41 results
P63: Best Practice Guidance on Human Interaction with Technology in Dementia Update June 2023 – Recommendations from the INDUCT and DISTINCT Networks
- Rose-Marie Dröes, Yvette Vermeer, Sébastien Libert, Gianna Kohl, Sophie Gaber, Sarah Wallcook, Harleen Rai, Aline Cavalcanti Barroso, Esther Gerritzen, Joeke van Santen, Floriana Mangiaracina, Kim Beentjes, David Neal, Josephine Tan, Sara Bartels, Hannah Christie, Pascale Heins, Golnaz Atefi, Rose Miranda, Annelien van Dael, Fanny Monnet, Kate Shiells, Ángel C. Pinto Bruno, Angie Alejandra Diaz, Mauricio Molinari Ulate, Aysan Mahmoudi Asl, Simone Fielding, Beliz Budak, Viktoria Hoel, Wei Qi Koh, Jaroslav Cibulka, Lieve Van den Block, Lara Pivodic, Dympna Casey, Georgina Charlesworth, Karin Dijkstra, Teake Ettema, Manuel Franco Martin, Paul Higgs, Iva Holmerova, Camilla Malinowsky, Orii McDermott, Franka Meiland, Louise Nygard, Martina Roes, Henriëtte van der Roest, Justine Schneider, Olga Stepankova, Annemieke van Straten, Elaine Toomey, Frans Verhey, Marjolein de Vugt, Karin Wolf-Ostermann, Martin Orrell
-
- Journal:
- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, pp. 158-159
-
- Article
-
- You have access Access
- Export citation
-
Objective:
INDUCT (Interdisciplinary Network for Dementia Using Current Technology), and DISTINCT (Dementia Inter-sectorial strategy for training and innovation network for current technology) are two Marie Sklodowska-Curie funded International Training Networks that aimed to develop a multi-disciplinary, inter-sectorial educational research framework for Europe to improve technology and care for people with dementia, and to provide the evidence to show how technology can improve the lives of people with dementia.
Methods:In INDUCT (2016-2020) 15 Early Stage Researchers worked on projects in the areas of Technology to support everyday life; technology to promote meaningful activities; and healthcare technology. In DISTINCT (2019-2023) 15 Early Stage Researchers worked on technology to promote Social health in three domains: fulfilling ones potential and obligations in society, managing one’s own life, and participation in social and other meaningful activities.
Both networks adopted three transversal objectives: 1) To determine practical, cognitive and social factors needed to make technology more useable for people with dementia; 2) To evaluate the effectiveness of specific contemporary technology; 3) To trace facilitators and barriers for implementation of technology in dementia care.
Results:The main recommendations resulting from all research projects are integrated in a web-based digital Best Practice Guidance on Human Interaction with Technology in Dementia which was recently updated (Dec 2022 and June 2023) and will be presented at the congress. The recommendations are meant for different target groups, i.e. people in different stages of dementia, their (in)formal carers, policy makers, designers and researchers, who can easily find the recommendations relevant to them in the Best Practice Guidance by means of a digital selection tool.
Conclusions:The INDUCT/DISTINCT Best Practice Guidance informs on how to improve the development, usage, impact and implementation of technology for people with dementia in various technology areas. This Best Practice Guidance is the result of intensive collaborative partnership of INDUCT and DISTINCT with academic and non-academic partners as well as the involvement of representatives of the different target groups throughout the projects.
Somatic multicomorbidity and disability in patients with psychiatric disorders in comparison to the general population: a quasi-epidemiological investigation in 54,826 subjects from 40 countries (COMET-G study)
- Konstantinos N. Fountoulakis, Grigorios N. Karakatsoulis, Seri Abraham, Kristina Adorjan, Helal Uddin Ahmed, Renato D. Alarcón, Kiyomi Arai, Sani Salihu Auwal, Michael Berk, Sarah Bjedov, Julio Bobes, Teresa Bobes-Bascaran, Julie Bourgin-Duchesnay, Cristina Ana Bredicean, Laurynas Bukelskis, Akaki Burkadze, Indira Indiana Cabrera Abud, Ruby Castilla-Puentes, Marcelo Cetkovich, Hector Colon-Rivera, Ricardo Corral, Carla Cortez-Vergara, Piirika Crepin, Domenico De Berardis, Sergio Zamora Delgado, David De Lucena, Avinash De Sousa, Ramona Di Stefano, Seetal Dodd, Livia Priyanka Elek, Anna Elissa, Berta Erdelyi-Hamza, Gamze Erzin, Martin J. Etchevers, Peter Falkai, Adriana Farcas, Ilya Fedotov, Viktoriia Filatova, Nikolaos K. Fountoulakis, Iryna Frankova, Francesco Franza, Pedro Frias, Tatiana Galako, Cristian J. Garay, Leticia Garcia-Álvarez, Maria Paz García-Portilla, Xenia Gonda, Tomasz M. Gondek, Daniela Morera González, Hilary Gould, Paolo Grandinetti, Arturo Grau, Violeta Groudeva, Michal Hagin, Takayuki Harada, Tasdik M. Hasan, Nurul Azreen Hashim, Jan Hilbig, Sahadat Hossain, Rossitza Iakimova, Mona Ibrahim, Felicia Iftene, Yulia Ignatenko, Matias Irarrazaval, Zaliha Ismail, Jamila Ismayilova, Asaf Jakobs, Miro Jakovljević, Nenad Jakšić, Afzal Javed, Helin Yilmaz Kafali, Sagar Karia, Olga Kazakova, Doaa Khalifa, Olena Khaustova, Steve Koh, Svetlana Kopishinskaia, Korneliia Kosenko, Sotirios A. Koupidis, Illes Kovacs, Barbara Kulig, Alisha Lalljee, Justine Liewig, Abdul Majid, Evgeniia Malashonkova, Khamelia Malik, Najma Iqbal Malik, Gulay Mammadzada, Bilvesh Mandalia, Donatella Marazziti, Darko Marčinko, Stephanie Martinez, Eimantas Matiekus, Gabriela Mejia, Roha Saeed Memon, Xarah Elenne Meza Martínez, Dalia Mickevičiūtė, Roumen Milev, Muftau Mohammed, Alejandro Molina-López, Petr Morozov, Nuru Suleiman Muhammad, Filip Mustač, Mika S. Naor, Amira Nassieb, Alvydas Navickas, Tarek Okasha, Milena Pandova, Anca-Livia Panfil, Liliya Panteleeva, Ion Papava, Mikaella E. Patsali, Alexey Pavlichenko, Bojana Pejuskovic, Mariana Pinto Da Costa, Mikhail Popkov, Dina Popovic, Nor Jannah Nasution Raduan, Francisca Vargas Ramírez, Elmars Rancans, Salmi Razali, Federico Rebok, Anna Rewekant, Elena Ninoska Reyes Flores, María Teresa Rivera-Encinas, Pilar Saiz, Manuel Sánchez de Carmona, David Saucedo Martínez, Jo Anne Saw, Görkem Saygili, Patricia Schneidereit, Bhumika Shah, Tomohiro Shirasaka, Ketevan Silagadze, Satti Sitanggang, Oleg Skugarevsky, Anna Spikina, Sridevi Sira Mahalingappa, Maria Stoyanova, Anna Szczegielniak, Simona Claudia Tamasan, Giuseppe Tavormina, Maurilio Giuseppe Maria Tavormina, Pavlos N. Theodorakis, Mauricio Tohen, Eva Maria Tsapakis, Dina Tukhvatullina, Irfan Ullah, Ratnaraj Vaidya, Johann M. Vega-Dienstmaier, Jelena Vrublevska, Olivera Vukovic, Olga Vysotska, Natalia Widiasih, Anna Yashikhina, Panagiotis E. Prezerakos, Daria Smirnova
-
- Journal:
- CNS Spectrums / Volume 29 / Issue 2 / April 2024
- Published online by Cambridge University Press:
- 25 January 2024, pp. 126-149
-
- Article
-
- You have access Access
- HTML
- Export citation
-
Background
The prevalence of medical illnesses is high among patients with psychiatric disorders. The current study aimed to investigate multi-comorbidity in patients with psychiatric disorders in comparison to the general population. Secondary aims were to investigate factors associated with metabolic syndrome and treatment appropriateness of mental disorders.
