ó D, Lopes AF, Raposo JF. Impact of blinded retrospective continuous glucose monitoring on clinical decision making and glycemic control in persons with type 2 diabetes on insulin therapy. Nutr Metab Cardiovasc Dis 2021; 31:1267-1275. [PMID: 33612381 DOI: 10.1016/j.numecd.2020.12.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 12/19/2020] [Accepted: 12/22/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS Blinded retrospective continuous glucose monitoring (rCGM) provides detailed information about real-life glycaemic profile. In persons with type 2 diabetes without adequate glycaemic control, the structured introduction of rCGM may be beneficial to sustain improvements in diabetes management. METHODS AND RESULTS 102 individuals with insulin-treated type 2 diabetes, age less than 66 years old and HbA1c >7.5%, were recruited. Participants performed a 7-day blinded rCGM (iPro2) every four months for one year. Biochemical, anthropometric, and rCGM data was collected. Participants' and healthcare professionals' perceptions were assessed. 90 participants completed the protocol. HbA1c was 9.1 ± 0.1% one year prior to enrolment and 9.4 ± 0.1% at enrolment (p < 0.01). With the rCGM-based intervention, a decrease in HbA1c was achieved at 4 months (8.4 ± 0.1%, p < 0.0001), and 12 months (8.1 ± 0.1%, p < 0.0001). A significant increase in time-in-range was observed (50.8 ± 2.4 at baseline vs 61.5 ± 2.2% at 12 months, for 70-180 mg/dL, p < 0.001), with no difference in exposure time to hypoglycaemia. After 12 months, there was an increase in self-reported diabetes treatment satisfaction (p < 0.05). CONCLUSION In persons with type 2 diabetes and poor metabolic control, specific data from blinded rCGM informed therapeutic changes and referral to targeted education consultations on nutrition and insulin administration technique. Therapeutic changes were made more frequently and targeted to changes in medication dose, timing, and/or type, as well as to lifestyle. Together, these brought significant improvements in clinical outcomes, effective shared decision-making, and satisfaction with treatment. REGISTRATION NUMBER NCT04141111.
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Affiliation(s)
- Rogério Tavares Ribeiro
- APDP - Diabetes Portugal, Lisbon, Portugal; iBiMED, Dep of Medical Sciences, University of Aveiro, Portugal; CEDOC, NOVA University of Lisbon, Portugal.
| | | | | | | | - João Filipe Raposo
- APDP - Diabetes Portugal, Lisbon, Portugal; CEDOC, NOVA University of Lisbon, Portugal; Dep of Public Health, NOVA Medical School, NOVA University of Lisbon, Portugal
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13
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Nagpal N, Ramos AM, Hajal N, Massey SH, Leve LD, Shaw DS, Ganiban JM, Reiss D, Neiderhiser JM. Psychopathology Symptoms are Associated with Prenatal Health Practices in Pregnant Women with Heavy Smoking Levels. Matern Child Health J 2021; 25:330-337. [PMID: 33417106 DOI: 10.1007/s10995-020-03048-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Smoking during pregnancy may be linked to other problematic prenatal health behaviors in women. We examined interrelationships among prenatal smoking, prenatal health behaviors and mental health. The objective of this study was to examine factors that may contribute to variations in prenatal health practices among women who smoke during pregnancy. METHODS Birth mothers from an adoption study (N = 912) were interviewed about prenatal smoking, health behaviors, and mental health symptoms at 5 months postpartum. RESULTS One-quarter of participants (N = 222) reported smoking 6 or more cigarettes daily for at least 1 trimester. For mothers who smoked more than 6 cigarettes daily, higher levels of antisocial behaviors (β = - .14, p = .03) and depressive symptoms (β = - .17, p = .03) were associated with less frequent prenatal folate use; antisocial behaviors and depressive symptoms were not associated for prenatal folate use among women who did not smoke more than 6 cigarettes daily. For mothers who did not smoke more than 6 cigarettes daily, more depressive symptoms were associated with fewer prenatal care visits (β = .12, p = .01). Antisocial behaviors and anxiety symptoms were not associated with prenatal care visits in either group of mothers. CONCLUSIONS FOR PRACTICE: Maternal antisocial behaviors and depressive symptoms during pregnancy may be markers for poorer adherence to recommendations for folate supplementation among women who smoke 6 or more cigarettes daily during pregnancy, independent of adequacy of prenatal care.
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Affiliation(s)
- Nikita Nagpal
- Department of Pediatrics, NYU Grossman School of Medicine/Bellevue Hospital Center, 462 First Avenue, Administration Building Rm A314, New York, NY, 10016, USA.
| | - Amanda M Ramos
- Department of Epidemiology, University of North Carolina, Chapel Hill, USA
| | - Nastassia Hajal
- Jane & Terry Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, USA
| | - Suena H Massey
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Leslie D Leve
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, USA
| | - Daniel S Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA
| | - Jody M Ganiban
- Department of Psychology, George Washington University, Washington, USA
| | - David Reiss
- Yale Child Study Center, Yale University, New Haven, USA
| | - Jenae M Neiderhiser
- Department of Psychology, The Pennsylvania State University, University Park, USA
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14
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Iversen MM, Igland J, Smith-Strøm H, Østbye T, Tell GS, Skeie S, Cooper JG, Peyrot M, Graue M. Effect of a telemedicine intervention for diabetes-related foot ulcers on health, well-being and quality of life: secondary outcomes from a cluster randomized controlled trial (DiaFOTo). BMC Endocr Disord 2020; 20:157. [PMID: 33087074 PMCID: PMC7580005 DOI: 10.1186/s12902-020-00637-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 10/13/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Follow-up care provided via telemedicine (TM) is intended to be a more integrated care pathway to manage diabetes-related foot ulcers (DFU) than traditionally-delivered healthcare. However, knowledge of the effect of TM follow-up on PROMs including self-reported health, well-being and QOL in patients with DFUs is lacking and often neglected in RCT reports in general. Therefore, in this study of secondary outcomes from the DiaFOTo trial, the aim was to compare changes in self-reported health, well-being and QOL between patients with DFUs receiving telemedicine follow-up care in primary healthcare in collaboration with specialist healthcare, and patients receiving standard outpatient care. METHODS The current study reports secondary endpoints from a cluster randomized controlled trial whose primary endpoint was ulcer healing time. The trial included 182 adults with diabetes-related foot ulcers (94/88 in the telemedicine/standard care groups) in 42 municipalities/districts, recruited from three clinical sites in Western Norway. Mean (SD) diabetes duration for the study population was 20.8 (15.0). The intervention group received care in the community in collaboration with specialist healthcare using an asynchronous telemedicine intervention. The intervention included an interactive web-based ulcer record and a mobile phone enabling counseling and communication between the community nurses and specialist healthcare; the control group received standard outpatient care. In total 156 participants (78/78) reported on secondary endpoints: self-reported health, well-being and quality of life evaluated by generic and disease-specific patient-reported outcome measures (e.g. Euro-QOL, the Hospital Anxiety and Depression Scale (HADS), Problem Areas in Diabetes (PAID), Neuropathy and Foot Ulcer-Specific Quality of Life Instrument (NeuroQOL)). Linear mixed-effects regression was used to investigate possible differences in changes in the scores between the intervention and control group at the end of follow-up. RESULTS In intention to treat analyses, differences between treatment groups were small and non-significant for the health and well-being scale scores, as well as for diabetes-related distress and foot ulcer-specific quality of life. CONCLUSIONS There were no significant differences in changes in scores for the patient reported outcomes between the intervention and control group, indicating that the intervention did not affect the participants' health, well-being and quality of life. TRIAL REGISTRATION Clinicaltrials.gov , NCT01710774 . Registered October 19th, 2012.
