社区老年人群糖代谢异常、糖尿病患病率与糖尿病控制情况及影响因素分析

目的 了解社区老年人群糖尿病的患病情况以及糖尿病的控制情况,并探讨其主要的影响因素。方法 2009年9月至2010年6月采用随机整群抽样,选择北京市万寿路地区≥60岁老年人群进行横断面调查。收集社区老年人的一般健康状况、糖尿病患病情况、服药治疗情况,并进行化验检查。结果 共纳入2 102名（其中男性848名,女1 254名）社区老年人,年龄在60～95（71.2±6.6）岁之间。老年人文化程度较高,吸烟（21.1%）、饮酒（42.2%）比例较低,约有10%人群有糖尿病家族史。社区老年人群糖尿病的患病率为24.8%,约有33.1%的社区老年人存在糖调节受损,其中主要是糖耐量减低。糖尿病的知晓率和治疗率分别为78.5%和69.3%,控制率为15.9%。多因素分析结果显示,超重/肥胖、有糖尿病家族史的老年人糖尿病患病风险是对照组的1.42（95% CI：1.14～1.76）和3.42（95% CI：2.70～4.35）倍,且超重/肥胖、饮酒和家族史也是影响糖尿病控制情况的重要因素。结论 社区老年人群糖代谢异常和糖尿病患病率相对较高,糖尿病知晓率与治疗率较高,但控制率较低。超重/肥胖、饮酒与家族史是影响糖尿病患病与控制情况的重要因素。     

How smart medication systems are used to support older people's drug regimens: A systematic literature review

Smart medication systems are used to help older people, and the professionals and family who care for them, to organize and manage their daily drug regimes. However, synthetized knowledge on previous studies about how these improve everyday life is needed. We searched the PubMed, Scopus, CINAHL, PsycINFO, SocINDEX and Cochrane library databases from 2005 to 2019 and this review focused on nine of the 2,424 papers we identified. According to our analysis, smart medication systems make it possible to regulate medication times and doses and detect medication errors. With further development, smart medication systems could be more be effective at preventing medication errors, improving medication adherence by older people and freeing up healthcare professional, so that they can focus on other tasks. However, more research on different systems is needed to improve existing solutions and to understand how they can make older people more independent when it comes to their daily medication.     

The hoverfly and the wasp: A critique of the hallmarks of aging as a paradigm

With the goal of representing common denominators of aging in different organisms López-Otín et al. in 2013 described nine hallmarks of aging. Since then, this representation has become a major reference point for the biogerontology field. The template for the hallmarks of aging account originated from landmark papers by Hanahan and Weinberg (2000, 2011) defining first six and later ten hallmarks of cancer. Here we assess the strengths and weaknesses of the hallmarks of aging account. As a checklist of diverse major foci of current aging research, it has provided a useful shared overview for biogerontology during a time of transition in the field. It also seems useful in applied biogerontology, to identify interventions (e.g. drugs) that impact multiple symptomatic features of aging. However, while the hallmarks of cancer provide a paradigmatic account of the causes of cancer with profound explanatory power, the hallmarks of aging do not. A worry is that as a non-paradigm the hallmarks of aging have obscured the urgent need to define a genuine paradigm, one that can provide a useful basis for understanding the mechanistic causes of the diverse aging pathologies. We argue that biogerontology must look and move beyond the hallmarks to understand the process of aging.     

Risk factors for plantar foot ulcer recurrence in patients with diabetes – A prospective pilot study

IntroductionDiabetic foot ulcer (DFU) is a complication of diabetes mellitus (DM) with established recurrence risk factors evaluating patients from United States or Europe. There are scarce studies in developing countries about these risks. The aim of this study was to evaluate risk factors associated with DFU recurrence in a Brazilian prospective cohort.Materials and methodsA prospective cohort of patients with healed DFU followed from January 2014 to June 2017 in Curitiba, Brazil. Periodic home visits from a specialist nurse in DFU were performed during the period of the study to evaluate recurrence of ulcer. The presence of risk factors in the group of patients that developed an ulcer in the follow-up period was compared with the presence of these factors in the group of patients without recurrence. At enrollment, 35 subjects presented a previous ulcer distal with complete healing to follow-up.ResultsFrom 35 patients, 15 were male (43%) and the mean age was of 65.8 ± 10.9 years (48–85 year). Most patients were married with a low income (<US$ 250/month). The mean BMI was 26.5 ± 5.6 kg/cm². Seventy-four percent (26/35) had another comorbidity. The mean duration of DM until ulcer was 14.6 ± 5.2 years. The global mortality during the study (3 years) was 14%. The DFU recurred in 23 patients (65.7%). Both groups had similar findings, except by lower income (<US$ 250/month) in the group of recurrent DFU.ConclusionRecurrence of DFU is frequent and associated with low familiar income in a pilot Brazilian study.     