MethodsThe sample included 54,826 subjects (64.73% females; 34.15% males; 1.11% nonbinary gender) from 40 countries (COMET-G study). The analysis was based on the registration of previous history that could serve as a fair approximation for the lifetime prevalence of various medical conditions.
ResultsAbout 24.5% reported a history of somatic and 26.14% of mental disorders. Mental disorders were by far the most prevalent group of medical conditions. Comorbidity of any somatic with any mental disorder was reported by 8.21%. One-third to almost two-thirds of somatic patients were also suffering from a mental disorder depending on the severity and multicomorbidity. Bipolar and psychotic patients and to a lesser extent depressives, manifested an earlier (15–20 years) manifestation of somatic multicomorbidity, severe disability, and probably earlier death. The overwhelming majority of patients with mental disorders were not receiving treatment or were being treated in a way that was not recommended. Antipsychotics and antidepressants were not related to the development of metabolic syndrome.
ConclusionsThe finding that one-third to almost two-thirds of somatic patients also suffered from a mental disorder strongly suggests that psychiatry is the field with the most trans-specialty and interdisciplinary value and application points to the importance of teaching psychiatry and mental health in medical schools and also to the need for more technocratically oriented training of psychiatric residents.
Coronavirus disease 2019 is associated with long-term depressive symptoms in Spanish older adults with overweight/obesity and metabolic syndrome
- Sangeetha Shyam, Carlos Gómez-Martínez, Indira Paz-Graniel, José J. Gaforio, Miguel Ángel Martínez-González, Dolores Corella, Montserrat Fitó, J. Alfredo Martínez, Ángel M. Alonso-Gómez, Julia Wärnberg, Jesús Vioque, Dora Romaguera, José López-Miranda, Ramon Estruch, Francisco J. Tinahones, José Manuel Santos-Lozano, J. Luís Serra-Majem, Aurora Bueno-Cavanillas, Josep A. Tur, Vicente Martín Sánchez, Xavier Pintó, María Ortiz Ramos, Josep Vidal, Maria Mar Alcarria, Lidia Daimiel, Emilio Ros, Fernando Fernandez-Aranda, Stephanie K. Nishi, Oscar García Regata, Estefania Toledo, Jose V. Sorli, Olga Castañer, Antonio Garcia-Rios, Rafael Valls-Enguix, Napoleon Perez-Farinos, M. Angeles Zulet, Elena Rayó-Gago, Rosa Casas, Mario Rivera-Izquierdo, Lucas Tojal-Sierra, Miguel Damas-Fuentes, Pilar Buil-Cosiales, Rebeca Fernández-Carrion, Albert Goday, Patricia J. Peña-Orihuela, Laura Compañ-Gabucio, Javier Diez-Espino, Susanna Tello, Ana González-Pinto, Víctor de la O, Miguel Delgado-Rodríguez, Nancy Babio, Jordi Salas-Salvadó
-
- Journal:
- Psychological Medicine / Volume 54 / Issue 3 / February 2024
- Published online by Cambridge University Press:
- 05 September 2023, pp. 620-630
-
- Article
- Export citation
-
Background
The coronavirus disease 2019 (COVID-19) has serious physiological and psychological consequences. The long-term (>12 weeks post-infection) impact of COVID-19 on mental health, specifically in older adults, is unclear. We longitudinally assessed the association of COVID-19 with depression symptomatology in community-dwelling older adults with metabolic syndrome within the framework of the PREDIMED-Plus cohort.
MethodsParticipants (n = 5486) aged 55–75 years were included in this longitudinal cohort. COVID-19 status (positive/negative) determined by tests (e.g. polymerase chain reaction severe acute respiratory syndrome coronavirus 2, IgG) was confirmed via event adjudication (410 cases). Pre- and post-COVID-19 depressive symptomatology was ascertained from annual assessments conducted using a validated 21-item Spanish Beck Depression Inventory-II (BDI-II). Multivariable linear and logistic regression models assessed the association between COVID-19 and depression symptomatology.
ResultsCOVID-19 in older adults was associated with higher post-COVID-19 BDI-II scores measured at a median (interquartile range) of 29 (15–40) weeks post-infection [fully adjusted β = 0.65 points, 95% confidence interval (CI) 0.15–1.15; p = 0.011]. This association was particularly prominent in women (β = 1.38 points, 95% CI 0.44–2.33, p = 0.004). COVID-19 was associated with 62% increased odds of elevated depression risk (BDI-II ≥ 14) post-COVID-19 when adjusted for confounders (odds ratio; 95% CI 1.13–2.30, p = 0.008).
ConclusionsCOVID-19 was associated with long-term depression risk in older adults with overweight/obesity and metabolic syndrome, particularly in women. Thus, long-term evaluations of the impact of COVID-19 on mental health and preventive public health initiatives are warranted in older adults.