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Affiliation(s)
- Marjolein M Iversen
- Faculty of Health and Social Sciences, Department of Health and Caring Sciences, Western Norway University of Applied Sciences, N-5020, Bergen, Norway.
- Department of Medicine, Section of Endocrinology, Stavanger University Hospital, Stavanger, Norway.
| | - Jannicke Igland
- Faculty of Health and Social Sciences, Department of Health and Caring Sciences, Western Norway University of Applied Sciences, N-5020, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Hilde Smith-Strøm
- Faculty of Health and Social Sciences, Department of Health and Caring Sciences, Western Norway University of Applied Sciences, N-5020, Bergen, Norway
- Department of Medicine, Section of Endocrinology, Stavanger University Hospital, Stavanger, Norway
| | - Truls Østbye
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Svein Skeie
- Department of Research, Stavanger University Hospital, Stavanger, Norway
| | - John G Cooper
- Department of Medicine, Section of Endocrinology, Stavanger University Hospital, Stavanger, Norway
| | - Mark Peyrot
- Faculty of Health and Social Sciences, Department of Health and Caring Sciences, Western Norway University of Applied Sciences, N-5020, Bergen, Norway
- Department of Sociology, Loyola University Maryland, Baltimore, MD, USA
| | - Marit Graue
- Faculty of Health and Social Sciences, Department of Health and Caring Sciences, Western Norway University of Applied Sciences, N-5020, Bergen, Norway
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15
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Peterhänsel C, Nagl M, Wagner B, Dietrich A, Kersting A. Childhood maltreatment in bariatric patients and its association with postoperative weight, depressive, and eating disorder symptoms. Eat Weight Disord 2020; 25:999-1010. [PMID: 31154633 DOI: 10.1007/s40519-019-00720-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 05/23/2019] [Indexed: 12/28/2022] Open
Abstract
PURPOSE The present study aimed to compare prevalence rates of childhood maltreatment between patients with severe obesity undergoing bariatric surgery and patients without a surgical procedure. Second purpose was to calculate the association between childhood maltreatment and outcomes 6 and 12 months after a bariatric procedure. METHODS Childhood maltreatment was assessed using the Childhood Trauma Questionnaire (CTQ) and compared between 120 bariatric surgery patients and 346 non-surgery patients with severe obesity. For the bariatric surgery subgroup, linear mixed models with repeated measures were used to analyze the predictive value of childhood maltreatment on weight outcomes and psychopathology. Additionally, between- and within-group comparisons were calculated to compare patients with and without childhood maltreatment regarding BMI and weight loss (%TWL, %EWL), depression severity (BDI-II), eating disorder psychopathology (EDE-Q), and suicidal ideation (BSS), at baseline, 6- and 12-month assessment. RESULTS Prevalence rates for childhood maltreatment, depression and suicidal ideation were significantly higher in non-surgery compared to bariatric surgery patients. Within the surgery group, no significant interaction effect between childhood maltreatment and time was found. Hence, childhood maltreatment did not impact the course of body weight, depression and eating disorder psychopathology from pre- to post-surgery. CONCLUSIONS Significantly higher rates of childhood maltreatment were found within non-surgery patients with obesity in comparison to bariatric surgery patients. Childhood maltreatment did not predict poorer outcomes after surgery. Since history of childhood maltreatment may increase the risk for psychological disturbances, regular screening and, if necessary, psychological support should be offered to both groups. LEVEL OF EVIDENCE Evidence obtained from well-designed cohort or case-control analytic studies, Level III. CLINICAL TRIAL REGISTRATION Deutsches Register Klinischer Studien-German Clinical Trials Register: DRKS00003976.
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Affiliation(s)
- C Peterhänsel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany.
- Integrated Research and Treatment Center (IFB) AdiposityDiseases, Leipzig University Medical Center, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Germany.
| | - M Nagl
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany
| | - B Wagner
- MSB Medical School Berlin, Calandrellistraße 1 - 9, 12247, Berlin, Germany
| | - A Dietrich
- Integrated Research and Treatment Center (IFB) AdiposityDiseases, Leipzig University Medical Center, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Germany
- Department of Surgery, Clinic for Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, Liebigstraße 20, 04103, Leipzig, Germany
| | - A Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany
- Integrated Research and Treatment Center (IFB) AdiposityDiseases, Leipzig University Medical Center, Philipp-Rosenthal-Str. 27, 04103, Leipzig, Germany
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16
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Affiliation(s)
- R Varalakshmi
- The Tamil Nadu Dr. Ambedkar Law University, Chennai, India.
| | - R Swetha
- The Tamil Nadu Dr. Ambedkar Law University, Chennai, India
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Upsher R, Allen-Taylor M, Reece I, Chamley M, Ismail K, Forbes A, Winkley K. Experiences of Attending Group Education to Support Insulin Initiation in Type 2 Diabetes: A Qualitative Study. Diabetes Ther 2020; 11:119-132. [PMID: 31732858 PMCID: PMC6965558 DOI: 10.1007/s13300-019-00727-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Type 2 diabetes is a progressive condition and many people require insulin therapy 5-10 years post diagnosis. Considering the global increase in type 2 diabetes, group education programmes to initiate insulin are beneficial as they are cost-effective and provide peer support. However, group education to initiate insulin has not been widely evaluated and there is a need to elicit the views and experience of people with type 2 diabetes who start insulin in groups. The aim of this study was to explore the perspectives of people with type 2 diabetes who receive nurse-led group-based insulin education. METHODS Qualitative, semi-structured interviews of people with type 2 diabetes in south London, UK, who had attended group education sessions to start insulin. Inductive thematic analysis identified themes within the data. RESULTS Fifteen people with type 2 diabetes were interviewed. Three main themes were identified: creating a supportive environment; facilitator skills; and effectiveness of group. Factors which created a supportive environment included peer support, providing reassurance and printed materials. Facilitator skills associated with positive experiences included addressing negative insulin beliefs and managing group dynamics. The effectiveness of the group was determined by ongoing self-management success, need for more peer support, and insulin concerns post insulin education group. CONCLUSION Positive experiences of insulin group education for people with type 2 diabetes were associated with sharing experiences with other people starting insulin, reassurance from healthcare professionals, appropriate supportive materials, and skill of the facilitator to address insulin concerns and manage group dynamics. People with type 2 diabetes may benefit more from education if healthcare professionals are skilled in psychological techniques to facilitate group education aimed at addressing concerns around insulin therapy. Further research needs to assess the effectiveness of structured insulin group education for people with type 2 diabetes.
