To develop and psychometrically test Character Strengths Use in Diabetes Self-management Scale in people with type 2 diabetes.
Cross-sectional design.
Based on literature reviews and examination by ...experts, a 20-item scale was developed and administered to 350 participants with type 2 diabetes who were enrolled from two endocrine clinics by convenience sampling in Taiwan. Item analysis, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), concurrent and predictive validity as well as reliability were used to examine the psychometric characteristics of the scale. Data were collected from November 2021 to March 2022.
EFA and CFA supported a 12-item scale with three factors, namely learning proactively, taking on challenges and thinking positively, fit the data well. The total score of the 12-item scale significantly and positively correlated with diabetes-specific quality of life, and significantly and negatively correlated with baseline and 9-month haemoglobin A1c levels. Cronbach's α for overall scale and subscales ranged between .78 and .91.
The 12-item Character Strengths Use in Diabetes Self-management Scale demonstrated satisfactory validity and reliability in people with type 2 diabetes.
Nurses could apply this new scale to identify the degree of using character strengths in self-management in people with type 2 diabetes; accordingly, character strength-based interventions could be provided to improve self-management in such patients with diabetes. Furthermore, the 12-item Character Strengths Use in Diabetes Self-management Scale has the potential to be used to measure the effectiveness of strength-based interventions in people with Type 2 diabetes.
Five patients with type 2 diabetes were invited to take the original 20-item scale to evaluate the clarity, readability and comprehensiveness of the 20 items.
Hypertension is known to be related to obesity and both are the major factors for cardiovascular diseases. The relationship between body composition and blood pressure (BP) are discussed recently. ...Our study aims to evaluate the association between waist circumference (WC) and appendicular muscle mass (AMM) in relation to BP among the community‐dwelling elderly population.
Total 3739 patients (1600 males and 2139 females) were recruited in a series of community‐based surveys that were conducted among the elderly population in Taiwan from 2017 to 2019. We collected data on anthropometric characteristics, handgrip strength, and BP using standard methods. AMM was calculated with an equation. History of chronic disease and lifestyle profiles were collected using questionnaires.
The group with high AMM to body weight ratio (AMMW) showed lower systolic BP (SBP) (136.8 ± 19.1 to 140.6 ± 17.0 for males; 137.8 ± 18.3 to 142.7 ± 17.5 for females, both P < .001). Among central obese persons those with higher AMMW ratio had lower SBP. In the final model, AMMW in percentage is negatively associated to SBP (β = −0.641 in male, −0.780 in female, both P < .01). In other words, every 10% increase in AMMW is associated with decrease of SBP 6.41 mmHg in male and 7.80 mmHg in female.
Obesity and central obesity were positively associated with BP. The AMMW ratio was negatively associated with HTN and with a protective effect on BP even among the central obese. Health promotion programs to increase physical training may prevent hypertension among the elderly in Taiwan.
Osteoarthritis (OA) is the most common form of arthritis associated with an increased prevalence of type 2 diabetes mellitus (T2DM), however their impact on decreasing joint replacement surgery has ...yet to be elucidated. This study aimed to investigate if the combination of COX-2 inhibitor and metformin therapy in OA with T2DM were associated with lower the rate of joint replacement surgery than COX-2 inhibitor alone.
In total, 968 subjects with OA and T2DM under COX-2 inhibitor and metformin therapy (case group) between 1 January to 31 December 2000 were selected from the National Health Insurance Research Database of Taiwan, along with 1936 patients were the 1:2 gender-, age-, and index year-controls matched without metformin therapy (control group) in this study. Cox proportional hazards analysis was used to compare the rate of receiving joint replacement surgery during 10 years of follow-up.
