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1.

Purpose

Probiotics and prebiotics have become an object of intense research, to identify methods of mitigating oxidative stress. Over the past few years, the number of in vitro and in vivo studies, related to antioxidant properties of probiotics/prebiotics has significantly increased. The aim of the present study was to assess whether probiotic in combination with prebiotic influences the level of human 4-hydroxynonenal, 8-isoprostane and glutathione reductase activity.

Material/methods

Experiments were carried out on healthy volunteers (male and female). All oxidative stress markers were measured in blood plasma pre- and post-administration of synbiotic.

Results

The administration of synbiotic resulted in a significant decrease in 4-hydroxynonenal in the female-synbiotic group (p?<?0.05), 8-isoprostanes in the female-synbiotic group and male-synbiotic group (p?<?0.05) and non-significant increase in the activity of glutathione reductase (p?>?0.05) vs. control.

Conclusions

The present results show that supplementation of synbiotics contributed to the decrease in oxidative stress parameters in the female patients.  相似文献   

2.

Objectives

The aim was to determine the impact of a telephone counseling service, provided bi-monthly by pharmacist, on patients’ beliefs about antihypertensive medicines and blood pressure (BP) control.

Methods

Either hypertensive patients were randomly assigned to a control group (CG, usual care) or an intervention group (IG). All patients had BP values registered and filled in the Italian version of the Belief Medicine Questionnaire (BMQ). After 12 months, patients filled in the BMQ again and had their self-reported BP registered. The intervention consisted of an educational/counseling session based on patients’ needs assessment provided bi-monthly by a pharmacist for one year via telephone.

Results

80 CG and 84 IG patients were recruited. After 12 months, there were significant differences between IG and CG for both BMQ’s Necessity and Concern score (p?<?0.001; p?<?0.001 respectively) and a significant reduction in BP values in IG (p?<?0.001).

Conclusions

The intervention improves BP control by modifying patients’ perception about treatments and involving patients as participants in the management of their health.

Practice implications

This paper could serve as a guideline for other studies to confirm the effectiveness of this intervention in modifying health behavior, and the role of hospital pharmacist.  相似文献   

3.

Objectives

To investigate the effectiveness of family intervention for type 2 diabetes and to examine predictors of glycaemic control.

Methods

This was a prospective randomised controlled trial. Participants with type 2 diabetes were randomly assigned to an intervention group (n?=?98) or a control group (n?=?98). A pharmacist delivered the educational sessions and encouraged family members to take an active role in self-management practices for the intervention patients. The control patients received usual care.

Results

At the end of the study (9-month follow-up), greater reduction in glycosylated haemoglobin (HbA1c) occurred in the intervention group than in the control group (?1.37% and ?0.21%, respectively; P?<?0.001). Between-group differences in the improvements of low-density lipoprotein cholesterol (LDL-C) and blood pressure were found (P?<?0.05). Higher scores in diabetes knowledge of patients, family support, medication adherence, self-management and self-efficacy were seen in the intervention group than in the control group (P?<?0.05). Multivariable analysis showed family members who were spouses or women were strong predictors of improved glycaemic control.

Conclusion

Family-involvement intervention is helpful in diabetes management, especially having spouses or women as caregivers.

Practice implications

Family involvement should be encouraged in diabetes care.  相似文献   

4.

Objective

We hypothesized that diabetes-related distress would vary by type of diabetes and medication regimen [Type 1 diabetes (T1DM), Type 2 diabetes with insulin use (T2DM-i), Type 2 diabetes without insulin use (T2DM)]. Thus, the aim of this study was to identify groups with elevated diabetes-related distress.

Methods

We administered the 17-item Diabetes-related Distress Scale (DDS-17) to 585 patients. We collected demographics, medications, and lab results from patient records.