Longitudinal impact and effects of booster sessions in a cognitive training program for healthy older adults

This paper reports the results from a 3-year follow-up study to measure the long-term efficacy of a cognitive training for healthy older adults and investigates the effects of booster sessions using an entropy-based metric. Design: semi-randomized quasi-experimental controlled design. Participants: 50 older adults, (M = 73.3, SD = 7.77) assigned into experimental (N = 25; Mean age = 73.9; SD = 8.62) and control groups (N = 25; mean age = 72.9; SD = 6.97). Instruments: six subtests of WAIS and two episodic memory tasks. Procedures: the participants were assessed on four occasions: after the end of the original intervention, pre-booster sessions (three years after the original intervention), immediately after the booster sessions and three months after the booster sessions. Results: the repeated measures ANOVA showed that two of the cognitive gains reported in the original intervention were also identified in the follow-up: Coding (F(1, 44) = 11.79, MSE = 0.77, p = .001, eta squared = 0.084) and Picture Completion (F(1, 47) = 10.01, MSE = 0.73, p = .003, eta squared = 0.060). After the booster sessions, all variables presented a significant interaction between group and time favorable to the experimental group (moderate to high effect sizes). To compare the level of cohesion of the cognitive variables between the groups, an entropy-based metric was used. The experimental group presented a lower level of cohesion on three of the four measurement occasions, suggesting a differential impact of the intervention with immediate and short-term effects, but without long-term effects.     

医学研究生《临床流行病学》教学满意度现况调查

目的　了解某医学院校研究生临床流行病学教学满意度状况,为进一步探索临床流行病学授课方式和提高教学质量提供依据。方法　对某校2013级全体硕士、博士研究生进行整群抽样,采用自行设计的问卷,在临床流行病学授课完成后进行调查。共调查559名研究生,其中硕士研究生324名（58.0%）,博士研究生235名（42.0%）;统招研究生350名（62.6%）,在职研究生209名（37.4%）。问卷内容包括调查对象一般情况、授课教材满意度评价、课程设置和授课教师满意度评价等多个方面,由被调查者自填完成。采用Epidata软件进行平行双录入,SPSS 19.0软件对数据进行分析。连续型变量采用x±s,分类变量采用n（%）表示;连续变量采用t检验、方差分析进行分组比较,分类变量采用χ2检验进行分组比较,P＜0.05为差异有统计学意义。结果　理论教材总体评价结果低于实习教材,二者的实用性、满足学习需求和难易程度的满意率分别为83.7%（468/559）、87.5%（489/559）、67.1%（375/559）和92.7%（518/559）、89.6%（501/559）、83.0%（464/559）;其中41.6%的在职研究生（87/209）和36.7%的硕士研究生（119/324）认为理论教材偏难的比例较高。课程设置和教师评价方面,研究生对于教师教学态度（99.5%,556/559）、教师教学方法（98.6%,551/559）、理论结合实习授课方式（97.5%,545/559）等条目满意度较高,均达到95.0%及以上。满意率最低的方面为课时数（67.4%,377/559）;有32.6%（182/559）的研究生认为目前课时较少,其中博士研究生（44.7%,105/235）和统招研究生（37.1%,130/350）认为课时少的比例较高。结论　该校临床流行病学授课效果较好,研究生对于所使用教材、课程设置、授课教师满意度较高,但也存在一些不足。今后教学工作中,应适当增加课时,并针对在职和统招研究生不同的学习特点设置相应的教学内容和方法,以进一步提高授课效果和教学质量。