Predecisional information distortion in physicians’ diagnostic judgments: Strengthening a leading hypothesis or weakening its competitor?
- Martine Nurek, Olga Kostopoulou, York Hagmayer
-
- Journal:
- Judgment and Decision Making / Volume 9 / Issue 6 / November 2014
- Published online by Cambridge University Press:
- 01 January 2023, pp. 572-585
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
-
Decision makers have been found to bias their interpretation of incoming information to support an emerging judgment (predecisional information distortion). This is a robust finding in human judgment, and was recently also established and measured in physicians’ diagnostic judgments (Kostopoulou et al. 2012). The two studies reported here extend this work by addressing the constituent modes of distortion in physicians. Specifically, we studied whether and to what extent physicians distort information to strengthen their leading diagnosis and/or to weaken a competing diagnosis. We used the “stepwise evolution of preference” method with three clinical scenarios, and measured distortion on separate rating scales, one for each of the two competing diagnoses per scenario.
In Study 1, distortion in an experimental group was measured against the responses of a separate control group. In Study 2, distortion in a new experimental group was measured against participants’ own, personal responses provided under control conditions, with the two response conditions separated by a month. The two studies produced consistent results. On average, we found considerable distortion of information to weaken the trailing diagnosis but little distortion to strengthen the leading diagnosis. We also found individual differences in the tendency to engage in either mode of distortion. Given that two recent studies found both modes of distortion in lay preference (Blanchard, Carlson & Meloy, 2014; DeKay, Miller, Schley & Erford, 2014), we suggest that predecisional information distortion is affected by participant and task characteristics. Our findings contribute to the growing research on the different modes of predecisional distortion and their stability to methodological variation.
Association between the Prime Diet Quality Score and depressive symptoms in a Mediterranean population with metabolic syndrome. Cross-sectional and 2-year follow-up assessment from PREDIMED-PLUS study
- Naomi Cano-Ibáñez, Lluis Serra-Majem, Sandra Martín-Peláez, Miguel Ángel Martínez-González, Jordi Salas-Salvadó, Maria Dolores Corella Piquer, Camille Lassale, José Alfredo Martínez Hernandez, Ángel M. Alonso-Gómez, Julia Wärnberg, Jesús Vioque Lopez, Dora Romaguera, José López-Miranda, Ramon Estruch, Ana María Gómez-Pérez, José Manuel Santos-Lozano, Fernando Fernández-Aranda, Aurora Bueno-Cavanillas, Josep A. Tur, Vicente Martín, Xavier Pintó Sala, Miguel Delgado-Rodríguez, Pilar Matía Martín, Josep Vidal, Jersy J. Cárdenas, Lidia Daimiel Ruiz, Emilio Ros, Pilar Buil-Cosiales, Nerea Becerra-Tomás, Carmen Saiz, Miguel-Ángel Muñoz-Perez, Itziar Abete, Lucas Tojal-Sierra, Olga Fernández-Barceló, Andrea Bernabé-Casanova, Jadwiga Konieczna, Antonio García-Ríos, Rosa Casas, Maria Rosa Bernal-López, José Lapetra, Estefanía Toledo, Carlos Gómez-Martínez, Oscar Coltell, Mireia Malcampo-Manrúbia, María Angeles Zulet, Carolina Sorto-Sánchez, Alfredo Gea, José Luis Hernández-Fleta, Olga Castañer Niño, Almudena Sánchez-Villegas
-
- Journal:
- British Journal of Nutrition / Volume 128 / Issue 6 / 28 September 2022
- Published online by Cambridge University Press:
- 29 October 2021, pp. 1170-1179
- Print publication:
- 28 September 2022
-
- Article
-
- You have access Access
- HTML
- Export citation
-
The burden of depression is increasing worldwide, specifically in older adults. Unhealthy dietary patterns may partly explain this phenomenon. In the Spanish PREDIMED-Plus study, we explored (1) the cross-sectional association between the adherence to the Prime Diet Quality Score (PDQS), an a priori-defined high-quality food pattern, and the prevalence of depressive symptoms at baseline (cross-sectional analysis) and (2) the prospective association of baseline PDQS with changes in depressive symptomatology after 2 years of follow-up. After exclusions, we assessed 6612 participants in the cross-sectional analysis and 5523 participants in the prospective analysis. An energy-adjusted high-quality dietary score (PDQS) was assessed using a validated FFQ. The cross-sectional association between PDQS and the prevalence of depression or presence of depressive symptoms and the prospective changes in depressive symptoms were evaluated through multivariable regression models (logistic and linear models and mixed linear-effects models). PDQS was inversely associated with depressive status in the cross-sectional analysis. Participants in the highest quintile of PDQS (Q5) showed a significantly reduced odds of depression prevalence as compared to participants in the lowest quartile of PDQS (Q1) (OR (95 %) CI = 0·82 (0·68, 0·98))). The baseline prevalence of depression decreased across PDQS quintiles (Pfor trend = 0·015). A statistically significant association between PDQS and changes in depressive symptoms after 2-years follow-up was found (β (95 %) CI = −0·67 z-score (–1·17, −0·18). A higher PDQS was cross-sectionally related to a lower depressive status. Nevertheless, the null finding in our prospective analysis raises the possibility of reverse causality. Further prospective investigation is required to ascertain the association between PDQS and changes in depressive symptoms along time.
Ten new insights in climate science 2021: a horizon scan
- Maria A. Martin, Olga Alcaraz Sendra, Ana Bastos, Nico Bauer, Christoph Bertram, Thorsten Blenckner, Kathryn Bowen, Paulo M. Brando, Tanya Brodie Rudolph, Milena Büchs, Mercedes Bustamante, Deliang Chen, Helen Cleugh, Purnamita Dasgupta, Fatima Denton, Jonathan F. Donges, Felix Kwabena Donkor, Hongbo Duan, Carlos M. Duarte, Kristie L. Ebi, Clea M. Edwards, Anja Engel, Eleanor Fisher, Sabine Fuss, Juliana Gaertner, Andrew Gettelman, Cécile A.J. Girardin, Nicholas R. Golledge, Jessica F. Green, Michael R. Grose, Masahiro Hashizume, Sophie Hebden, Helmke Hepach, Marina Hirota, Huang-Hsiung Hsu, Satoshi Kojima, Sharachchandra Lele, Sylvia Lorek, Heike K. Lotze, H. Damon Matthews, Darren McCauley, Desta Mebratu, Nadine Mengis, Rachael H. Nolan, Erik Pihl, Stefan Rahmstorf, Aaron Redman, Colleen E. Reid, Johan Rockström, Joeri Rogelj, Marielle Saunois, Lizzie Sayer, Peter Schlosser, Giles B. Sioen, Joachim H. Spangenberg, Detlef Stammer, Thomas N.S. Sterner, Nicola Stevens, Kirsten Thonicke, Hanqin Tian, Ricarda Winkelmann, James Woodcock
-
- Journal:
- Global Sustainability / Volume 4 / 2021
- Published online by Cambridge University Press:
- 18 October 2021, e25
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
-
Non-technical summary
We summarize some of the past year's most important findings within climate change-related research. New research has improved our understanding about the remaining options to achieve the Paris Agreement goals, through overcoming political barriers to carbon pricing, taking into account non-CO2 factors, a well-designed implementation of demand-side and nature-based solutions, resilience building of ecosystems and the recognition that climate change mitigation costs can be justified by benefits to the health of humans and nature alone. We consider new insights about what to expect if we fail to include a new dimension of fire extremes and the prospect of cascading climate tipping elements.