Results

Patients were categorized by type of diabetes and medication: T1DM (n?=?149); T2DM-i (n?=?333); and T2DM (n?=?103). ANOVA revealed significant differences in sample characteristics. ANCOVA were conducted on all four DDS-17 domains [Emotional Burden (EB); Physician-related Distress (PD); Regimen-related Distress (RD); and Interpersonal Distress (ID)]; covariates included in the models were sex, age, duration of diabetes, BMI, and HbA1c. EB was significantly lower in T1DM than T2DM-i, p?<?0.05. In addition, RD was significantly lower in T1DM than either T2DM-i, p?<?0.05 and T2DM, p?<?0.05.

Conclusions

EB and RD are higher for those with type 2 diabetes. Thus, interventions to reduce EB and RD need to be considered for patients with type 2 diabetes.

Implications

DDS-17 is useful in identifying diabetes-related distress in patients with diabetes. Efforts need to be made to reduce EB and RD.  相似文献   

5.

Objective

This study aims to assess the effectiveness of a peer support intervention, in which patients with T2DM were provided ongoing self-management support by trained peers with diabetes directed at improving self-care behaviors, self-efficacy and life quality.

Methods

In this randomized controlled trial, 200 patients referred to a diabetes specialty clinic were allocated to peer support or control group. Participants in both groups received usual education by diabetes educators.Intervention participants worked with the trained volunteer peers who encouraged participants to engage in daily self-management and to discuss and share their experiences and challenges of diabetes management. The primary outcomes were HbA1c, BMI, self-care behaviors, self-efficacy and life quality

Results

After 6 months, patients in the peer support group experienced a significant decline in mean A1c value (P = 0.045). Also, mean diabetes self-management scores, mean self-efficacy scores and mean quality of life scores significantly improved in peer support group compared to control group (P values <0.001).

Conclusion

Peer support activities can be successfully applied in diabetes self-management, especially in areas with a shortage of professionals and economic resources.

Practice implications

Peer support strategies should be integrated into our healthcare system to meet minimum needs of people with T2DM in Iran.  相似文献   

6.

Objective

Is there a relationship between decision-making preferences and psychological distress?

Methods

Patients who had received treatment for head and neck cancer (HNC) at four institutions within NSW, Australia were invited to complete a single questionnaire.

Results

Five hundred and ninety-seven patients completed the questionnaire. The majority of patients (308, 54%) preferred shared decision making. Significant predictors of a preference towards active decision making were education level (OR 2.1 for tertiary, p?<?0.001), primary cancer site (OR 1.9 for thyroid compared to salivary gland, p?=?0.024) and gender (OR 1.4 for female, p?=?0.028). Mean psychological distress score on Kessler 6 (K6) was 9 (Range: 0–28). Significant predictors of psychological distress were age (p?<?0.001), gender (p?<?0.001), primary site (p?<?0.01), and decision preference (p?<?0.01).

Conclusion

HNC patients who are either tertiary educated or female are more likely to prefer active involvement in decision-making. Psychological distress is more likely in patients actively involved in decision making, younger patients, and in females.

Practice implications

: Patients experienced paternalistic decision-making, but most preferred active or a shared approached. Clinicians need to be aware of potential for psychological distress in active decision-makers and refer patients for psychosocial support.  相似文献   

7.
8.

Purpose

The aim of the study was to assess plasma RBP4 concentration in elderly subjects in relation to nutritional status and kidney function in the population of the PolSenior Study.

Material and methods

We assessed RBP4, glucose, insulin, albumin, lipid profile, C-reactive protein, (hsCRP) and creatinine concentrations in 2614 PolSenior Study participants (1235 women and 1379 men). The study group was divided based on BMI and HOMA-IR values, and the occurrence of diabetes.

Results

Plasma RBP4 concentration was similar in normal weight, overweight, and obese subgroups, both in women (40.4 vs 40.8 vs 41.8?ng/ml, respectively), and men (41.2 vs 40.3 vs 42.9?ng/ml, respectively). Similar values were found in subjects with HOMA-IR <2.5; ≥2.5 and diabetes, while those with decreased eGFR (<60?ml/min/1.73?m2) were characterized by increased RBP4 levels [46.0 (32.0–64.8) vs 39.4 (28.2–54.9) ng/ml; p?<?0.001]. Plasma RBP4 level variability was explained by: age, waist circumference or BMI, and eGFR, but not HOMA-IR and/or hsCRP. The standardized coefficients β (slopes) for BMI and waist circumference were similar.

