Complex interventions for preventing diabetic foot ulceration.

Background: Ulceration of the feet, which can lead to the amputation of feet and legs, is a major problem for people with diabetes mellitus, and can cause substantial economic burden. Single preventive strategies have not been shown to reduce the incidence of foot ulceration to a significant extent. Therefore, in clinical practice, preventive interventions directed at patients, healthcare providers and/or the structure of health care are often combined (complex interventions).

Patient education for preventing diabetic foot ulceration.

Background: Ulceration of the feet, which can result in loss of limbs and even death, is one of the major health problems for people with diabetes mellitus.

Objectives: To assess the effects of patient education on the prevention of foot ulcers in patients with diabetes mellitus.

Search Methods: We searched The Cochrane Wounds Group Specialised Register (searched 03 September 2014); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 8).

Patient education for preventing diabetic foot ulceration.

Background: Ulceration of the feet, which can result in loss of limbs and even death, is one of the major health problems for people with diabetes mellitus.

Objectives: To assess the effects of patient education on the prevention of foot ulcers in patients with diabetes mellitus.

Search Strategy: Eligible studies were identified by searching the Cochrane Wounds Group Specialised Register (22 December 2009), the Cochrane Central Register of Controlled Trials (Cochrane Library 2009 Issue 4 ), Ovid MEDLINE (1950 to November Week 3 2009), Ovid MEDLINE In-Process & Other Non-Indexed Citations (Searched 22/12/09), Ovid EMBASE (1980 to 2009 Week 51) and EBSCO CINAHL (1982 to December 22 2009).

Complex interventions for preventing diabetic foot ulceration.

Background: Ulceration of the feet, which can lead to the amputation of feet and legs, is a major problem for people with diabetes mellitus, and can cause substantial economic burden. Single preventive strategies have not been shown to reduce the incidence of foot ulceration to a significant extent. Therefore, in clinical practice, preventive interventions directed at patients, health care providers and/or the structure of health care are often combined (complex interventions).

Somatic chronic diseases and 6-year change in cognitive functioning among older persons.

The influence of seven highly prevalent somatic chronic diseases on changes in cognitive functioning is investigated in older persons in a prospective design covering a 6-year follow-up period. The data were collected as part of the Longitudinal Aging Study Amsterdam (LASA). The associations between chronic diseases and cognitive functioning during 6 years of follow-up were analyzed among 1358 respondents (age 62-85) using generalized estimated equations (GEE).

Disease control in general practice patients with asthma.

Objectives: To examine asthma control in conjunction with medication use in asthma patients from general practice. To determine features of patients with inadequately controlled asthma.

Methods: A cross-sectional study was performed among 661 adult asthma patients recruited from general practice.

Predictors of survival in nursing home patients with severe dementia in whom artificial nutrition and hydration are [corrected] forgone.

Background: To investigate the characteristics of patients in whom artificial nutrition and hydration (ANH) is forgone, duration of survival after the decision and factors that are associated with duration of survival.

Methods: Observational study based on written questionnaires in 32 Dutch nursing homes. Of 178 nursing home patients with dementia, their treating nursing home physician (NHP) filled in a questionnaire directly after the decision was made to forgo ANH.

Discomfort in nursing home patients with severe dementia in whom artificial nutrition and hydration is forgone.

Background: While there is debate about whether it may be better to forgo than to initiate artificial nutrition and hydration (ANH) in nursing home patients with severe dementia, the consequences of forgoing ANH in these patients, in particular their discomfort, have not yet been investigated.

Methods: In this prospective, longitudinal, observational study of 178 patients in Dutch nursing homes, discomfort was measured at all measurement times according to the observational Discomfort Scale-Dementia of Alzheimer Type. Furthermore, at all measurement times, plausible determinants of discomfort were registered.

Quality of care for patients with type 2 diabetes mellitus in the Netherlands and the United States: a comparison of two quality improvement programs.

Objective: To assess differences in diabetes care and patient outcomes by comparing two multifaceted quality improvement programs in two different countries, and to increase knowledge of effective elements of such programs.

Study Setting: Primary care in the ExtraMural Clinic (EMC) of the Department of General Practice of the Vrije Universiteit in Amsterdam, the Netherlands, and the Group Health Cooperative (GHC), a group-model health maintenance organization (HMO) in western Washington State in the United States. Data were collected from 1992 to 1997.

Chronic diseases and depression: the modifying role of psychosocial resources.

Psychosocial coping resources have been found to protect against depressive symptoms in people with and without chronic diseases. It has not been established, however, whether these resources have the same effects across patients with different diseases. Therefore, the aim of the study was to estimate the direct and buffer effects of psychosocial resources on depression, and to examine whether these effects are different for various chronic diseases.

The longitudinal relation between chronic diseases and depression in older persons in the community: the Longitudinal Aging Study Amsterdam.

Objective: The purposes of this study were to examine the differences in influence of various chronic diseases on depressive symptomatology over time and to determine whether there were differences in such influence depending on physical limitations and time of onset of disease.

Study Design And Setting: Data for this study were obtained from the Longitudinal Aging Study Amsterdam. Two thousand two hundred eighty-eight respondents (age 55-85) were included and followed for a maximum of 6 years.

Comorbidity of somatic chronic diseases and decline in physical functioning:; the Longitudinal Aging Study Amsterdam.

Objective: To assess the association of decline in physical functioning with number of chronic diseases and with specific comorbidity in different index diseases.

Methods: A longitudinal design was employed using data from 2,497 older adults participating in the Longitudinal Aging Study Amsterdam. Logistic regression analyses were used to determine influence of chronic diseases on change in physical functioning, operationalized using the Edwards-Nunnally index.

The influence of differing social ties on decline in physical functioning among older people with and without chronic diseases: the Longitudinal Aging Study Amsterdam.

Background And Aims: Global social support measures have been shown to be related to several health outcomes. However, little is known about the effects of differing social ties and their support on the risk for decline in physical functioning among older people, without as compared with those with chronic diseases. This study examines whether differing types of social ties and support differentially mitigate the negative effects of chronic diseases on decline in physical functioning.

Concepts of self-rated health: specifying the gender difference in mortality risk.

Purpose: This study addresses the question of how the relation between self-rated health (SRH) and mortality differs between genders. In addition to the general question, four specific concepts of SRH are distinguished: SRH in comparison with age peers, SRH in comparison with one's own health 10 years ago, and current and future health perceptions. For these concepts, the gender-specific risks of mortality were evaluated for a short and a longer follow-up period.

Gender differences in health-related quality of life among asthma patients.

Objective: To identify and explain differences between men and women with asthma regarding health-related quality of life (HRQoL).

Methods: A cross-sectional study was performed among 967 asthma patients recruited from general practice. Data were collected by means of a pulmonary function assessment, a face-to-face interview, and a written questionnaire.

Patient education for preventing diabetic foot ulceration. A systematic review.

Objective: Ulceration of the feet, which can result in loss of limbs and death, is a major health problem for people with diabetes mellitus. The objective of this review is to assess the effectiveness of patient education to prevent diabetic foot ulcers.

Research Design And Methods: We conducted a systematic review of randomized controlled trials (RCTs) that evaluated educational programmes for the prevention of foot ulcers in people with diabetes mellitus.