Technical summaryA synthesis is made of 10 topics within climate research, where there have been significant advances since January 2020. The insights are based on input from an international open call with broad disciplinary scope. Findings include: (1) the options to still keep global warming below 1.5 °C; (2) the impact of non-CO2 factors in global warming; (3) a new dimension of fire extremes forced by climate change; (4) the increasing pressure on interconnected climate tipping elements; (5) the dimensions of climate justice; (6) political challenges impeding the effectiveness of carbon pricing; (7) demand-side solutions as vehicles of climate mitigation; (8) the potentials and caveats of nature-based solutions; (9) how building resilience of marine ecosystems is possible; and (10) that the costs of climate change mitigation policies can be more than justified by the benefits to the health of humans and nature.
Social media summaryHow do we limit global warming to 1.5 °C and why is it crucial? See highlights of latest climate science.
PP70 Identification Of Prostheses With Worse Than Expected Outcomes
- Jorge Arias de la Torre, Olga Martínez, Kayla Smith, Miquel Pons-Cabrafiga, Daniel Prieto-Alhambra, Jose Valderas, Vicente Martin, Jonathan Evans, Raul Marcos, Marta Esteban, Susana Villabrille, Mireia Espallargues
-
- Journal:
- International Journal of Technology Assessment in Health Care / Volume 35 / Issue S1 / 2019
- Published online by Cambridge University Press:
- 31 December 2019, p. 51
-
- Article
-
- You have access Access
- Export citation
-
Introduction
Monitoring the effectiveness of knee and hip arthroplasties could be useful at the clinical, economic, and patient levels. In Catalonia, there is currently no systematic monitoring of the different prostheses available. The aims of this study were to propose an approach for the systematic identification of knee and hip prostheses with the highest revision rates, and to identify those with the poorest outcomes.
MethodsData recorded from January 2005 to December 2016 were considered from 53 out of the 61 public hospitals in Catalonia included in the Catalonian Arthroplasty Register (RACat). Specific prostheses were classified by joint, type, fixation, and, in total hip prostheses, the bearing surface. Prostheses with the worst outcomes were identified using a three-step approach, based on previous literature: (i) screening using Poisson models; (ii) comparison of prostheses using adjusted Cox models; and (iii) consensus-based review by a panel of orthopedic surgeons to detect possible sources of bias. After this process, selected prostheses were provisionally labeled as having the poorest outcomes. This process will be repeated periodically within the RACat to definitively classify the prostheses.
ResultsAfter first two steps, ten knee prostheses and eight hip prostheses were identified. After the panel discussion (third step), one knee and one hip prosthesis were excluded from the final list. The knee prosthesis was excluded because it was a unicompartmental implant, while the hip prosthesis was excluded because it was a monoblock implant. Finally, nine knee prostheses and seven hip prostheses were provisionally identified as having the worst results relative to other available prostheses. These results await confirmation in subsequent analyses.
ConclusionsThis study contributed to the current need to identify hip and knee prostheses whose outcomes might be worse than expected. This identification could have an impact at the patient, surgeon, industry, and stakeholder levels.
Comprehension and acceptance of the Meaning-Centered Psychotherapy with a Puerto Rican patient diagnosed with advanced cancer: A case study
- Normarie Torres-Blasco, Eida Castro, Iris Crespo-Martín, Karina Gonzalez, Emely Perez Ramirez, Olga Garduño, Rosario Costas-Muñiz
-
- Journal:
- Palliative & Supportive Care / Volume 18 / Issue 1 / February 2020
- Published online by Cambridge University Press:
- 27 November 2019, pp. 103-109
-
- Article
- Export citation
-
Background
Meaning-centered psychotherapy (MCP) is a structured psychotherapeutic intervention that aims to improve existential and spiritual well-being in patients with advanced cancer. To validate it, several efficacy studies with predominantly non-Hispanic white patients have been done. Puerto Ricans residing on the island are a largely overlooked segment of the US Latinx population. They have a strong national identity and are embedded in a collectivist culture which shares the Spanish language, cultural traditions, and an emphasis on familism, a cultural factor that values the role of the family in ensuring the well-being of its members.
ObjectiveThe purpose of this study is to present a case study focused on a Puerto Rican advanced cancer patient who underwent MCP to assess the comprehension and acceptance of the MCP intervention.
MethodWe used a mixed-methods study design that included the taking of ethnographic notes, and pre- and post-test assessments of the scores the patient received on all the measures (using validated scales). The ethnographic notes were analyzed to determine the participant's comprehension and acceptance of the MCP intervention. Content analysis was performed on the ethnographic notes by three independent coders using a deductive coding approach. Pre- and post-interview assessments were conducted to explore changes in distress, spiritual well-being, and self-perceived quality of life.
ResultsA Latino patient with stage III cancer, low income, and low literacy skills showed low comprehension of the concepts of meaning, the finite, legacy, and moderate comprehension and acceptance of the concepts of the search for hope, purpose in life, connecting with life, courage, life's limitations, and sources of meaning. However, the patient showed high comprehension of death and dying (i.e., meaningful death). The patient showed low acceptance of death and dying concepts and high acceptance of the integration of family members into the therapy.
Significance of ResultsAdditional studies are needed to address cultural themes and to improve the comprehensibility and acceptance of the manual's content and the central MCP concepts. The findings suggest that MCP has the potential of being a feasible form of psychotherapy for Latinx patients suffering from distress, low spiritual well-being, and low self-perceived QOL.