At the end of follow-up, 438 of all enrolled subjects (15.08%) had received the joint replacement surgery, including 124 in the case group (12.81%) and 314 in the control group (16.22%). The case group tended to be associated with lower rate of receiving the joint replacement surgery at the end of follow-up than the control group (p = 0.003). Cox proportional hazards regression (HR) analysis revealed that study subjects under combination therapy with metformin had lower rate of joint replacement surgery (adjusted HR 0.742 (95% CI = 0.601-0.915, p = 0.005)). In the subgroups, study subjects in the combination metformin therapy who were female, good adherence (>80%), lived in the highest urbanization levels of residence, treatment in the hospital center and lower monthly insurance premiums were associated with a lower risk of joint replacement surgery than those without.
Patients who have OA and T2DM receiving combination COX-2 inhibitors and metformin therapy associated with lower joint replacement surgery rates than those without and this may be attributable to combination therapy much more decrease pro-inflammatory factors associated than those without metformin therapy.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Aim
To examine (1) the mediating role of self‐efficacy between resilience and self‐management behaviours and (2) the moderating role of diabetes distress on the relationship between self‐efficacy and ...self‐management behaviours in patients newly diagnosed with type 2 diabetes.
Design
Cross‐sectional design.
Methods
Totally, 195 patients newly diagnosed with type 2 diabetes for more than 5 months but less than 18 months were recruited from three endocrine clinics in Taiwan through convenience sampling. Self‐reported questionnaires including demographic and disease characteristics, resilience, self‐efficacy and self‐management behaviours were used to collect data from October 2020 to May 2021. Moderated mediation analysis was performed by Hayes's PROCESS macro.
Result
According to bootstrapping results, the indirect effect of resilience on self‐management was significant, although the direct effect of resilience on self‐management was not. Participants were categorized into with and without diabetes distress groups. The results of moderated mediation analysis indicated self‐efficacy significantly correlated with self‐management behaviours in participants without diabetes distress, although self‐efficacy did not significantly correlate with self‐management in participants with diabetes distress.
Conclusion
The association of resilience with self‐management behaviours was fully mediated through self‐efficacy with diabetes distress moderating the relationship between self‐efficacy and self‐management behaviours in patients newly diagnosed with type 2 diabetes.
Impact
Improving resilience could enhance self‐efficacy leading to possible improvement in self‐management behaviour, although improving self‐efficacy might not benefit self‐management behaviours for those with high levels of diabetes distress. Healthcare providers need to first assess and address the diabetes distress before intervening to improve self‐efficacy to enhance self‐management behaviours in patients newly diagnosed with type 2 diabetes.
Patient or Public Contribution
When designing this study, two patients newly diagnosed with diabetes were consulted about the importance of self‐management behaviours for them personally.
Recent evidence has suggested that synovial inflammation and macrophage polarization were involved in the pathogenesis of osteoarthritis (OA). Additionally, high-molecular-weight hyaluronic acid ...(HMW-HA) was often used clinically to treat OA. GRP78, an endoplasmic reticulum (ER) stress chaperone, was suggested to contribute to the hyperplasia of synovial cells in OA. However, it was still unclear whether HMW-HA affected macrophage polarization through GRP78. Therefore, we aimed to identify the effect of HMW-HA in primary synovial cells and macrophage polarization and to investigate the role of GRP78 signaling. We used IL-1β to treat primary synoviocytes to mimic OA, and then treated them with HMW-HA. We also collected conditioned medium (CM) to culture THP-1 macrophages and examine the changes in the phenotype. IL-1β increased the expression of GRP78, NF-κB (p65 phosphorylation), IL-6, and PGE2 in primary synoviocytes, accompanied by an increased macrophage M1/M2 polarization. GRP78 knockdown significantly reversed the expression of IL-1β-induced GRP78-related downstream molecules and macrophage polarization. HMW-HA with GRP78 knockdown had additive effects in an IL-1β culture. Finally, the synovial fluid from OA patients revealed significantly decreased IL-6 and PGE2 levels after the HMW-HA treatment. Our study elucidated a new form of signal transduction for HMW-HA-mediated protection against synovial inflammation and macrophage polarization and highlighted the involvement of the GRP78-NF-κB signaling pathway.