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Affiliation(s)
- Rebecca Upsher
- Diabetes, Psychiatry, and Psychology, Department of Psychological Medicine, King's College London and Institute of Psychiatry, Psychology and Neuroscience, London, UK.
| | - Maya Allen-Taylor
- Florence Nightingale Faculty of Nursing and Midwifery and Palliative Care, King's College London, London, UK
| | - Ilse Reece
- Florence Nightingale Faculty of Nursing and Midwifery and Palliative Care, King's College London, London, UK
| | - Mark Chamley
- Lambeth Clinical Commissioning Group Diabetes Intermediate Care Team, South London, London, UK
| | - Khalida Ismail
- Diabetes, Psychiatry, and Psychology, Department of Psychological Medicine, King's College London and Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Angus Forbes
- Florence Nightingale Faculty of Nursing and Midwifery and Palliative Care, King's College London, London, UK
| | - Kirsty Winkley
- Florence Nightingale Faculty of Nursing and Midwifery and Palliative Care, King's College London, London, UK
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18
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Perrin N, Bodicoat DH, Davies MJ, Robertson N, Snoek FJ, Khunti K. Effectiveness of psychoeducational interventions for the treatment of diabetes-specific emotional distress and glycaemic control in people with type 2 diabetes: A systematic review and meta-analysis. Prim Care Diabetes 2019; 13:556-567. [PMID: 31040069 DOI: 10.1016/j.pcd.2019.04.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 11/26/2018] [Accepted: 04/02/2019] [Indexed: 01/28/2023]
Abstract
AIMS Psychological comorbidity, such as depression and/or diabetes-specific emotional distress (DSD), is highly prevalent in people with type 2 diabetes (T2DM) and associated with poorer treatment outcomes. While treatments for depression are well established, interventions specifically designed for DSD are sparse. The aim of this study was to determine interventions that successfully address DSD and HbA1c in people with T2DM. METHODS Seven databases were searched to identify potentially relevant studies. Eligible studies were selected and appraised independently by two reviewers. Multiple meta-analyses and meta-regression analyses were performed to synthesise the data; the primary analyses determined the effect of interventions on DSD, with secondary analyses assessing the effect on HbA1c. RESULTS Thirty-two studies (n = 5206) provided sufficient DSD data, of which 23 (n = 3818) reported data for HbA1c. Meta-analyses demonstrated that interventions significantly reduced DSD (p = 0.034) and HbA1c (p = 0.006) compared to controls, although subgroup meta-analyses and meta-regression to explore specific intervention characteristics that might mediate this effect yielded non-significant findings. CONCLUSIONS The findings demonstrate that existing interventions successfully reduce DSD and HbA1c in people with T2DM. While promising, deductions should be interpreted tentatively, highlighting a stark need for further focused exploration of how best to treat psychological comorbidity in people with T2DM.
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Affiliation(s)
- N Perrin
- Division of Rural Health and Wellbeing, University of the Highlands and Islands, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, United Kingdom.
| | - D H Bodicoat
- Diabetes Research Centre, University of Leicester, Leicester, United Kingdom
| | - M J Davies
- Diabetes Research Centre, University of Leicester, Leicester, United Kingdom
| | - N Robertson
- School of Psychology, University of Leicester, Leicester, United Kingdom
| | - F J Snoek
- Department of Medical Psychology, VU University Medical Centre, Department of Medical Psychology, Academic Medical centre, Amsterdam, Netherlands
| | - K Khunti
- Diabetes Research Centre, University of Leicester, Leicester, United Kingdom
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19
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Busetto L, Dicker D, Azran C, Batterham RL, Farpour-Lambert N, Fried M, Hjelmesæth J, Kinzl J, Leitner DR, Makaronidis JM, Schindler K, Toplak H, Yumuk V. Obesity Management Task Force of the European Association for the Study of Obesity Released "Practical Recommendations for the Post-Bariatric Surgery Medical Management". Obes Surg 2019; 28:2117-2121. [PMID: 29725979 DOI: 10.1007/s11695-018-3283-z] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Bariatric patients may face specific clinical problems after surgery, and multidisciplinary long-term follow-up is usually provided in specialized centers. However, physicians, obstetricians, dieticians, nurses, clinical pharmacists, midwives, and physical therapists not specifically trained in bariatric medicine may encounter post-bariatric patients with specific problems in their professional activity. This creates a growing need for dissemination of first level knowledge in the management of bariatric patients. Therefore, the Obesity Management Task Force (OMTF) of the European Association for the Study of Obesity (EASO) decided to produce and disseminate a document containing practical recommendations for the management of post-bariatric patients. The list of practical recommendations included in the EASO/OMTF document is reported in this brief communication.
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Affiliation(s)
- Luca Busetto
- Department of Internal Medicine, University of Padova, Padova, Italy. .,Clinica Medica 3, Azienda Ospedaliera di Padova, Via Giustiniani 2, 35128, Padova, Italy.
| | - Dror Dicker
- Department of Internal Medicine D and Obesity Clinic, Hasharon Hospital, Rabin Medical Center, Petah Tikva, Israel.,Sackler School of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Carmil Azran
- Clinical Pharmacy, Herzliya Medical Center, Herzliya, Israel
| | - Rachel L Batterham
- University College London Hospital Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital, London, UK.,National Institute of Health Research, University College London Hospital Biomedical Research Centre, London, UK.,Centre for Obesity Research, Rayne Institute, Department of Medicine, University College London, London, UK
| | - Nathalie Farpour-Lambert
- Obesity Prevention and Care Program Contrepoids, Service of Therapeutic Education for Chronic Diseases, Department of Community Medicine, Primary Care and Emergency, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
| | - Martin Fried
- OB Klinika, Centre for Treatment of Obesity and Metabolic Disorders, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jøran Hjelmesæth
- Morbid Obesity Centre, Vestfold Hospital Trust and Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Johann Kinzl
- Department of Psychiatry and Psychotherapy II, Medical University Innsbruck, Innsbruck, Austria
| | | | - Janine M Makaronidis
- National Institute of Health Research, University College London Hospital Biomedical Research Centre, London, UK.,Centre for Obesity Research, Rayne Institute, Department of Medicine, University College London, London, UK
| | - Karin Schindler
- Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Hermann Toplak
- Department of Medicine, Medical University Graz, Graz, Austria
| | - Volkan Yumuk
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
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20
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Franco A, Más-Serrano P, González Y, Balibrea N, Rodríguez D, López MI, Pérez Contreras FJ. Pre-emptive deceased-donor kidney transplant: A matched cohort study. Nefrologia 2019; 40:32-37. [PMID: 31416631 DOI: 10.1016/j.nefro.2019.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 04/12/2019] [Accepted: 04/19/2019] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Currently, kidney transplantation is the treatment of choice for patients with kidney disease who require replacement therapy. Dialysis is a necessary step, but not mandatory prior to transplantation. There is the possibility of pre-emptive transplantation or transplantation in pre-dialysis, that is, without previous dialysis. The aim of the present study is to evaluate the result of our experience with a pre-emptive kidney transplant from a deceased donor. MATERIALS AND METHODS Retrospective, observational, matched cohort study. We compared 66 pre-emptive with 66 non pre-emptive recipients, who received a first renal graft performed at our centre, matched by age and gender of donors and recipients, time of transplant, immunological risk, immunosuppression and cold ischaemia time. Early graft loss, incidence of acute rejection, delayed graft function, renal function at 12 and 36 months and graft and recipient survival were assessed in this period. RESULTS The percentage of recipients who presented early graft loss, delayed graft function and acute rejection was similar in both groups. No differences were observed in their renal function at 12 and 36 months after transplantation, as well as the actuarial survival of patients (P=0.801) and grafts (P=0.693) in the studied period. The total calculated cost of the period on dialysis for the control group was 8,033,893.16 euros. CONCLUSIONS Pre-emptive transplantation can yield comparable outcomes to those for post-dialysis kidney transplantation, and results in better quality of life for patients with end-stage kidney disease, as well as a reduced cost.