Design and development of sign language questionnaires based on video and web interfaces
- Juan Pedro López, Marta Bosch-Baliarda, Carlos Alberto Martín, José Manuel Menéndez, Pilar Orero, Olga Soler, Federico Álvarez
-
- Article
- Export citation
-
Conventional tests with written information used for the evaluation of sign language (SL) comprehension introduce distortions due to the translation process. This fact affects the results and conclusions drawn and, for that reason, it is necessary to design and implement the same language interpreter-independent evaluation tools. Novel web technologies facilitate the design of web interfaces that support online, multiple-choice questionnaires, while exploiting the storage of tracking data as a source of information about user interaction. This paper proposes an online, multiple-choice sign language questionnaire based on an intuitive methodology. It helps users to complete tests and automatically generates accurate, statistical results using the information and data obtained in the process. The proposed system presents SL videos and enables user interaction, fulfilling the requirements that SL interpretation is not able to cover. The questionnaire feeds a remote database with the user answers and powers the automatic creation of data for analytics. Several metrics, including time elapsed, are used to assess the usability of the SL questionnaire, defining the goals of the predictive models. These predictions are based on machine learning models, with the demographic data of the user as features for estimating the usability of the system. This questionnaire reduces costs and time in terms of interpreter dedication, as well as widening the amount of data collected while employing user native language. The validity of this tool was demonstrated in two different use cases.
Maternally inherited rRNA triggers de novo nucleolus formation in porcine embryos
- Martin Morovic, Olga Østrup, Frantisek Strejcek, Michal Benc, Matej Murin, Katarina Jedlickova, Alexandra Bartkova, Andrea Lucas-Hahn, Lazo Pendovski, Jozef Laurincik
-
- Article
- Export citation
-
The present study examines the role of RNA polymerase I (RPI)-mediated transcription, maternally inherited rRNA and nucleolar proteins in the resumption of fibrillogranular nucleoli during embryonic genome activation (EGA) in porcine embryos. Late 4-cell embryos were incubated in the absence (control) or presence of actinomycin D (AD) (0.2 μg/ml for inhibition of RPI; 2.0 μg/ml for inhibition of total transcription) and late 2-cell embryos were cultured to the late 4-cell stage with 0.2 μg/ml AD to block EGA. Embryos were then processed for reverse-transcriptase polymerase chain reaction (RT-PCR), and for autoradiography (ARG), transmission electron microscopy (TEM), fluorescence in situ hybridization (FISH), silver staining and immunofluorescence (for RPI). Embryos in the control group displayed extranucleolar and intranucleolar ARG labelling, and exhibited de novo synthesis of rRNA and reticulated functional nucleoli. Nucleolar proteins were located in large foci. After RPI inhibition, nucleolar precursors transformed into segregated fibrillogranular structures, however no fibrillar centres were observed. The localization of rDNA and clusters of rRNA were detected in 57.1% immunoprecipitated (IP) analyzed nucleoli and dispersed RPI; 30.5% of nuclei showed large deposits of nucleolar proteins. Embryos from the AD-2.0 group did not display any transcriptional activity. Nucleolar formation was completely blocked, however 39.4% of nuclei showed rRNA clusters; 85.7% of nuclei were co-localized with nucleolar proteins. Long-term transcriptional inhibition resulted in the lack of ARG and RPI labelling; 40% of analyzed nuclei displayed the accumulation of rRNA molecules into large foci. In conclusion, maternally inherited rRNA co-localized with rDNA and nucleolar proteins can initiate a partial nucleolar assembly, resulting in the formation of fibrilogranular structures independently on activation of RPI-mediated transcription.
When health technology assessment is confidential and experts have no power: the case of Hungary
- Marcell Csanádi, Olga Löblová, Piotr Ozierański, András Harsányi, Zoltán Kaló, Martin McKee, Lawrence King
-
- Journal:
- Health Economics, Policy and Law / Volume 14 / Issue 2 / April 2019
- Published online by Cambridge University Press:
- 26 March 2018, pp. 162-181
-
- Article
- Export citation
-
Health technology assessment (HTA) is not simply a mechanistic technical exercise as it takes place within a specific institutional context. Yet, we know little about how this context influences the operation of HTA and its ability to influence policy and practice. We seek to demonstrate the importance of considering institutional context, using a case study of Hungary, a country that has pioneered HTA in Central and Eastern Europe. We conducted 26 in-depth, semi-structured interviews with public- and private-sector stakeholders. We found that while the HTA Department, the Hungarian HTA organisation, fulfilled its formal role envisaged in the legislation, its potential for supporting evidence-based decision-making was not fully realised given the low levels of transparency and stakeholder engagement. Further, the Department’s practical influence throughout the reimbursement process was perceived as being constrained by the payer and policy-makers, as well as its own limited organisational capacity. There was also scepticism as to whether the current operational form of the HTA process delivered ‘good value for money’. Nevertheless, it still had a positive impact on the development of a broader institutional HTA infrastructure in Hungary. Our findings highlight the importance of considering institutional context in analysing the HTA function within health systems.
Public Procurement as a Tool for the Protection and Promotion of Human Rights: a Study of Collaboration, Due Diligence and Leverage in the Electronics Industry
- Olga MARTIN-ORTEGA
-
- Journal:
- Business and Human Rights Journal / Volume 3 / Issue 1 / January 2018
- Published online by Cambridge University Press:
- 06 February 2018, pp. 75-95
-
- Article
-
- You have access Access
- HTML
- Export citation
-
This article explores the innovative use of public procurement as a tool to respect, protect and promote human rights by capitalizing on the significant leverage that public buyers have over corporate practices in their supply chain. It provides an analysis of Electronics Watch, an organization that focuses on the role of states’ own procurement practices as central to the state duty to protect the human rights of those who are affected by its activities as an economic actor. Through the assessment of the Electronics Watch model this article argues that by bringing together the economic leverage of public buyers and corporate human rights due diligence, one can create transformative tools for the improvement of working conditions in global supply chains.
Transparency in practice: Evidence from ‘verification analyses’ issued by the Polish Agency for Health Technology Assessment in 2012–2015
- Piotr Ozierański, Olga Löblová, Natalia Nicholls, Marcell Csanádi, Zoltán Kaló, Martin McKee, Lawrence King
-
- Journal:
- Health Economics, Policy and Law / Volume 14 / Issue 2 / April 2019
- Published online by Cambridge University Press:
- 08 January 2018, pp. 182-204
-
- Article
- Export citation
-
Transparency is recognised to be a key underpinning of the work of health technology assessment (HTA) agencies, yet it has only recently become a subject of systematic inquiry. We contribute to this research field by considering the Polish Agency for Health Technology Assessment (AHTAPol). We situate the AHTAPol in a broader context by comparing it with the National Institute for Health and Care Excellence (NICE) in England. To this end, we analyse all 332 assessment reports, called verification analyses, that the AHTAPol issued from 2012 to 2015, and a stratified sample of 22 Evidence Review Group reports published by NICE in the same period. Overall, by increasingly presenting its key conclusions in assessment reports, the AHTAPol has reached the transparency standards set out by NICE in transparency of HTA outputs. The AHTAPol is more transparent than NICE in certain aspects of the HTA process, such as providing rationales for redacting assessment reports and providing summaries of expert opinions. Nevertheless, it is less transparent in other areas of the HTA process, such as including information on expert conflicts of interest. Our findings have important implications for understanding HTA in Poland and more broadly. We use them to formulate recommendations for policymakers.