Conclusions

The results revealed that in older subjects, circulating RBP4 levels are mostly affected by kidney function and modestly by age, gender, and nutritional status, but not insulin resistance.  相似文献   

9.

Objective

This study evaluates the effectiveness of technology versus in-person, group-initiated diabetes prevention to enhance comprehension of learning objectives between patients with differing health literacy (HL).

Methods

Evidence-based content through either a DVD (n?=?217) or in-person, group class (n?=?225) to initiate the intervention. A teach-back call was used to assess comprehension of, and reinforce, learning objectives. Chi-squared was used to determine differences between conditions (DVD vs Class) and HL levels (High n?=?361 vs. Low n?=?81) and regression analyses were used to examine relationships.

Results

DVD participants performed significantly better across teach back questions (15.4?±?2.5 v. 14.8?±?2.6, p?<?0.01), demonstrated comprehension in fewer teach-back rounds (1.9?±?0.7 v. 2.1?±?0.7, p?<?0.01), and answered more questions correctly on the first try (4.2?±?1.6 v. 3.4?±?1.8, p?<?0.01). Models for HL levels and modality by HL level were statistically significant (p?<?0.01) favoring the DVD.

Conclusion

Initiating a diabetes prevention program with the use of a DVD appears to be a superior option to in-person, class sessions. Teach-back and teach-to-goal strategies enables participants of both high and low health literacy levels to receive and confirm mastery of diabetes prevention objectives.

Practice Implications

A teach-back call may improve information uptake increasing the likelihood of health behavior uptake.  相似文献   

10.

Purpose

The primary purpose is to review diabetes workplace interventions and the degree to which they improve diabetes-related outcomes in employees diagnosed with or at risk for T2DM.

Methods

Three electronic databases and ancestry searches were used to identify peer reviewed articles published in English from 2000 to June 2017.

Results

The number of participants represented by the 22 selected studies, excluding one large outlier, was 4243. On average, the samples were 57% female and ethnically diverse. Interventions—healthy eating behaviors, physical activity, and/or monitoring and self-managing diabetes and cardiovascular risk factors—were delivered in group sessions of fewer than 20 employees. Programs involved 1-h weekly sessions held during lunch hour or at other times during the workday for 12 to 24?weeks. Study outcomes, commonly measured at 6 and/or 12 months, were consistently positive.

Conclusion

The literature search uncovered beginning evidence that workplace interventions hold promise for preventing diabetes and/or its complications. More rigorous, creatively designed, workplace studies, are needed for employees at high-risk for developing diabetes.

Practice implications

Implications include the need for employer education about the benefits of employer support for such programs and attention to motivational strategies so employees will take full advantage of programs that are offered.  相似文献   

11.

Objective

to identify the expressed reasons adults with type 2 diabetes decline structured diabetes education (SDE).

Methods

cross sectional survey of 335 adults with type 2 diabetes who had declined SDE within the past two years, from across Northern Ireland and England.Standardised instruments comprising The Diabetes Attitude Scale, Diabetes Empowerment Scale (Short Form), and Diabetes Knowledge Test plus a questionnaire to elicit the reasons for declining SDE were used.

Results

Mean age 57.6 years (±21.1) 50.7% males, predominantly of White ethnicity (85.7%). They were most frequently invited to attend by a diabetes specialist nurse (36%), general practitioner (27%) or practice nurse (19%).Although a diversity of reasons for declining SDE were cited the most common were; ‘The course was too long’ (47.2%), ‘I have other health problems’ (41.2%) and they had other priorities (33.4%).Hierarchical cluster analysis revealed that expressed reasons for declining SDE were highly individualised.

Conclusion

The wide range of reasons that impeded attendance suggests there is no simple solution that will improve attendance rates.

Practice implications

In the same way that medical treatment for diabetes is becoming increasingly individualised, educational provision should be encouraged to move away from a one size fits all model.  相似文献   

12.