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Affiliation(s)
- Antonio Franco
- Servicio de Nefrología, Hospital General Universitario de Alicante, España.
| | - Patricio Más-Serrano
- Servicio de Farmacia Hospitalaria, Hospital General Universitario de Alicante, España
| | - Yussel González
- Servicio de Nefrología, Hospital General Universitario de Alicante, España
| | - Noelia Balibrea
- Servicio de Nefrología, Hospital General Universitario de Alicante, España
| | - David Rodríguez
- Servicio de Nefrología, Hospital General Universitario de Alicante, España; Servicio de Farmacia Hospitalaria, Hospital General Universitario de Alicante, España
| | - María Isabel López
- Servicio de Nefrología, Hospital General Universitario de Alicante, España
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Saulnier PJ, Briet C, Gand E, Chaillous L, Dubois S, Bonnet F, Leguerrier AM, Fradet G, Delcourt Crespin I, Kerlan V, Gouet D, Perlemoine C, Ducluzeau PH, Pichelin M, Wargny M, Gonder-Frederick L, Ragot S, Hadjadj S, Cariou B. No association between fear of hypoglycemia and blood glucose variability in type 1 diabetes: The cross-sectional VARDIA study. J Diabetes Complications 2019; 33:554-560. [PMID: 31182337 DOI: 10.1016/j.jdiacomp.2019.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 12/20/2018] [Accepted: 05/05/2019] [Indexed: 01/17/2023]
Abstract
AIMS In type 1 diabetes (T1D), treatment efficacy is limited by the unpredictability of blood glucose results and glycemic variability (GV). Fear of Hypoglycemia (FOH) remains a major brake for insulin treatment optimization. We aimed to assess the association of GV with FOH in participants with T1D in an observational cross-sectional study performed in 9 French Diabetes Centres (NCT02790060). METHODS Participants were T1D for ≥5 years, aged 18-75 years, on stable insulin therapy for ≥3 months. The coefficient of variation (CV) of blood glucose and mean amplitude of glycemic excursions (MAGE) were used to assess GV from 7-point self-monitoring of blood glucose (SMBG). FOH was assessed using the validated French version of the Hypoglycemia Fear Survey-II (HFS-II) questionnaire. RESULTS Among a total of 570 recruited participants, 298 were suitable for analysis: 46% women, 58% on continuous subcutaneous insulin infusion [CSII], mean age 49 ± 16 years, HbA1c 7.5 ± 0.9%, HFS-II score 67 ± 18 and 12% with recent history of severe hypoglycemia during the previous 6 months, mean CV 39.8 ± 9.7% and MAGE 119 ± 42 mg/dL. CV and MAGE did not significantly correlate with HFS-II score (R = -0.05;P = 0.457 and R = 0.08;P = 0.170). Participants with severe hypoglycemia in the previous 6 months had higher HFS scores. Participants with higher HFS scores presented more hypoglycemias during follow-up. CONCLUSIONS FOH as determined using the HFS-II questionnaire was not associated with 7-point SMBG variability in participants with T1D, but was associated with a positive history of severe hypoglycemia. Higher FOH was associated with higher frequency of hypoglycemia during follow-up.
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Affiliation(s)
- Pierre Jean Saulnier
- Clinical Investigation Centre CIC1402, CHU Poitiers, University of Poitiers, INSERM, Poitiers, France; Endocrinology, Diabetes and Nutrition Department, CHU Poitiers, Poitiers, France.
| | - Claire Briet
- Diabetes Department, CHU Angers, Angers University, Institut MITOVASC, INSERM U1083, Angers, France
| | - Elise Gand
- Endocrinology, Diabetes and Nutrition Department, CHU Poitiers, Poitiers, France
| | - Lucy Chaillous
- L'institut du thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, Nantes, France
| | - Severine Dubois
- Diabetes Department, CHU Angers, Angers University, Institut MITOVASC, INSERM U1083, Angers, France
| | | | | | | | | | | | | | | | | | - Matthieu Pichelin
- L'institut du thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, Nantes, France
| | - Matthieu Wargny
- L'institut du thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, Nantes, France
| | | | - Stephanie Ragot
- Clinical Investigation Centre CIC1402, CHU Poitiers, University of Poitiers, INSERM, Poitiers, France
| | - Samy Hadjadj
- Clinical Investigation Centre CIC1402, CHU Poitiers, University of Poitiers, INSERM, Poitiers, France; Endocrinology, Diabetes and Nutrition Department, CHU Poitiers, Poitiers, France; L'institut du thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, Nantes, France
| | - Bertrand Cariou
- L'institut du thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, Nantes, France
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Tyndall V, Stimson RH, Zammitt NN, Ritchie SA, McKnight JA, Dover AR, Gibb FW. Marked improvement in HbA 1c following commencement of flash glucose monitoring in people with type 1 diabetes. Diabetologia 2019; 62:1349-1356. [PMID: 31177314 PMCID: PMC6647076 DOI: 10.1007/s00125-019-4894-1] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 04/15/2019] [Indexed: 02/06/2023]
Abstract
AIMS/HYPOTHESIS Minimal evidence supports the efficacy of flash monitoring in lowering HbA1c. We sought to assess the impact of introducing flash monitoring in our centre. METHODS We undertook a prospective observational study to assess change in HbA1c in 900 individuals with type 1 diabetes following flash monitoring (comparator group of 518 with no flash monitoring). Secondary outcomes included changes in hypoglycaemia, quality of life, flash monitoring data and hospital admissions. RESULTS Those with baseline HbA1c ≥58 mmol/mol (7.5%) achieved a median -7 mmol/mol (interquartile range [IQR] -13 to -1) (0.6% [-1.2 to -0.1]%) change in HbA1c (p < 0.001). The percentage achieving HbA1c <58 mmol/mol rose from 34.2% to 50.9% (p < 0.001). Median follow-up was 245 days (IQR 182 to 330). Individuals not using flash monitoring experienced no change in HbA1c across a similar timescale (p = 0.508). Higher HbA1c (p < 0.001), younger age at diagnosis (p = 0.003) and lower social deprivation (p = 0.024) were independently associated with an HbA1c fall of ≥5 mmol/mol (0.5%). More symptomatic (OR 1.9, p < 0.001) and asymptomatic (OR 1.4, p < 0.001) hypoglycaemia was reported after flash monitoring. Following flash monitoring, regimen-related and emotional components of the diabetes distress scale improved although the proportion with elevated anxiety (OR 1.2, p = 0.028) and depression (OR 2.0, p < 0.001) scores increased. Blood glucose test strip use fell from 3.8 to 0.6 per day (p < 0.001). Diabetic ketoacidosis admissions fell significantly following flash monitoring (p = 0.043). CONCLUSIONS/INTERPRETATION Flash monitoring is associated with significant improvements in HbA1c and fewer diabetic ketoacidosis admissions. Higher rates of hypoglycaemia may relate to greater recognition of hitherto unrecognised events. Impact upon quality of life parameters was mixed but overall treatment satisfaction was overwhelmingly positive.
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Affiliation(s)
- Victoria Tyndall
- Edinburgh Centre for Endocrinology and Diabetes, Western General Hospital, Edinburgh, UK
| | - Roland H Stimson
- Edinburgh Centre for Endocrinology and Diabetes, Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh, UK
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, EH14 4TJ, UK
| | - Nicola N Zammitt
- Edinburgh Centre for Endocrinology and Diabetes, Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh, UK
| | - Stuart A Ritchie
- Edinburgh Centre for Endocrinology and Diabetes, Western General Hospital, Edinburgh, UK
| | - John A McKnight
- Edinburgh Centre for Endocrinology and Diabetes, Western General Hospital, Edinburgh, UK
| | - Anna R Dover
- Edinburgh Centre for Endocrinology and Diabetes, Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh, UK
| | - Fraser W Gibb
- Edinburgh Centre for Endocrinology and Diabetes, Royal Infirmary of Edinburgh, Little France Crescent, Edinburgh, UK.
- Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, EH14 4TJ, UK.