Validation of the energy budget of an alpine snowpack simulated by several snow models (Snow MIP project)
- Pierre Etchevers, Eric Martin, Ross Brown, Charles Fierz, Yves Lejeune, Eric Bazile, Aaron Boone, Yong-Jiu Dai, Richard Essery, Alberto Fernandez, Yeugeniy Gusev, Rachel Jordan, Victor Koren, Eva Kowalczyk, N. Olga Nasonova, R. David Pyles, Adam Schlosser, Andrey B. Shmakin, Tatiana G. Smirnova, Ulrich Strasser, Diana Verseghy, Takeshi Yamazaki, Zong-Liang Yang
-
- Journal:
- Annals of Glaciology / Volume 38 / 2004
- Published online by Cambridge University Press:
- 14 September 2017, pp. 150-158
-
- Article
-
- You have access Access
- HTML
- Export citation
-
Many snow models have been developed for various applications such as hydrology, global atmospheric circulation models and avalanche forecasting. The degree of complexity of these models is highly variable, ranging from simple index methods to multi-layer models that simulate snow-cover stratigraphy and texture. In the framework of the Snow Model Intercomparison Project (SnowMIP), 23 models were compared using observed meteorological parameters from two mountainous alpine sites. The analysis here focuses on validation of snow energy-budget simulations. Albedo and snow surface temperature observations allow identification of the more realistic simulations and quantification of errors for two components of the energy budget: the net short- and longwave radiation. In particular, the different albedo parameterizations are evaluated for different snowpack states (in winter and spring). Analysis of results during the melting period allows an investigation of the different ways of partitioning the energy fluxes and reveals the complex feedbacks which occur when simulating the snow energy budget. Particular attention is paid to the impact of model complexity on the energy-budget components. The model complexity has a major role for the net longwave radiation calculation, whereas the albedo parameterization is the most significant factor explaining the accuracy of the net shortwave radiation simulation.
Contributors
-
- By Cecil S. Ash, Paul Barach, Ulrike Buehner, M. Ross Bullock, Leonardo Canale, Henry G. Chou, Jeffrey A. Claridge, John J. Como, Armagan Dagal, Martin Dauber, James S. Davis, Shalini Dhir, François Donati, Roman Dudaryk, Richard P. Dutton, Talmage D. Egan, Yashar Eshraghi, John R. Fisgus, Jeff Gadsden, Sugantha Ganapathy, Mark A. Gerhardt, Inderjit Gill, Joseph F. Golob, Glenn P. Gravlee, Marcello Guglielmi, Jana Hambley, Peter Hebbard, Elena J. Holak, Khadil Hosein, Ken Johnson, Matthew A. Joy, George W. Kanellakos, Olga Kaslow, Arthur M. Lam, Vanetta Levesque, Jessica Anne Lovich-Sapola, M. Jocelyn Loy, Peter F. Mahoney, Donn Marciniak, Maureen McCunn, Craig C. McFarland, Maroun J. Mhanna, Timothy Moore, Cynthia Nguyen, Maxim Novikov, E. Orestes O’Brien, Ketan P. Parekh, Claire L. Park, Michael J. A. Parr, Elie Rizkala, Steven Roth, Alistair Royse, Colin Royse, Kasia Petelenz Rubin, David Ryan, Claire Sandstrom, Carl I. Schulman, Rishad Shaikh, Ranjita Sharma, Jeffrey H. Silverstein, Peter Slinger, Charles E. Smith, Christopher Smith, Paul Soeding, Rakesh V. Sondekoppam, P. David Soran, Eldar Søreide, Elizabeth A. Steele, Kristian Strand, Dennis M. Super, Kutaiba Tabbaa, Nicholas T. Tarmey, Joshua M. Tobin, Kalpana Tyagaraj, Heather A. Vallier, Sandra Werner, Earl Willis Weyers, William C. Wilson, Shoji Yokobori, Charles J. Yowler
- Edited by Charles E. Smith
-
- Book:
- Trauma Anesthesia
- Published online:
- 05 April 2015
- Print publication:
- 09 April 2015, pp vii-x
-
- Chapter
- Export citation
Chapter 6 - Where Is My Grandfather? Impunity and Memory in Spain
- Edited by S. Elizabeth Bird, Fraser M. Ottanelli
-
- Book:
- The Performance of Memory as Transitional Justice
- Published by:
- Intersentia
- Published online:
- 16 December 2020
- Print publication:
- 18 December 2014, pp 97-114
-
- Chapter
- Export citation
-
Summary
The transition from the dictatorship of Francisco Franco to democratic rule (the so-called Spanish Transition) has been portrayed as a model of negotiated, reformist, non-rupturist, peaceful change. It is also an experience of silence, choice to forget, limited rehabilitation of victims and impunity for the perpetrators. Following the dictator's death in 1975, it has taken an additional twenty five years for the victims of the Civil War and the repression that followed, and their relatives to raise the veil of fear and put forward demands for justice and truth. It was not until a younger generation started to inquire about the fate of their grandparents that some mobilisation at the civil and institutional level allowed for a transitional justice debate to take place. Whilst the claims for truth and moral restoration found some echo in the approval of the ‘Historical Memory Law’ and other limited measures, the door for accountability for human rights violations has remained firmly closed. After forty years of dictatorship, followed by twenty-five more of silence along with the continued dissemination of a one-sided version of history, the challenge now is how to build a shared, negotiated and collective memory of Spain's violent past.
This chapter offers an overview of the human rights violations committed during the Spanish Civil War and the repression during Franco's dictatorship as well as the terms in which the political transition to democracy was carried out. This description is followed by an analysis of the limited rehabilitation and reparation measures adopted until today. The scattered and belated attempts for reparation have given priority to individual memory and the restoration of individual family stories. Public policies have not made truth sharing and building of collective memory, let alone accountability, a matter of state responsibility toward its citizens. We argue that by focusing on private memory the state fails to break the ‘official memory’ imposed during Franco's regime and the ‘pact of silence’ that followed during the transition.