Objectives

The aim of this study was to implement and evaluate the outcomes of chemotherapy counselling based on the “Managing Patients on Chemotherapy” module on self-esteem and psychological affect (anxiety, depression) of cancer patients by pharmacists in ten selected government hospitals in Peninsular Malaysia.

Methods

A randomized control trial was conducted among 2120 cancer patients from April 2016 to January 2017 in ten selected government hospitals in Peninsular Malaysia. Cancer patients were randomly assigned to intervention and control groups. The intervention group received chemotherapy counselling by pharmacists based on the “Managing Patients on Chemotherapy” module. The outcomes were assessed at baseline, 1st, 2nd and 3rd follow-ups after counselling. In the course of data analysis; independent sample t-test, chi-square and two-way repeated measures ANOVA were conducted.

Results

Mean scores of self-esteem in the intervention group had significant difference in comparison with those of the control group in the 1st, 2nd and 3rd follow-ups after counselling (P?<?0.0001). Also, among those with depression and anxiety at baseline, there was reduction in depression and anxiety scores after the 1st, 2nd and 3rd follow-ups after counselling (p?<?0.05).

Conclusion

Repetitive counselling by pharmacists based on the “Managing Patients on Chemotherapy” module had positive effect on improving self-esteem and psychological affect of cancer patients undergoing chemotherapy in Peninsular Malaysia.

Practice implications

This module can be used for all Malaysian cancer patients undergoing chemotherapy to improving self-esteem and psychological affect.  相似文献   

13.

Objective

Intervening on barrier beliefs (BBs) may inhibit the role of barriers as mediating factors in lifestyle behavior. The aim of this study was to analyze the effects of a barrier-belief counseling intervention (BBCI) on physical activity (PA) and healthy food intake.

Methods

An RCT was conducted in a primary care setting among adults (aged 18–70), with two interventions: a BBCI (n?=?123) and a standardized lifestyle group intervention (SLI) (n?=?122). A non-treated hanging control group (n?=?36) received no intervention. Outcomes on PA (accelerometer and SQUASH) and fruit and vegetable intake (self-report) were measured with follow-ups at 6, 12 and 18 months, and analyzed using multiple regression.

Results

The BBCI was more effective on PA compared with the SLI (p?<?.01): in the short term all PA outcomes improved (p?<?.05), in the long term moderate-to-vigorous PA outcomes improved (p?<?.05), all with small effect sizes. No differences between interventions were found on fruit and vegetable intake. None of the outcomes in the control group changed over time.

Conclusions

BBCI in primary care improves PA compared with SLI.

Practice implications

The customized BB approach seems promising for implementation in healthcare practice to stimulate PA.  相似文献   

14.

Background

Tripartite motif‐containing protein 44 (TRIM44) has been recently identified as a novel oncogene that is overexpressed in several types of human cancers; however, its role in endometrial cancer (EC) remains unknown. The purpose of the current study was to investigate the TRIM44 protein expression and clinicopathological significance of TRIM44 in EC.

Methods

Paraffin-embedded surgical specimens were collected from 143 patients with EC for the immunohistochemical analysis of TRIM44 expression. Western blotting was performed to evaluate differences in TRIM44 protein expression in EC and normal endometrial tissues.

Results

TRIM44 expression was low in normal tissues and high in EC tissues (P?<?0.001). TRIM44 overexpression was significantly associated with the Federation of Gynecology and Obstetrics (FIGO) stage, histological grade, depth of myometrial invasion and lymph node metastasis (P?<?0.05). Moreover, TRIM44 expression was an independent prognostic factor for both overall survival and disease-free survival in patients with EC (both P?<?0.05).

Conclusions

The present study provides evidence that TRIM44 predicts the risk of development and prognosis of EC, highlighting its potential application as a therapeutic target for this malignancy.  相似文献   

15.

Objective

To document the effect of a cancer specific question prompt list (QPL) on patients question asking and shared decision-making (SDM), and to evaluate the combined effect of the QPL and consultation audio recording (CAR) on patient outcomes.