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Zoppi M, Tedrus GMAS, Laloni DT. Stigma, emotional aspects, and psychological symptoms in individuals with epilepsy. Epilepsy Behav 2019; 93:56-59. [PMID: 30831403 DOI: 10.1016/j.yebeh.2019.01.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 01/28/2019] [Accepted: 01/29/2019] [Indexed: 11/28/2022]
Abstract
The relationship between stigma and psychological aspects in adults with epilepsy is poorly studied. The Stigma Scale of Epilepsy (SSE) was related to the Factorial Neuroticism Scale (FNS), Symptoms Assessment Scale-40 (SAS-40), and clinical aspects of 71 individuals with epilepsy, at a significance level of p < 0.05. Clinical and sociodemographic aspects are associated with the presence of psychological symptoms and emotional maladjustment. The occurrence of psychological symptoms in the SAS-40 was associated with uncontrolled seizures, longer illness duration, and perception of greater stigma. There was a relationship between perceived stigma, age, and epilepsy duration. In the linear regression for determining the factors that potentially affected perception of stigma, the symptom dimensions 'somatization' in the SAS-40 (p < 0.001) and the 'psychosocial maladjustment' in the FNS (p = 0.012) were included, and the clinical aspects were excluded. Psychological symptoms were associated with uncontrolled seizures and perceived stigma. Perception of stigma was associated with somatization and psychosocial maladjustment.
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Affiliation(s)
- Mariana Zoppi
- School of Psychology, Pontifícia Universidade Católica de Campinas, Brazil
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Goncharenko V, Bubnov R, Polivka J, Zubor P, Biringer K, Bielik T, Kuhn W, Golubnitschaja O. Vaginal dryness: individualised patient profiles, risks and mitigating measures. EPMA J 2019; 10:73-79. [PMID: 30984316 DOI: 10.1007/s13167-019-00164-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 02/14/2019] [Indexed: 11/25/2022]
Abstract
Vaginal dryness (VD) affects both pre- and postmenopausal women at any age. Since the hormonal regulation changes during the climacteric period are considered as being the main course of the VD, affected women prefer not to talk about the problem. However, the problem does exist, and unfortunately if any, relatively minor group in the population possesses the health literacy at sufficient level to understand that VD is a suboptimal health condition which carries a multi-factorial character. Thereby, some of the contributing factors are clearly preventable and, therefore, if treated properly, have a potential to milden the VD. Current chapter demonstrates specific signs and symptoms of Flammer syndrome in women suffering from vaginal dryness, although individualised patient profiles clearly discriminate between pre- and postmenopausal women regarding the subgroup-specific symptoms. Noteworthy, about 20% of the VD patients involved in the study notify a delayed or even impaired wound healing observed for themselves over a couple of years. Optimising modifiable risk factors accompanying FS phenotype at the level of primary prevention is strongly recommended. Individualised patient profiles provide important information for VD mitigating measures tailored to the person. Further, future projects should essentially deal with the complexity of vulvar-vaginal dryness as part of the Sicca syndrome in individuals with FS phenotype, in order to prevent genital female cancers which may occur at any age. In contrast to the human papilloma virus as possible trigger of the disease, the role of the vulvar-vaginal dryness as an important risk factor is strongly underestimated in currently applied diagnostic and treatment approaches.
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Affiliation(s)
- Vadym Goncharenko
- Gynaecologic Department, Clinical Hospital "Pheophania", Kyiv, Ukraine
| | - Rostyslav Bubnov
- Ultrasound Department, Clinical Hospital "Pheophania", Kyiv, Ukraine
- 3Zabolotny Institute of Microbiology and Virology, National Academy of Sciences of Ukraine, Kyiv, Ukraine
| | - Jiri Polivka
- 4Department of Histology and Embryology and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
- 5Department of Neurology, University Hospital Pilsen, Pilsen, Czech Republic
| | - Pavol Zubor
- 6Department of Obstetrics and Gynaecology, Jessenius Faculty of Medicine, Martin University Hospital, Martin, Slovak Republic
- 7Division of Oncology, Biomedical Centre Martin, Jessenius Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovak Republic
| | - Kamil Biringer
- 6Department of Obstetrics and Gynaecology, Jessenius Faculty of Medicine, Martin University Hospital, Martin, Slovak Republic
| | - Tibor Bielik
- 6Department of Obstetrics and Gynaecology, Jessenius Faculty of Medicine, Martin University Hospital, Martin, Slovak Republic
| | - Walther Kuhn
- Centre of Obstetrics, Gynaecology and Gynaecologic Oncology, DonauIsar Klinikum Deggendorf-Dingolfing, Landau, Germany
| | - Olga Golubnitschaja
- 9Radiological clinic, UKB, Rheinische Friedrich-Wilhelms-University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany
- 10Breast Cancer Research Centre, UKB, Rheinische Friedrich-Wilhelms-University of Bonn, Bonn, Germany
- 11Centre for Integrated Oncology, UKB, Cologne-Bonn, Rheinische Friedrich-Wilhelms-University of Bonn, Bonn, Germany
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Rønningen R, Wammer ACP, Grabner NH, Valderhaug TG. Associations between Lifetime Adversity and Obesity Treatment in Patients with Morbid Obesity. Obes Facts 2019; 12:1-13. [PMID: 30654360 PMCID: PMC6465708 DOI: 10.1159/000494333] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 10/08/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Bariatric surgery is associated with greater and more sustainable weight loss compared with lifestyle intervention programs. On the other hand, bariatric surgery may also be associated with physical and psychosocial complications. The influence of psychological evaluation on treatment choice, however, is not known. We aimed to examine variables associated with treatment choice and, specifically, if self-reported lifetime adversity influenced obesity treatment, i.e. bariatric surgery, high-intensive lifestyle treatment or low-intensive lifestyle treatment in primary care. METHODS We consecutively included 924 patients from the registry study of patients with morbid obesity at Akershus University Hospital, Lørenskog, Norway. Treatment selection was made through a shared decision-making process. Self-reported lifetime adversity was registered by trained personnel. Logistic regression models were used to assess the associations between obesity treatment and possible predictors. RESULTS Patients who chose bariatric surgery were more likely to have type 2 diabetes (DM2) compared with patients who chose lifestyle treatment (bariatric surgery: 35%, high-intensive lifestyle treatment: 26%, and low-intensive lifestyle treatment: 26%; p = 0.035). Patients who chose bariatric surgery were less likely than patients who chose lifestyle intervention to report lifetime adversity (bariatric surgery: 39%, high-intensive lifestyle treatment: 47%, and low-intensive lifestyle treatment: 51%; p = 0.004). After multivariable adjustments, increasing BMI, having DM2, and joint pain were associated with choosing bariatric surgery over non-surgical obesity treatment (odds ratio [95% CI]: BMI 1.03 [1.01-1.06], DM2 1.47 [1.09-1.99], and joint pain 1.46 [1.08-1.96]). Self-reported lifetime adversity was furthermore associated with lower odds of choosing bariatric surgery in patients with morbid obesity (0.67 [0.51-0.89]). CONCLUSION This study shows that increasing BMI, DM2, and joint pain were all associated with treatment choice for obesity. In addition, self-reported lifetime adversity was associated with the patients' treatment choice for morbid obesity. Consequently, we suggest that decisions concerning obesity treatment should include dialogue-based assessments of the patients' lifetime adversity.
