Impact of the Healthy Eating and Exercise Lifestyle Programme on Depressive Symptoms in Overweight People With Heart Disease and Diabetes.
Impact of the Healthy Eating and Exercise Lifestyle Programme on depressive symptoms in overweight people with heart disease and diabetes.
Eur J Prev Cardiol. 2013 Apr 9;
Gallagher R, Zelestis E, Hollams D, Denney-Wilson E, Kirkness A
BACKGROUND: The Healthy Eating and Exercise Lifestyle Program (HEELP) is a secondary risk factor intervention programme for people with heart disease and/or type 2 diabetes, which has proven benefits for weight loss and exercise. This secondary analysis evaluated the effects of HEELP on achieving recommended levels of exercise and the prevalence of depressive symptoms, and whether meeting exercise recommendations had an independent effect on depressive symptoms. DESIGN: A randomized parallel controlled trial of patients (n?=?147) with body mass index 27-39?kg/m(2) were recruited from cardiac rehabilitation and diabetes education programmes. METHODS: HEELP participants received a 16-week group-based lifestyle intervention of twice-weekly supervised exercise and five information sessions; the control group received usual care. At 16 weeks, achievement of recommended levels of exercise (?5 days/week, moderate or higher intensity, and total duration of ?150?minutes/week) and depressive symptoms (Hospital Anxiety and Depression Scale) were assessed. RESULTS: More HEELP participants met the recommendations for exercise frequency (71 vs. 50%, p?=?0.036), intensity (76 vs. 60%, p?=?0.05), and total duration (65 vs. 43%, p?=?0.047). The prevalence of depressive symptoms in HEELP was half that of the control group (17 vs. 34%; OR 0.397, 95% CI 0.18-0.86). Participants who met recommendations for total duration of exercise were less likely to report depressive symptoms (OR 0.29, 95% CI 0.112-0.717) after adjusting for treatment group and weight change. CONCLUSIONS: A group-based lifestyle intervention improves exercise and reduces depressive symptoms despite multiple risk factors. HubMed – rehab
[A Cross-Sectorial Analysis of Physio and Occupational Therapy Pathways after Stroke.]
Gesundheitswesen. 2013 Apr 9;
Peschke D, Kohler M, Schenk L, Kuhlmey A
This article examines the provision of physiotherapy and occupational therapy for stroke patients from a cross-sectorial perspective, from acute to rehabilitative care to outpatient services.The sample comprises all clients of the Deutsche BKK, a large German health insurance company, who received acute care for stroke in 2007, who survived the initial hospital stay, and who had a secondary diagnosis of motor deficits (n=1 929).For 60.4% of these stroke patients, no further treatment was provided after acute care. The odds of receiving early rehabilitation treatment while in hospital stay decreased by 1% with each year of life. Only 18.8% of patients received a form of treatment that was largely in line with current recommendations for stroke care, beginning with early rehabilitation and including further treatment in the context of rehabilitation measures or outpatient care. Patients who were in long-term nursing care before stroke were at increased risk of not being placed on this treatment pathway, which has been positively evaluated. 20.7% of patients did not receive any early rehabilitation treatment, but received further rehabilitation treatment and/or outpatient services after hospital discharge.We recommend that receipt of long-term nursing care should routinely be regarded as a risk factor for underprovision of treatment after stroke (yellow flag). HubMed – rehab
Models of delivering palliative and end-of-life care in sub-Saharan Africa: a narrative review of the evidence.
Curr Opin Support Palliat Care. 2013 Apr 6;
Mwangi-Powell FN, Powell RA, Harding R
PURPOSE OF REVIEW: This narrative review examines evidence for models of palliative and end-of-life (eol) care delivery in sub-Saharan Africa (SSA) since 2010. It highlights recent developments, on-going challenges and innovative approaches used to address obstacles to increased access to care. RECENT FINDINGS: Electronic databases were searched for the literature published in English during the period 2010-2012 around broad thematic areas of palliative and eol care delivery models in SSA. Literature showed increased palliative and eol care service development, underpinned by advocacy work undertaken by regional and national palliative care associations. Despite this increase, care provision remains inadequately integrated in national public health agendas and systems. Consequently, it continues to be heavily reliant upon nongovernmental, community-based and home-based care (HBC) models. Efforts are, however, underway to integrate palliative care into national health systems, which should increase access to care. National policies and government financing will be important to sustain this integration. SUMMARY: Although community and HBC programs remain primary models of palliative and eol care delivery in SSA, there is an urgent need to develop a public health approach that integrates care into national health systems to increase accessibility. HubMed – rehab
Efficacy of Short-Term Inpatient Rehabilitation for Dementia Patients and Caregivers: Prospective Cohort Study.
Dement Geriatr Cogn Disord. 2013 Apr 5; 35(5-6): 300-312
Schiffczyk C, Romero B, Jonas C, Lahmeyer C, Müller F, Riepe MW
Background/Aims: The efficacy of nonpharmacological and multicomponent treatments in patients with dementia is under discussion, as is the ongoing debate which endpoints best measure efficacy. Methods: 194 dyads of dementia patients and their proxies interested in a combined short-term inpatient rehabilitative treatment were assessed in the patients’ homes. Results: Analysis showed that cognition in male patients (cognitive part of the Alzheimer’s Disease Assessment Scale: p = 0.048) and depressive mood in female patients were improved after treatment at the 3-month follow-up (Geriatric Depression Scale: p = 0.030). Moreover, the burden on male caregivers was reduced (behavioral pathology in Alzheimer’s Disease Rating Scale: p = 0.002) at 3 months. Conclusion: Combined short-term rehabilitative treatment of patients and psychosocial intervention for caregivers is modestly effective in patients with dementia and their caregivers, but may be subject to gender-specific effects. HubMed – rehab