Sarcopenia and muscle weakness in elderly are contributed burden of public health and impact on quality of life. Weak grip strength was key role in diagnosis of sarcopenia and reported increased ...mortality, function declined in elderly. This study evaluated the association between GS and each common anthropometric characteristic in community-dwelling elderly.
From 2017 to 2019, we conducted a community-based health survey among the elderly in Chiayi county, Taiwan. Participants were 65 years old or older, and total of 3,739 elderly subjects (1,600 males and 2,139 females) with a mean age of 76 years (range 65-85 years old) were recruited. General demographic data and lifestyle patterns were measured using a standard questionnaire. Anthropometric characteristics such as body height, body weight, body mass index (BMI), body waist and hip circumference, and body fat were measured by standard methods. GS was measured using a digital dynamometers (TKK5101) method.
The mean GS was 32.8 ± 7.1 kg for males and 21.6 ± 4.8 kg for females (p < 0.001). For both sexes, elderly subjects with the same body weight but smaller body waist circumference had greater GS. The subjects with the same body waist size but heavier weight had greater GS. Furthermore, after adjusting for age, lifestyles, disease status, and potential anthropometric variable, multivariate regression analyses indicated that BMI was positively associated with GS (for males, beta = 0.310 and for females beta = 0.143, both p < 0.001) and body waist was negatively associated with GS (for males, beta = -0.108, p < 0.001; for females, beta = -0.030, p = 0.061).
This study suggested that old adults with higher waist circumstance had weaker GS. Waist circumstance was negatively associated with GS, body weight was positively associated with GS in contrast. It may implies that central obesity was more important than overweight for GS in elderly.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background: Lyme disease or Lyme borreliosis is the most commonly transmitted tick‑borne infection in the United States and among the most frequently diagnosed tick‑borne infections worldwide. Lyme ...disease is caused by Borrelia burgdorferi. Aim: In this study, we explored the epidemiological characteristics, differences, and trends in domestic and imported cases of Lyme disease in Taiwan between 2007 and 2020 according to patient sex, age, month of confirmation, and area of residence. Methods: We analyzed publicly available annual summary data on domestic cases of Lyme disease from 2007 to 2020 obtained from a Taiwanese Centers for Disease Control (TCDC) database. In total, 17 confirmed imported cases of Lyme disease were reported. Results: Cases in individuals aged 20-59 years gradually increased, and a distinct pattern of seasonal variation (summer) was observed as a potential risk factor. Furthermore, more men had domestically acquired Lyme disease, and cases were identified in individuals living in the Taipei metropolitan area (11 cases 64.7%) and rural areas (Gao‑Ping region, three cases 17.6%). Imported cases originated in North America (11 cases 64.7%) and Europe (6 cases 35.3%). The incidence of Lyme disease per million population was 0-0.13. The incidence of Lyme disease increased from 2007-2013 to 2014-2020, indicating that the recentness of imported cases may be a risk factor. Conclusion: This is the first study to compare imported cases of Lyme disease from 2007 to 2020 from the surveillance data of the TCDC database. This study highlights the essentiality of longitudinal and geographically extended studies in understanding zoonotic disease transmission in Taiwan. Our findings may inform future surveillance and research efforts.