Method

This exploratory study compared two groups of patients receiving either a QPL or combined QPL/CAR, to a control group. Measurements included number/types of questions asked, and physician SDM behavior (OPTION score). Questionnaire data included anxiety/depression and quality of life (QoL).

Results

A total of 93 patients participated (31 Control, 30 QPL and 32 Combined). Patients in the intervention groups asked more questions concerning prognosis (p?<?.0001), the disease (p?=?.006) and quality of treatment (p?<?.001) than patients in the control group, but no impact was found on the OPTION score. An increase in mean consultation length was observed in the intervention groups compared to the control group (44 vs. 36?min; p?=?.028). Patients rated both interventions positively.

Conclusion

Provision of the QPL facilitates patients to ask a broader range of questions, but does not increase physician SDM behavior.

Practical implementation

The combination of QPL and CAR seems feasible and should be tested in an implementation study following the disease trajectory.  相似文献   

16.

Background and aim

Nucleolar and spindle-associated protein 1 (NUSAP1) is an indispensable mitotic regulator. Aberrant NUSAP1 expression is associated with perturbed mitosis and tumorigenesis. In this study, we investigated the clinical significance of NUSAP1 expression in colon cancer.

Methods and materials

Immunohistochemical staining was performed to determine NUSAP1 protein levels in paraffin colon tumor specimens. Real-time fluorescent quantitative polymerase chain reaction (RT-qPCR) was conducted to detect NUSAP1 mRNA levels in colon tumor samples. The association between NUSAP1 protein expression and clinicopathological characteristics of patients with colon cancer was assessed. A Kaplan-Meier analysis was performed to determine the prognostic significance of NUSAP1 in colon cancer. A Cox proportional hazards model was used to calculate univariate and multivariate hazard ratios for the NUSAP1 and other clinicopathological variables.

Result

NUSAP1 protein and mRNA levels were significantly higher in colon tumor tissues than in paired non-cancerous adjacent tissues (P?<?0.001, respectively). NUSAP1 protein expression was significantly correlated with histopathological grading (P?<?0.001), depth of invasion (P?=?0.001), lymph node metastasis (P?<?0.001) and TNM stage (P?<?0.001). The overall survival rate of patients with high NUSAP1 expression was significantly lower than for patients with low NUSAP1 expression (log-rank test, P?<?0.001). A multivariate Cox model demonstrated that NUSAP1 is an independent risk factor for overall survival (P?=?0.025).

Conclusion

NUSAP1 is overexpressed in colon cancer and high expression of NUSAP1 acts as an independent predictive factor for poor prognosis in colon cancer.  相似文献   

17.

Objectives

This study aimed to validate a new consolidated measure of health literacy and numeracy (health literacy scale [HLS] plus the subjective numeracy scale [SNS]) in patients with type 2 diabetes (T2DM).

Methods

A convenience sample (N?=?102) of patients with T2DM was recruited from an academic family medicine center in the southeastern US between September-December 2017. Participants completed a questionnaire that included the composite HLS/SNS (22 questions) and a commonly used objective measure of health literacy—S-TOFHLA (40 questions). Internal reliability of the HLS/SNS was assessed using Cronbach’s alpha. Criterion and construct validity was assessed against the S-TOFHLA.

Results

The composite HLS/SNS had good internal reliability (Cronbach’s alpha?=?0.83). A confirmatory factor analysis revealed there were four factors in the new instrument. Model fit indices showed good model-data fit (RMSEA?=?0.08). The Spearman’s rank order correlation coefficient between the HLS/SNS and the S-TOFHLA was 0.45 (p?<?0.01).

Conclusions

Our study suggests that the composite HLS/SNS is a reliable, valid instrument.  相似文献   

18.

Purpose

Human leukocyte antigen (HLA)-G is a non-classic major histocompatibility complex HLA class I molecule. HLA-G may have tolerogenic properties which are linked to epigenetic-sensitive pathways. There is a correlation of sHLA-G levels and graft acceptance in transplantation studies. There are previous data on correlation of sHLA-G with graft rejection as well as with viral infections such as hepatitis C virus (HCV) in kidney transplanted patients. Here, we report the sHLA-G expression in patients on the waiting list for kidney transplantation, with and without anti-HCV compared to a control group.