THE SPANISH CIVIL WAR AND THE DICTATORSHIP: THE WINNERS’ ‘OFFICIAL MEMORY’
The Spanish Civil War broke out on 17 July 1936, after a military rebellion of a sector of the army against the legitimate and democratically-elected government of the Second Republic. It ended on 1 April 1939, with the victory of the rebels, which in turn led to the instauration of the dictatorial regime of General Francisco Franco, which lasted until his death in 1975.
Measuring the quality of life in mild to very severe dementia: Testing the inter-rater and intra-rater reliability of the German version of the QUALIDEM
- Martin Nikolaus Dichter, Christian G. G. Schwab, Gabriele Meyer, Sabine Bartholomeyczik, Olga Dortmann, Margareta Halek
-
- Journal:
- International Psychogeriatrics / Volume 26 / Issue 5 / May 2014
- Published online by Cambridge University Press:
- 10 February 2014, pp. 825-836
-
- Article
- Export citation
-
Background:
Quality of life (Qol) is an increasingly used outcome measure in dementia research. The QUALIDEM is a dementia-specific and proxy-rated Qol instrument. We aimed to determine the inter-rater and intra-rater reliability in residents with dementia in German nursing homes.
Methods:The QUALIDEM consists of nine subscales that were applied to a sample of 108 people with mild to severe dementia and six consecutive subscales that were applied to a sample of 53 people with very severe dementia. The proxy raters were 49 registered nurses and nursing assistants. Inter-rater and intra-rater reliability scores were calculated on the subscale and item level.
Results:None of the QUALIDEM subscales showed strong inter-rater reliability based on the single-measure Intra-Class Correlation Coefficient (ICC) for absolute agreement ≥ 0.70. Based on the average-measure ICC for four raters, eight subscales for people with mild to severe dementia (care relationship, positive affect, negative affect, restless tense behavior, social relations, social isolation, feeling at home and having something to do) and five subscales for very severe dementia (care relationship, negative affect, restless tense behavior, social relations and social isolation) yielded a strong inter-rater agreement (ICC: 0.72–0.86). All of the QUALIDEM subscales, regardless of dementia severity, showed strong intra-rater agreement. The ICC values ranged between 0.70 and 0.79 for people with mild to severe dementia and between 0.75 and 0.87 for people with very severe dementia.
Conclusions:This study demonstrated insufficient inter-rater reliability and sufficient intra-rater reliability for all subscales of both versions of the German QUALIDEM. The degree of inter-rater reliability can be improved by collaborative Qol rating by more than one nurse. The development of a measurement manual with accurate item definitions and a standardized education program for proxy raters is recommended.
Bilateral lesions of nucleus subpretectalis/interstitio-pretecto-subpretectalis (SP/IPS) selectively impair figure–ground discrimination in pigeons
- ERIN N. SCULLY, MARTIN J. ACERBO, OLGA F. LAZAREVA
-
- Journal:
- Visual Neuroscience / Volume 31 / Issue 1 / January 2014
- Published online by Cambridge University Press:
- 09 October 2013, pp. 105-110
-
- Article
- Export citation
-
Earlier, we reported that nucleus rotundus (Rt) together with its inhibitory complex, nucleus subpretectalis/interstitio-pretecto-subpretectalis (SP/IPS), had significantly higher activity in pigeons performing figure–ground discrimination than in the control group that did not perform any visual discriminations. In contrast, color discrimination produced significantly higher activity than control in the Rt but not in the SP/IPS. Finally, shape discrimination produced significantly lower activity than control in both the Rt and the SP/IPS. In this study, we trained pigeons to simultaneously perform three visual discriminations (figure–ground, color, and shape) using the same stimulus displays. When birds learned to perform all three tasks concurrently at high levels of accuracy, we conducted bilateral chemical lesions of the SP/IPS. After a period of recovery, the birds were retrained on the same tasks to evaluate the effect of lesions on maintenance of these discriminations. We found that the lesions of the SP/IPS had no effect on color or shape discrimination and that they significantly impaired figure–ground discrimination. Together with our earlier data, these results suggest that the nucleus Rt and the SP/IPS are the key structures involved in figure–ground discrimination. These results also imply that thalamic processing is critical for figure–ground segregation in avian brain.
Use of vitamin D supplements during infancy in an international feeding trial
- Eveliina Lehtonen, Anne Ormisson, Anita Nucci, David Cuthbertson, Susa Sorkio, Mila Hyytinen, Kirsi Alahuhta, Carol Berseth, Marja Salonen, Shayne Taback, Margaret Franciscus, Teba González-Frutos, Tuuli E Korhonen, Margaret L Lawson, Dorothy J Becker, Jeffrey P Krischer, Mikael Knip, Suvi M Virtanen, , Thomas Mandrup-Poulsen, Elias Arjas, Åke Lernmark, Barbara Schmidt, Jeffrey P. Krischer, Hans K. Åkerblom, Mila Hyytinen, Mikael Knip, Katriina Koski, Matti Koski, Eeva Pajakkala, Marja Salonen, David Cuthbertson, Jeffrey P. Krischer, Linda Shanker, Brenda Bradley, Hans-Michael Dosch, John Dupré, William Fraser, Margaret Lawson, Jeffrey L. Mahon, Mathew Sermer, Shayne P. Taback, Dorothy Becker, Margaret Franciscus, Anita Nucci, Jerry Palmer, Minna Pekkala, Suvi M. Virtanen, Jacki Catteau, Neville Howard, Patricia Crock, Maria Craig, Cheril L. Clarson, Lynda Bere, David Thompson, Daniel Metzger, Colleen Marshall, Jennifer Kwan, David K. Stephure, Daniele Pacaud, Wendy Schwarz, Rose Girgis, Marilyn Thompson, Shayne P. Taback, Daniel Catte, Margaret L. Lawson, Brenda Bradley, Denis Daneman, Mathew Sermer, Mary-Jean Martin, Valérie Morin, Lyne Frenette, Suzanne Ferland, Susan Sanderson, Kathy Heath, Céline