The C-C chemokine motif ligand 5 (CCL5) and its receptors have recently been thought to be substantially involved in the development of obesity-associated adipose tissue inflammation and insulin ...resistance. However, the respective contributions of tissue-derived and myeloid-derived CCL5 to the etiology of obesity-induced adipose tissue inflammation and insulin resistance, and the involvement of monocytic myeloid-derived suppressor cells (MDSCs), remain unclear. This study used CCL5-knockout mice combined with bone marrow transplantation (BMT) and mice with local injections of shCCL5/shCCR5 or CCL5/CCR5 lentivirus into bilateral epididymal white adipose tissue (eWAT). CCL5 gene deletion significantly ameliorated HFD-induced inflammatory reactions in eWAT and protected against the development of obesity and insulin resistance. In addition, tissue (non-hematopoietic) deletion of CCL5 using the BMT method not only ameliorated adipose tissue inflammation by suppressing pro-inflammatory M-MDSC (CD11b
Ly6G
Ly6C
) accumulation and skewing local M1 macrophage polarization, but also recruited reparative M-MDSCs (CD11b
Ly6G
Ly6C
) and M2 macrophages to the eWAT of HFD-induced obese mice, as shown by flow cytometry. Furthermore, modulation of tissue-derived CCL5/CCR5 expression by local injection of shCCL5/shCCR5 or CCL5/CCR5 lentivirus substantially impacted the distribution of pro-inflammatory and reparative M-MDSCs as well as macrophage polarization in bilateral eWAT. These findings suggest that an obesity-induced increase in adipose tissue CCL5-mediated signaling is crucial in the recruitment of tissue M-MDSCs and their trans-differentiation to tissue pro-inflammatory macrophages, resulting in adipose tissue inflammation and insulin resistance.
Purpose
To evaluate whether concomitant use of amiodarone and sulfonylureas is associated with an increased risk of serious hypoglycemia.
Methods
We conducted two nested case‐control studies by ...analyzing the Taiwan National Health Insurance Research Database from 2008 to 2013 among diabetic patients continuously receiving sulfonylureas. Cases were defined as patients with severe hypoglycemia and those with a composite outcome of severe hypoglycemia, altered consciousness, and fall‐related fracture in the first and second study, respectively. In both studies, each case was individually matched up to 10 randomly‐selected controls. Conditional logistic regressions were employed to estimate odds ratios (ORs).
Results
We identified 1343 cases and 11 597 controls as well as 2848 cases of composite events and 24 808 controls among 46 317 sulfonylurea users. Concurrent use of amiodarone with sulfonylureas was associated with a 1.56‐fold (95% CI: 0.98‐2.46) increased risk of severe hypoglycemia, despite not statistically significant. Notably, an approximately 2‐fold increased risk of severe hypoglycemia was observed with amiodarone therapy lasting for >180 days (adjusted OR: 2.08; 95% CI: 1.01‐4.30) or at a daily dose greater than 1 defined daily dose (adjusted OR: 2.21; 95% CI: 1.25‐3.91) when concurrently administrating sulfonylureas. A significantly increased risk of hypoglycemia‐related composite events was also found with amiodarone concurrently used with sulfonylureas (adjusted OR: 1.59; 95% CI: 1.13‐2.24).
Conclusions
Concurrent use of amiodarone and sulfonylureas is associated with an increased risk of serious hypoglycemia among diabetic patients, with an elevated risk for amiodarone used in a long‐term or at a high daily dose.
•Monounsaturated fatty acids is vital for prevention of cardiovascular diseases.•Palmitic acid induced murine macrophages toward to pro-inflammatory via TLR2 or TLR4.•Palmitoleic acid revealed the ...effects of against inflammation through TLR2 or TLR4.•Macrophages state is upon the balance of saturated and unsaturated fatty acids.
Adipose tissue resident macrophages play an important role in the regulation of the inflammatory response. Monounsaturated fatty acids assist in the prevention of cardiovascular diseases via an anti-inflammatory effect. However, the mechanisms by which monounsaturated fatty acids, such as palmitoleic acid, regulate the inflammatory response has not been well investigated. In this study, we found that a high concentration of palmitic acid induced J774A.1 murine macrophages toward a pro-inflammatory state, possibly through the activation of the TLR2 or TLR4 genes, and their downstream signaling pathways. In contrast, palmitoleic acid induced a protective effect against inflammation in macrophage of non-obese rodents by inducing an alternative activation pathway via reducing TLR2 or TLR4 signaling. This study indicates that the balance of palmitic acid (saturated fatty acid) and palmitoleic acid (monounsaturated fatty acid) effects macrophage activation. The potential therapeutic impact of palmitoleic acid to ameliorate non-obese-mediated inflammation warrants further investigation.
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