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Affiliation(s)
- Reidun Rønningen
- Department of Endocrinology, Akershus University Hospital HF, Lørenskog, Norway
| | | | - Nina Holte Grabner
- Department of Psychiatry, Unit for Consultation-Liason Psychiatry, Akershus University Hospital, Lørenskog, Norway
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Pinto-Bastos A, Conceição E, de Lourdes M, Arrojado F, Brandão I, Machado PPP. Psychological and Behavioral Aspects of Primary and Reoperative Surgery: a 6-Month Longitudinal Study. Obes Surg 2018; 28:3984-3991. [PMID: 30105661 DOI: 10.1007/s11695-018-3452-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Problematic eating behaviors and general psychopathology have been associated with poor weight loss after bariatric surgery. However, little is known about how these aspects impact weight loss outcomes for the increasing number of patients undergoing reoperative surgeries. This study compares disordered eating and weight-related outcomes before and 6 months after surgery in patients undergoing primary (P-Group) and reoperative bariatric surgery (R-Group). METHODS This longitudinal study assessed 122 P-Group and 116 R-Group patients before and 6 months after surgery. The assessment included the eating disorder examination diagnostic items, and a set of self-report measures assessing eating disorder symptomatology, grazing, depression, anxiety, and negative urgency. RESULTS Preoperatively, no differences were found between the R- and P-Groups in terms of disordered eating-related variables (except for shape concern, which was higher for the R-Group). At 6 months after surgery, the R-Group revealed significantly higher values for restraint (F(1,219) = 5.84, p = 0.016), shape (F(1,219) = 5.59, p = 0.019), weight concerns (F(1,219) = 13.36, p = 0.000), depression (F(1,219) = 7.17, p = 0.008), anxiety (F(1,219) = 6.94, p = - 0.009), and compulsive grazing (F(1,219) = 6.13, p = 0.014). No significant pre- or post-surgery predictors of weight loss were found for the P-Group (χ2 = 0.70, p = 0.872). In the R-Group, post-surgery anxiety (Waldχ2(1) = 6.19, p = 0.01) and the post-surgery number of days with grazing in the previous month (Waldχ2(1) = 3.90, p = 0.04) were significant predictors of weight loss. CONCLUSION At 6 months after surgery, the R-Group presented more problematic eating and general psychological distress, which may put these patients at greater risk of poorer long-term weight outcomes.
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Affiliation(s)
- Ana Pinto-Bastos
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
| | - Eva Conceição
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal.
| | - Marta de Lourdes
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
| | - Filipa Arrojado
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
| | - Isabel Brandão
- Faculty of Medicine, University of Porto, Centro Hospitalar de São João, Porto, Portugal
| | - Paulo P P Machado
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
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Zubor P, Kubatka P, Kapustova I, Miloseva L, Dankova Z, Gondova A, Bielik T, Krivus S, Bujnak J, Laucekova Z, Kehrer C, Kudela E, Danko J. Current approaches in the clinical management of pregnancy-associated breast cancer-pros and cons. EPMA J 2018; 9:257-70. [PMID: 30174762 DOI: 10.1007/s13167-018-0139-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 06/04/2018] [Indexed: 02/07/2023]
Abstract
Malignancies are one of the leading causes of mortality in women during their reproductive life. Treatment of gynecological malignant tumors during pregnancy is possible but not simple, since it creates a conflict between care of the mother and the fetus. BC is the most prevalent malignancy diagnosed in pregnancy, ranking up to 21% of all pregnancy-related malignancies. Due to its stets increasing prevalence, aggressive cancer subtype, and severe ethical and psychological aspects linked to the disease, experts raise an alarm for an acute necessity to improve the overall management of the PABC-the issue which has strongly motivated our current paper. Comprehensive research data and clinical experience accumulated in recent years have advanced our understanding of the disease complexity. PABC treatment must be individualized with an emphasis on optimal care of the mother, while observing standard treatment protocols with regard to safety of the fetus. Treatment protocols should be elaborated based on the individualized patient profile, bearing in mind the acute danger to the mother, maximizing the therapy efficacy and minimizing harmful effects to the fetus. Complex consulting on treatment options, their impacts on pregnancy and potential teratogenic effects requires tight "doctor-patient" collaboration. Complications that may arise due to the treatment of breast cancer in pregnancy require a multiprofessional expertise including oncologists, neonatologists, perinatologists, obstetricians, teratologists, and toxicologists, and an extensive psychological support throughout the pregnancy and after giving birth. Thereby, specifically psychological aspects of PABC diagnosis and follow-up are frequently neglected, being not yet adequately explored in the entire disease management approach. Herewith, we update the status quo regarding the currently available diagnostic modalities, complex treatment algorithms, and novel clinical approaches which altogether argue for an urgent necessity of a paradigm shift moving away from reactive to predictive, preventive, and personalized medical approach in the overall management of PABC meeting the needs of young populations, persons at high risk, affected patients, and families as the society at large.
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Sherf-Dagan S, Schechter L, Lapidus R, Sakran N, Goitein D, Raziel A. Perceptions of Success in Bariatric Surgery: a Nationwide Survey Among Medical Professionals. Obes Surg 2018; 28:135-141. [PMID: 28695458 DOI: 10.1007/s11695-017-2800-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Various definitions for bariatric surgery (BS) success exist, with weight loss and comorbidity resolution outcomes being the most prominent. The study's aim was to compare how various healthcare professionals perceive success in BS. METHODS A 29-item, 10-point Likert scale online survey was distributed via email to Israeli healthcare professionals involved in the different BS aspects using common national professional organizations. These included bariatric surgeons, dietitians, social workers, psychologists, psychiatrists, primary care physicians, gastroenterologists, and nurses. Statement relevancy to BS success was rated. An item was classed as "very important" for BS success if at least 70% of participants rated it 8 or higher in each subgroup. Inter-observer agreement was calculated using kappa statistics. Data on specific occupation, years-in-practice, and major workplace were collected as well. RESULTS A total of 155 responses was obtained. The majority of respondents were dietitians (34.8%, n = 54), followed by bariatric surgeons (31.0%, n = 48) and nurses (14.8%, n = 23). Most respondents work mainly at public hospitals (32.9%, n = 51), followed by private hospitals (26.5%, n = 41). The mean years-in-practice among all healthcare professionals was 8.5 ± 8.5 years. Overall inter-observer agreement for prioritized items in accordance to BS success among all health professional subgroups was fair (Fleiss kappa = 0.278, P < 0.001), while dietitians and mental health specialists showed the highest agreement rate (Cohen's kappa = 0.592, P < 0.001). CONCLUSION The study highlights the various views on defining BS success by different healthcare professionals, although there was some overlap of core outcomes prioritized by all professionals. International uniform definitions for BS success are required.
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Affiliation(s)
- Shiri Sherf-Dagan
- Department of Nutrition, Assuta Medical Center, 20 Habarzel St, 69710, Tel Aviv, Israel.
