Purpose The purpose of this study is to evaluate the feasibility and effectiveness of an adapted Diabetes Prevention Program (DPP) lifestyle program, DPP Group Lifestyle Balance (GLB), delivered in 3 economically diverse senior/community centers. Methods The DPP-GLB was implemented in 3 senior/community centers in Allegheny County, PA. A 6-month delayed control intervention design was used. Participants were randomized to begin the DPP-GLB immediately (immediate) or after a 6-month delay (delayed). Adults (n = 134; mean age = 62.8 years) with BMI ≥24 kg/m and prediabetes and/or the metabolic syndrome took part. Weight, physical activity (PA), and diabetes and cardiovascular disease (CVD) risk factors were assessed at 6, 12, and 18 months from baseline. Results At 6 months, the immediate group demonstrated greater mean weight loss than the delayed control group as well as significantly greater improvements in PA, A1C, fasting insulin, and waist circumference. In pre-post analyses, both randomized groups showed similar success that was maintained at 18 months. Conclusions The DPP-GLB delivered in economically diverse community centers was effective in this group of older adults. These findings support provision of coverage for prevention programs in older adults at risk for diabetes/CVD, which is important considering the large number of individuals who will be Medicare eligible in the near future.
Background The presence of risk factors for type 2 diabetes and cardiovascular disease, or the conditions themselves, contributes to lower health-related quality of life (HRQoL) among adults. Although community-based lifestyle intervention programs have been shown to be effective for improving risk factors for these diseases, the impact of these interventions on HRQoL has rarely been described. Purpose To examine changes in HRQoL following participation in the Group Lifestyle Balance program, a community translation of the Diabetes Prevention Program lifestyle intervention for adults with pre-diabetes and/or the metabolic syndrome. Methods Participants enrolled in the 12-month, 22-session intervention program (N=223) completed the EuroQol Health Questionnaire (EQ-5D-3L) at baseline, 6, and 12 months. Linear mixed effects regression models determined change in EQ-5D-Visual Analog Scale (VAS) and Index scores post-intervention. Results Mean EQ-5D-VAS improved by +7.38 (SE=1.03) at 6 months and by +6.73 (SE=1.06) at 12 months post-intervention (both; p<0.0001). Mean changes in EQ-5D Index values were +0.00 (SE=0.01; NS) and +0.01 (SE=0.01; p<0.05), respectively. Adjusted for age, baseline score, and achieving intervention goals, mean change in EQ-5D-VAS was +11.83 (SE=1.61) at 6 months and +11.23 (SE=1.54) at 12 months (both; p<0.0001). Adjusted mean change in EQ-5D Index value was +0.04 (SE=0.01) at 6 months and +0.05 (SE=0.01) at 12 months (both; p<0.01). Conclusions Participation in a community lifestyle intervention program resulted in improved HRQoL among adults with pre-diabetes and/or the metabolic syndrome. These benefits to HRQoL, together with improved clinical and behavioral outcomes, should increase the appeal of such programs for improving health.
Oblique impact of single drops on deep fluids at various impact angles $\alpha $ is studied for a wide Weber number range (15$\,{\le}\,$We$\,{\le}\,$249), where $\alpha $ is varied between 5.4$^\circ$ and 64.4$^\circ$ with respect to the target surface, and drop and target consist of the same fluid (water/glycerol). In the range of studied parameters, coalescence always takes place. Below a critical level of the Weber number We$_{N}$ formed with the normal velocity component, We$_{N}\,{<}\, 10$, capillary waves are produced on the drop and target surface in the first stage after impact. For We$_{N}\,{>}\, 10$, a lamella is ejected from the target surface and drop volume for which both experimental and numerical evidence is given. For We$\,{<}\, 140$ and $\alpha \,{<}\, 23^\circ$, the drop spreads on the target surface with no visible immersion of drop fluid into the target fluid. Outside this range, a partial immersion of drop fluid can be seen: for We$_{N}\,{>}\,$10, it occurs in the front part of the spreading drop; for $\alpha \,{>}\,$23$^\circ$, in the rear part of the impact crater. The spreading patterns of the drop fluid are visualized with dyed drop fluid once it has come to rest after impact. In many cases, patterns of high complexity and strong sensitivity to the impact conditions can be seen which are very reproducible for similar impact conditions. The mechanisms underlying capillary wave or lamella formation and the partial immersions of drop fluid are discussed and their relevance for pattern formation is taken into account.
OBJECTIVEAlthough oxidative stress (OxS) is thought to contribute to atherosclerosis and coronary artery disease (CAD), little is known about the variability in an individual’s ability to respond to OxS. Therefore, we assessed potential indices of response to OxS and evaluated whether they modify the association between OxS and CAD.RESEARCH DESIGN AND METHODSWe evaluated plasma α- and γ-tocopherol per unit cholesterol (potential response markers); urinary 15-isoprostane F2t per milligram creatinine (isoprostane [IsoP], a potential stress marker); and the α-tocopherol-to-IsoP ratio (as a measure of response to stress), measured three times during 20 years of follow-up, in relation to CAD incidence in a cohort with childhood-onset type 1 diabetes (n = 658; mean age at baseline, 28 years; duration of diabetes, 19 years). Participants with three samples (blood and either 24-h or overnight urine) available before the onset of CAD or the end of follow-up (n = 356) were selected for study.RESULTSIn multivariable mixed models, α-tocopherol over time was inversely associated with CAD (β = −0.27; P = 0.02), whereas a direct association was observed for IsoP (β = 0.0008; P = 0.06). Moreover, the α-tocopherol-to-IsoP ratio was strongly and inversely related to CAD incidence (β = −0.72; P = 0.003), whereas in a separate model including α-tocopherol and IsoP, both biomarkers maintained statistical significance. No association was observed for γ-tocopherol (β = −0.22; P = 0.54).CONCLUSIONSThese data suggest that a greater potential capability (α-tocopherol) to respond to OxS (urinary IsoP) relates to CAD incidence.
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