Huot, Monique Gonthier, Maryse Thibeault, Laurent Legault, Diane Laforte, Elizabeth A. Cummings, Karen Scott, Tracey Bridger, Cheryl Crummell, Robyn Houlden, Adriana Breen, George Carson, Sheila Kelly, Koravangattu Sankaran, Marie Penner, Richard A. White, Nancy King, James Popkin, Laurie Robson, Eva Al Taji, Irena Aldhoon, Pavla Mendlova, Jan Vavrinec, Jan Vosahlo, Ludmila Brazdova, Jitrenka Venhacova, Petra Venhacova, Adam Cipra, Zdenka Tomsikova, Petra Krckova, Pavla Gogelova, Ülle Einberg, Mall-Anne Riikjärv, Anne Ormisson, Vallo Tillmann, Päivi Kleemola, Anna Parkkola, Heli Suomalainen, Anna-Liisa Järvenpää, Anu-Maaria Hämälainen, Hannu Haavisto, Sirpa Tenhola, Pentti Lautala, Pia Salonen, Susanna Aspholm, Heli Siljander, Carita Holm, Samuli Ylitalo, Raisa Lounamaa, Anja Nuuja, Timo Talvitie, Kaija Lindström, Hanna Huopio, Jouni Pesola, Riitta Veijola, Päivi Tapanainen, Abram Alar, Paavo Korpela, Marja-Liisa Käär, Taina Mustila, Ritva Virransalo, Päivi Nykänen, Bärbel Aschemeier, Thomas Danne, Olga Kordonouri, Dóra Krikovszky, László Madácsy, Yeganeh Manon Khazrai, Ernesto Maddaloni, Paolo Pozzilli, Carla Mannu, Marco Songini, Carine de Beaufort, Ulrike Schierloh, Jan Bruining, Margriet Bisschoff, Aleksander Basiak, Renata Wasikowa, Marta Ciechanowska, Grazyna Deja, Przemyslawa Jarosz-Chobot, Agnieszka Szadkowska, Katarzyna Cypryk, Malgorzata Zawodniak-Szalapska, Luis Castano, Teba Gonzalez Frutos, Mirentxu Oyarzabal, Manuel Serrano-Ríos, María Teresa Martínez-Larrad, Federico Gustavo Hawkins, Dolores Rodriguez Arnau, Johnny Ludvigsson, Malgorzata Smolinska Konefal, Ragnar Hanas, Bengt Lindblad, Nils-Osten Nilsson, Hans Fors, Maria Nordwall, Agne Lindh, Hans Edenwall, Jan Aman, Calle Johansson, Margrit Gadient, Eugen Schoenle, Dorothy Becker, Ashi Daftary, Margaret Franciscus, Carol Gilmour, Jerry Palmer, Rachel Taculad, Marilyn Tanner-Blasiar, Neil White, Uday Devaskar, Heather Horowitz, Lisa Rogers, Roxana Colon, Teresa Frazer, Jose Torres, Robin Goland, Ellen Greenberg, Maudene Nelson, Holly Schachner, Barney Softness, Jorma Ilonen, Massimo Trucco, Lynn Nichol, Erkki Savilahti, Taina Härkönen, Mikael Knip, Outi Vaarala, Kristiina Luopajärvi, Hans-Michael Dosch
-
- Journal:
- Public Health Nutrition / Volume 17 / Issue 4 / April 2014
- Published online by Cambridge University Press:
- 24 June 2013, pp. 810-822
-
- Article
-
- You have access Access
- HTML
- Export citation
-
Objective
To examine the use of vitamin D supplements during infancy among the participants in an international infant feeding trial.
DesignLongitudinal study.
SettingInformation about vitamin D supplementation was collected through a validated FFQ at the age of 2 weeks and monthly between the ages of 1 month and 6 months.
SubjectsInfants (n 2159) with a biological family member affected by type 1 diabetes and with increased human leucocyte antigen-conferred susceptibility to type 1 diabetes from twelve European countries, the USA, Canada and Australia.
ResultsDaily use of vitamin D supplements was common during the first 6 months of life in Northern and Central Europe (>80 % of the infants), with somewhat lower rates observed in Southern Europe (>60 %). In Canada, vitamin D supplementation was more common among exclusively breast-fed than other infants (e.g. 71 % v. 44 % at 6 months of age). Less than 2 % of infants in the USA and Australia received any vitamin D supplementation. Higher gestational age, older maternal age and longer maternal education were study-wide associated with greater use of vitamin D supplements.
ConclusionsMost of the infants received vitamin D supplements during the first 6 months of life in the European countries, whereas in Canada only half and in the USA and Australia very few were given supplementation.
The effect of intermittent energy and carbohydrate restriction v. daily energy restriction on weight loss and metabolic disease risk markers in overweight women
- Michelle Harvie, Claire Wright, Mary Pegington, Debbie McMullan, Ellen Mitchell, Bronwen Martin, Roy G. Cutler, Gareth Evans, Sigrid Whiteside, Stuart Maudsley, Simonetta Camandola, Rui Wang, Olga D. Carlson, Josephine M. Egan, Mark P. Mattson, Anthony Howell
-
- Journal:
- British Journal of Nutrition / Volume 110 / Issue 8 / 28 October 2013
- Published online by Cambridge University Press:
- 16 April 2013, pp. 1534-1547
- Print publication:
- 28 October 2013
-
- Article
-
- You have access Access
- HTML
- Export citation
-
Intermittent energy restriction may result in greater improvements in insulin sensitivity and weight control than daily energy restriction (DER). We tested two intermittent energy and carbohydrate restriction (IECR) regimens, including one which allowed ad libitum protein and fat (IECR+PF). Overweight women (n 115) aged 20 and 69 years with a family history of breast cancer were randomised to an overall 25 % energy restriction, either as an IECR (2500–2717 kJ/d, < 40 g carbohydrate/d for 2 d/week) or a 25 % DER (approximately 6000 kJ/d for 7 d/week) or an IECR+PF for a 3-month weight-loss period and 1 month of weight maintenance (IECR or IECR+PF for 1 d/week). Insulin resistance reduced with the IECR diets (mean − 0·34 (95 % CI − 0·66, − 0·02) units) and the IECR+PF diet (mean − 0·38 (95 % CI − 0·75, − 0·01) units). Reductions with the IECR diets were significantly greater compared with the DER diet (mean 0·2 (95 % CI − 0·19, 0·66) μU/unit, P= 0·02). Both IECR groups had greater reductions in body fat compared with the DER group (IECR: mean − 3·7 (95 % CI − 2·5, − 4·9) kg, P= 0·007; IECR+PF: mean − 3·7 (95 % CI − 2·8, − 4·7) kg, P= 0·019; DER: mean − 2·0 (95 % CI − 1·0, 3·0) kg). During the weight maintenance phase, 1 d of IECR or IECR+PF per week maintained the reductions in insulin resistance and weight. In the short term, IECR is superior to DER with respect to improved insulin sensitivity and body fat reduction. Longer-term studies into the safety and effectiveness of IECR diets are warranted.