Methods

Serum of 67 patients on the waiting list for kidney transplantation (n?=?43 with anti-HCV and n?=?24 without anti-HCV) was analyzed. Among these patients, n?=?39 were on the waiting list for the first transplantation, while n?=?28 were patients who returned in the list. The control group included n?=?23 blood donors with anti-HCV (n?=?13) and without anti-HCV (n?=?10).

Results

The expression of sHLA-G was significantly lower in the control group (39.6?±?34.1 U/ml) compared to both - patients on the waiting list for the first transplantation (62.5?±?42.4 U/ml, p=0.031) and patients who returned in the list (76.7?±?53.9 U/ml, p=0.006). No significant differences were observed in all anti-HCV positive groups. A positive linear correlation between sHLA-G and TNF-α, and patient age was observed.

Conclusions

Serum sHLA-G values were significantly increased in both - patients on the waiting list for the first transplantation and patients who returned in the list, as compared to control group. Our findings confirm the key tolerogenic role of sHLA-G levels as epigenetic-related marker for measuring the state of kidney allograft acceptance.  相似文献   

19.

Objective

This study was aimed to explore the potential roles of miR-130b for the efficacy of radiofrequency ablation (RFA) in patients with primary hepatocellular carcinoma (PHC).

Methods

The serum sample of 110 PHC patients, which underwent RFA treatment, was collected on 1d pre-operation (Pre 1), 7d (POD 7) and 14d post-operation (POD 14). qRT-PCR was used to detect miR-130b expression. The relationship between miR-130b expression and clinicopathological features, postoperative recurrence and survival rate were analyzed.

Results

The liver function of PHC patients was improved after RFA treatment. The level of alpha fetoprotein (AFP) was gradually reduced on POD 7 and POD 14 (all P?<? 0.05). Before RFA, the expression of miR-130b in PHC patients was upregulated, while the expression of miR-130b decreased significantly with time after RFA treatment. And high expression of miR-130b was closely related to cirrhosis (P?=? 0.027) and tumor differentiation degree (P?<? 0.01). Serum miR-130b levels were significantly higher in patients with recurrence than in patients without recurrence (P?<? 0.05). Patients were divided into two groups according to miR-130b expression level (median ΔCt), compared with low ΔCt group, the incidence of recurrence in high ΔCt group was significantly higher after RFA (P?=? 0.020). Kaplan-Meier survival analysis showed that the survival rate of high ΔCt group was significantly shorter than that of low ΔCt group (P?<? 0.001).

Conclusion

Our study provided evidence that serum miR-130b level may be used as an ideal marker for monitoring the recurrence and prognosis of PHC after RFA treatment.  相似文献   

20.

Objective

To demonstrate how maladaptive emotion regulation (ER) can lead to diabetes distress (DD), with subsequent effects on management and metabolic outcomes among adults with type 1 diabetes.

Methods

Data are based on pre-intervention assessment for a random controlled trial to reduce DD. Patients were recruited in California, Oregon, Arizona and Ontario, Canada. After screening and consent, patients completed an online assessment and released their most recent laboratory HbA1C. Structural equation modeling was used to define an ER measurement model and test for significant pathways.

Results

Three ER mechanisms combined into a single construct: emotion processing, non-judgment of emotions, non-reactivity to emotions. Models indicated a significant pathway from ER and cognitions to DD to disease management to metabolic control.

Conclusions

As hypothesized, the three ER mechanisms formed a single, coherent ER construct. Patients with poor ER reported high DD; and high DD was linked to poor diabetes management and poor metabolic control.

Practice implications

Identifying both the level of DD and the ER mechanisms that lead to high DD should be explored in clinical settings. Helping T1Ds to become more aware, less judgmental and less reactive behaviorally to what they feel about diabetes and its management may reduce DD.  相似文献   

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