| | - Lihi Schechter
- Department of Health Systems Management, Ben-Gurion University of the Negev, Beer-Sheba, Israel
| | - Rita Lapidus
- Department of Health Systems Management, Ben-Gurion University of the Negev, Beer-Sheba, Israel
| | - Nasser Sakran
- Assia Medical Group, Assuta Medical Center, Tel-Aviv, Israel.,Department of Surgery A, Emek Medical Center, Afula, Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
| | - David Goitein
- Assia Medical Group, Assuta Medical Center, Tel-Aviv, Israel.,Department of Surgery C, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Asnat Raziel
- Assia Medical Group, Assuta Medical Center, Tel-Aviv, Israel
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Assi J, Santos J, Bonetti T, Serafini PC, Motta ELA, Chehin MB. Psychosocial benefits of fertility preservation for young cancer patients. J Assist Reprod Genet 2018; 35:601-6. [PMID: 29435699 DOI: 10.1007/s10815-018-1131-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 01/23/2018] [Indexed: 10/18/2022] Open
Abstract
PURPOSE The risk of ovarian failure after radiotherapy and/or chemotherapy is a concern among oncologic women. There is no doubt regarding the psycho-emotional benefits of fertility preservation (FP) after a cancer diagnosis because concerns about biological conception are a source of anxiety and can even affect the patient's cancer recovery. The aim of this study was to evaluate oncology patients' feelings, concerns, and life quality impacts related to FP. METHODS This qualitative cross-sectional study was based on a questionnaire administered to a selected group of women diagnosed with cancer who underwent FP. Thirty-four eligible women (23-39 years old) completed this questionnaire. RESULTS Two of the participants already had a child, and most of them (61.8%) stated a desire to have children at the time of FP. Their feelings primarily involved safety (44.1%) and hope (23.5%). Time and/or financial issues (82.4%) were the main challenge for FP. All of the women noted the importance of FP, with many stating that it is warranted to allow the possibility of a biological pregnancy due to the risk of infertility. Finally, questions about the impact on their lives if they had not undergone FP indicated emotional impairment, low quality of life, relationship problems, and uncertainty about maternity. CONCLUSIONS FP for oncology patients is a positive strategy. The women in this study felt that FP was a worthwhile process and that the security of having undergone FP brought them peace during oncological treatment and contributed to their quality of life.
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Dempsey PC, Dunstan DW, Larsen RN, Lambert GW, Kingwell BA, Owen N. Prolonged uninterrupted sitting increases fatigue in type 2 diabetes. Diabetes Res Clin Pract 2018; 135:128-133. [PMID: 29129482 DOI: 10.1016/j.diabres.2017.11.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 10/06/2017] [Accepted: 11/02/2017] [Indexed: 11/16/2022]
Abstract
Fatigue is a prevalent, costly and disabling clinical complaint among those with type 2 diabetes. In a randomized crossover trial, prolonged uninterrupted sitting increased fatigue by 29% relative to days when sitting was regularly interrupted by brief activity-breaks. This may have implications for diabetes-related quality of life, occupational productivity and self-care.
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Affiliation(s)
- Paddy C Dempsey
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; Centre for Urban Transitions & Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, VIC, Australia.
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; Institute of Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia; Mary MacKillop Institute of Health Research, Australian Catholic University, Melbourne, VIC, Australia; School of Public Health, The University of Queensland, Brisbane, QLD, Australia; School of Sport Science, Exercise and Health, The University of Western Australia, Perth, WA, Australia; Central Clinical School/Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Robyn N Larsen
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Gavin W Lambert
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; Centre for Urban Transitions & Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Bronwyn A Kingwell
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; Central Clinical School/Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Neville Owen
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; Centre for Urban Transitions & Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, VIC, Australia; Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; School of Public Health, The University of Queensland, Brisbane, QLD, Australia; Central Clinical School/Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
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Abstract
The term "cancer survivor" is commonly used by different persons, clinical institutions, academic bodies, and political organizations although it lacks of a unanimous and detailed definition. The objective of the study is to make a systematic review of published and proposed definitions of "cancer survivor." Utilizing a systematic search strategy with different strings of "cancer survivor," we searched the following databases: Medline (June 1975-June 2015), Scopus (all the years), Web of Science (all the years), Google Scholar (all the years), ERIC (all the years). This review suggests that there is not a unique definition of who is a "cancer survivor" and what is "cancer survivorship." However, the most widely used definition sees cancer survivorship as a process that begins at the moment of diagnosis and continues through the balance of life. This definition highlights psychological and legal patient's needs-as well as medical ones-to receive care and assistance from the beginning and, at the same time, it establishes valid criteria for making scientific and statistical sampling research. The extensive use of the term "cancer survivor" indicates that it is a significant term. This review has been written to outline the state of the art and it invites to reflect on a shared definition that could satisfy both clinical and research aspects. Implication for cancer survivors: this compendium of proposed definitions may improve communication among the many patients and patient organizations that use and work with this term.
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Affiliation(s)
- Chiara Marzorati
- Foundations of the Life Sciences Bioethics and Cognitive Sciences, European School of Molecular Medicine (SEMM), European Institute of Oncology, Via Adamello 16, 20139, Milan, Italy
- Applied Research Unit for Cognitive and Psychological Science, European Institute of Oncology, Via Ripamonti 432, 20143, Milan, Italy
| | - Silvia Riva
- Applied Research Unit for Cognitive and Psychological Science, European Institute of Oncology, Via Ripamonti 432, 20143, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Gabriella Pravettoni
- Applied Research Unit for Cognitive and Psychological Science, European Institute of Oncology, Via Ripamonti 432, 20143, Milan, Italy.
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.
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Busetto L, Dicker D, Azran C, Batterham RL, Farpour-Lambert N, Fried M, Hjelmesæth J, Kinzl J, Leitner DR, Makaronidis JM, Schindler K, Toplak H, Yumuk V. Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management. Obes Facts 2017; 10:597-632. [PMID: 29207379 PMCID: PMC5836195 DOI: 10.1159/000481825] [Citation(s) in RCA: 193] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 09/21/2017] [Indexed: 12/17/2022] Open
Abstract
Bariatric surgery is today the most effective long-term therapy for the management of patients with severe obesity, and its use is recommended by the relevant guidelines of the management of obesity in adults. Bariatric surgery is in general safe and effective, but it can cause new clinical problems and is associated with specific diagnostic, preventive and therapeutic needs. For clinicians, the acquisition of special knowledge and skills is required in order to deliver appropriate and effective care to the post-bariatric patient. In the present recommendations, the basic notions needed to provide first-level adequate medical care to post-bariatric patients are summarised. Basic information about nutrition, management of co-morbidities, pregnancy, psychological issues as well as weight regain prevention and management is derived from current evidences and existing guidelines. A short list of clinical practical recommendations is included for each item. It remains clear that referral to a bariatric multidisciplinary centre, preferably the one performing the original procedure, should be considered in case of more complex clinical situations.
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Affiliation(s)
- Luca Busetto
- Department of Internal Medicine, University of Padova, Padova, Italy
- *Prof. Dr. Luca Busetto, Clinica Medica 3, Azienda Ospedaliera di Padova, Via Giustiniani 2, 35128 Padova, Italy,
| | - Dror Dicker
- Department of Internal Medicine D and Obesity Clinic, Hasharon Hospital, Rabin Medical Center, Petah Tikva, Sackler School of Medicine Tel Aviv University, Tel Aviv, Israel
| | - Carmil Azran
- Clinical Pharmacy, Herzliya Medical Center, Herzliya, Israel
| | - Rachel L. Batterham
- Centre for Obesity Research, Rayne Institute, Department of Medicine, University College London, London, UK
- University College London Hospital Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital, London, UK
- National Institute of Health Research, University College London Hospital Biomedical Research Centre, London, UK
| | - Nathalie Farpour-Lambert
- Obesity Prevention and Care Program Contrepoids, Service of Therapeutic Education for Chronic Diseases, Department of Community Medicine, Primary Care and Emergency, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
| | - Martin Fried
- OB Klinika, Centre for Treatment of Obesity and Metabolic Disorders, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jøran Hjelmesæth
- Morbid Obesity Centre, Vestfold Hospital Trust and Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Johann Kinzl
- Department of Psychiatry and Psychotherapy II, Medical University Innsbruck, Innsbruck, Austria
| | | | - Janine M. Makaronidis
- Centre for Obesity Research, Rayne Institute, Department of Medicine, University College London, London, UK
- National Institute of Health Research, University College London Hospital Biomedical Research Centre, London, UK
| | - Karin Schindler
- Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Hermann Toplak
- Department of Medicine, Medical University Graz, Graz, Austria
| | - Volkan Yumuk
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
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33
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Pouwer F. Depression: a common and burdensome complication of diabetes that warrants the continued attention of clinicians, researchers and healthcare policy makers. Diabetologia 2017; 60:30-34. [PMID: 27838735 DOI: 10.1007/s00125-016-4154-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 10/13/2016] [Indexed: 01/28/2023]
Abstract
There is ample evidence that depression is a common comorbid health issue in people with type 1 or type 2 diabetes. Reviews have also concluded that depression in diabetes is associated with higher HbA1c levels, less optimal self-care behaviours, lower quality of life, incident vascular complications and higher mortality rates. However, longitudinal studies into the course of depression in people with type 1 diabetes remain scarce. In this issue of Diabetologia, Kampling and colleagues (doi: 10.1007/s00125-016-4123-0 ) report the 5 year trajectories of depression in adults with newly diagnosed type 1 diabetes (mean age, 28 years). Their baseline results showed that shortly after the diagnosis of type 1 diabetes a major depressive episode was diagnosed in approximately 6% of participants, while 8% suffered from an anxiety disorder. The longitudinal depression data showed that, in a 5 year period, 79% reported no depressive symptoms at any time, while 7% had a high depression score that improved and 14% reported worsening of depressive symptoms. Here, the clinical relevance of these findings is discussed and areas for further research are described.
