968 resultados para Diabète mellitus
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Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.
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Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.
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Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.
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Introdução: Os core sets são desenvolvidos com o objetivo de identificar e agrupar categorias da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) e que caraterizam os principais problemas de funcionalidade dos indivíduos com uma condição clinica específica. Ao simplificar o número de categorias da CIF, facilita-se a sua aplicação na prática clínica. Objetivos: O comprehensive core set da CIF para a Diabetes Mellitus (DM) representa o conjunto típico de problemas de funcionalidade em utentes com DM. O objetivo deste estudo visa a exploração da validade do conteúdo deste core set e identificar os problemas mais comuns de utentes com DM a partir da perspetiva do fisioterapeuta através da utilização da CIF. Metodologia: Foi realizado um estudo qualitativo, com fisioterapeutas com experiência no tratamento de utentes com DM. Os dados foram recolhidos segundo o método de Delphi, através da realização de três questionários. As respostas foram analisadas por dois investigadores que procederam ao linking para as categorias da CIF. O grau de concordância foi efetuado utilizando a estatística de kappa. Resultados: Sete fisioterapeutas de 5 centros de saúde da região centro de Portugal foram questionados na primeira e segunda ronda; seis completaram a terceira ronda. Os fisioterapeutas chegaram ao consenso sobre o total de 26 categorias da CIF, sendo que 19 correspondem às categorias presentes no core set e 7 às não incluídas no core set da CIF para a DM. Seis componentes foram identificados como fatores pessoais. Conclusões: As categorias presentes no comprehensive core set da CIF para a DM pela perspetiva dos fisioterapeutas foram apoiadas. Contudo, algumas categorias adicionais foram propostas para inclusão no comprehensive core set da CIF para a DM.
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Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.
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Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.
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Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.
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Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal.
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Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.
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Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.
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Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.
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Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.
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Several determinants of fear of falling (FoF) and low balance confidence overlap with the consequences/complications of diabetes mellitus (DM). FoF is strongly associated with low balance confidence, and balance confidence mediates the relationship between FoF and balance and physical function. The purpose of this thesis was two-fold: (1) to examine the prevalence, severity and determinants of FoF in older adults (aged≥65) with DM, and (2) to evaluate the validity of the short version of the Activities-specific Balance Confidence scale (ABC-6) and its association with balance and postural control in older adults with DM. Three separate studies were conducted of older adults with DM (DM-group) and without DM (noDM-group). Study I revealed that although FoF prevalence adjusted for age and sex was not different between-groups, the DM-group had 8.8% fewer participants in the low and 8.4% more in the high Falls-Efficacy Scale International categories when compared to the noDM-group. Higher FoF severity in the DM-group was associated with poor physical performance, being female, fall history and clinical depressive symptoms. Study II provided evidence of convergent, discriminant and concurrent validity of the ABC-6 for use in older adults with DM with and without diabetic peripheral neuropathy (DPN). Notably, the ABC-6 was more sensitive in detecting subtle differences in balance confidence between the DM-group and noDM-group when compared to the original ABC scale (ABC-16), and can be administered in less time. Study III explored balance confidence (ABC-6) and its association with balance and postural control in older adults with DM. Subtle differences in axial segmental control (i.e., lower trunk roll velocity and higher head-trunk correlations) while walking and lower balance confidence were apparent in the DM-group, even in the absence of DPN, when compared to the noDM-group. Balance confidence partially explained the variance in head-trunk stiffening between-groups, and consequently low balance confidence in older adults with DM may contribute to the dependence on postural control strategies that are normally only utilized in high-risk situations. Findings from this thesis will help to guide the development of protocols for screening and intervention recommendations of patient education and targeted rehabilitation programs for older adults with DM.
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Although epidemiological studies suggest that type 2 diabetes mellitus (T2DM) increases the risk of late-onset Alzheimer's disease (LOAD), the biological basis of this relationship is not well understood. The aim of this study was to examine the genetic comorbidity between the 2 disorders and to investigate whether genetic liability to T2DM, estimated by a genotype risk scores based on T2DM associated loci, is associated with increased risk of LOAD. This study was performed in 2 stages. In stage 1, we combined genotypes for the top 15 T2DM-associated polymorphisms drawn from approximately 3000 individuals (1349 cases and 1351 control subjects) with extracted and/or imputed data from 6 genome-wide studies (>10,000 individuals; 4507 cases, 2183 controls, 4989 population controls) to form a genotype risk score and examined if this was associated with increased LOAD risk in a combined meta-analysis. In stage 2, we investigated the association of LOAD with an expanded T2DM score made of 45 well-established variants drawn from the 6 genome-wide studies. Results were combined in a meta-analysis. Both stage 1 and stage 2 T2DM risk scores were not associated with LOAD risk (odds ratio = 0.988; 95% confidence interval, 0.972-1.004; p = 0.144 and odds ratio = 0.993; 95% confidence interval, 0.983-1.003; p = 0.149 per allele, respectively). Contrary to expectation, genotype risk scores based on established T2DM candidates were not associated with increased risk of LOAD. The observed epidemiological associations between T2DM and LOAD could therefore be a consequence of secondary disease processes, pleiotropic mechanisms, and/or common environmental risk factors. Future work should focus on well-characterized longitudinal cohorts with extensive phenotypic and genetic data relevant to both LOAD and T2DM.
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Bakgrund: Diabetes mellitus typ 2 (DMT2) ökar i världen och kan leda till allvarliga fotkomplikationer. Det har påvisats brister i den förbyggande vården för att undvika fotkomplikationer. Sjuksköterskan ansvarar för att stötta personer med DMT2 och målet är att få dem att känna sig självständiga och delaktiga i sin egenvård. Syfte: Syftet med studien var att belysa omvårdnadsåtgärder och egenvård som förebygger fotkomplikationer för personer med DMT2 Metod: En litteraturstudie som utgår ifrån 20 vetenskapliga artiklar med kvantitativ uppbyggnad. Sökningarna av Artiklarna är sökta i databaserna Cinahl och Pubmed. Samtliga artiklar är kvalitetsgranskade. Resultat: Identifiering av risker är en viktig faktor i förebyggandet av fotkomplikationer. Dagliga inspektioner och undersökningar av fötterna är viktiga egenvårdsråd som sjuksköterskan bör tilldela genom individuell undervisning. Sjuksköterskan skall efter bästa förmåga stötta och motivera personer med DMT2 till god egenvård. Slutsats: Sjuksköterskan bör undervisa och ge personer med DMT2 tillräcklig kunskap, för att självständigt kunna utföra förebyggande egenvård.