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Affiliation(s)
- François Pouwer
- Department of Psychology, University of Southern Denmark, Campusvej 55, DK-5230, Odense M, Denmark.
- Department of Medical and Clinical Psychology, Centre of Research on Psychology and Somatic Diseases (CoRPS), Tilburg University, Tilburg, the Netherlands.
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Abstract
Health behavior change is central in obesity management. Due to its complexity, there has been a growing body of research on: i) the factors that predict the adoption and maintenance of health behaviors, ii) the development and testing of theories that conceptualize relationships among these factors and with health behaviors, and iii) how these factors can be implemented in effective behavior change interventions, considering characteristics of the content (techniques) and delivery. This short review provides an overview of advances in behavior change science theories and methods, focusing on obesity management, and includes a discussion of the main challenges imposed by this research field.
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Affiliation(s)
- Pedro J. Teixeira
- Interdisciplinary Center for the Study of Human Performance (CIPER), Self-Regulation Group, Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada/Dafundo, Portugal
- *Prof. Dr. Pedro J. Teixeira, Interdisciplinary Center for the Study of Human Performance (CIPER), Self-Regulation Group, Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1499–002 Cruz Quebrada/Dafundo, Portugal,
| | - Marta M. Marques
- Interdisciplinary Center for the Study of Human Performance (CIPER), Self-Regulation Group, Faculty of Human Kinetics, University of Lisbon, Cruz Quebrada/Dafundo, Portugal
- UCL Centre for Behaviour Change University College London, London, UK
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Duarte C, Stubbs J, Pinto-Gouveia J, Matos M, Gale C, Morris L, Gilbert P. The Impact of Self-Criticism and Self-Reassurance on Weight-Related Affect and Well-Being in Participants of a Commercial Weight Management Programme. Obes Facts 2017; 10:65-75. [PMID: 28376484 PMCID: PMC5644966 DOI: 10.1159/000454834] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 11/23/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Certain psychological and emotional factors can undermine attempts at weight management. Previously we have found that shame and self-criticism were significantly associated with disinhibition and perceived hunger in 2,236 participants of a weight management programme. This effect was fully mediated through weight-related negative affect. The present study examined the impact of self-criticism and self-reassurance on well-being and whether it was mediated by weight-related affect in the same population. METHODS Participants completed an online survey of measures of self-criticism and self-reassurance, and negative and positive affect associated with weight and well-being. RESULTS Path analysis suggested that self-criticism was significantly associated with decreased well-being, both directly and indirectly, mediated by increased negative and decreased positive weight-related affect. Self-reassurance had a stronger association with increased well-being by predicting lower negative and increased positive weight-related affect. All effects were significant at p < 0.001. CONCLUSION Self-criticism and self-reassurance were related to well-being in participants attempting to manage their weight, both directly and through their impact on weight-related affect. The positive association between self-reassurance and well-being was stronger than the negative association between self-criticism and well-being. Supporting the development of self-reassuring competencies in weight management programmes may improve weight-related affect and well-being.
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Affiliation(s)
- Cristiana Duarte
- Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculty of Psychology and Educational Sciences, Coimbra, Portugal
- *Cristiana Duarte, CINEICC, Faculdade de Psicologia e Ciências da Educação, Universidade de Coimbra, Rua do Colégio Novo, Apartado 6153, 3001-802 Coimbra, Portugal,
| | - James Stubbs
- Appetite Control and Energy Balance Research Group, School of Psychology, University of Leeds, Leeds, UK
| | - José Pinto-Gouveia
- Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculty of Psychology and Educational Sciences, Coimbra, Portugal
| | - Marcela Matos
- Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculty of Psychology and Educational Sciences, Coimbra, Portugal
| | - Corinne Gale
- Mental Health Research Unit, Kingsway Hospital, Derby, UK
| | - Liam Morris
- Nutrition and Research Department, Slimming World, UK
| | - Paul Gilbert
- Mental Health Research Unit, Kingsway Hospital, Derby, UK
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36
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Abstract
Despite advances in standard of living of the population, the condition of widows and divorced women remains deplorable in society. The situation is worse in developing nations with their unique social, cultural and economic milieu, which at times ignores the basic human rights of this vulnerable section of society. A gap exists in life expectancies of men and women in both developing and developed nations. This, coupled with greater remarriage rates in men, ensures that the number of widows continues to exceed that of widowers. Moreover, with women becoming more educated, economically independent and aware of their rights, divorce rates are increasing along with associated psychological ramifications. The fact that widowed/divorced women suffer from varying psychological stressors is often ignored. It has been concluded in various studies that such stressors could be harbingers of psychiatric illnesses (e.g., depression, anxiety, substance dependence), and hence should be taken into account by treating physicians, social workers and others who come to the aid of such women. A change in mindset of the society is required before these women get their rightful place, for which a strong will is needed in the minds of the people, and in law-governing bodies.
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Affiliation(s)
- J K Trivedi
- Honorary Member, Wolrd Psychiatric Association, Professor & Ex-Head, India
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37
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Abstract
One fifth of the population report adverse reactions to food. Reasons for these symptoms are heterogeneous, varying from food allergy, food intolerance, irritable bowel syndrome to somatoform or other mental disorders. Literature reveals a large discrepancy between truly diagnosed food allergy and reports of food allergy symptoms by care seekers. In most studies currently available the characterization of patient groups is incomplete, because they did not distinguish between immunologic reactions and other kinds of food reactions. In analysing these adverse reactions, a thorough physical and psychological diagnostic approach is important. In our qualitative review, we present those diagnostic measures that are evidenced-based as well as clinically useful, and discuss the various psychological dimensions of adverse reactions to food. It is important to acknowledge the complex interplay between body and mind: Adults and children suffering from food allergy show impaired quality of life and a higher level of stress and anxiety. Pavlovian conditioning of adverse reactions plays an important role in maintaining symptoms. The role of personality, mood, or anxiety in food reactions is debatable. Somatoform disorders ought to be identified early to avoid lengthy and frustrating investigations. A future task will be to improve diagnostic algorithms, to describe psychological aspects in clearly characterised patient subgroups, and to develop strategies for an optimized management of the various types of adverse reactions to food.
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Affiliation(s)
- Martin Teufel
- Department of Internal Medicine VI-Psychosomatic Medicine and Psychotherapy, University of Tubingen, Osianderstrasse 5, D-72076 Tubingen, Germany.
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