What Are Effective Program Characteristics of Self-Management Interventions in Patients With Heart Failure? : An Individual Patient Data Meta-analysis

Background To identify those characteristics of self-management interventions in patients with heart failure (HF) that are effective in influencing health-related quality of life, mortality, and hospitalizations. Methods and Results Randomized trials on self-management interventions conducted between January 1985 and June 2013 were identified and individual patient data were requested for meta-analysis. Generalized mixed effects models and Cox proportional hazard models including frailty terms were used to assess the relation between characteristics of interventions and health-related outcomes. Twenty randomized trials (5624 patients) were included. Longer intervention duration reduced mortality risk (hazard ratio 0.99, 95% confidence interval [CI] 0.97–0.999 per month increase in duration), risk of HF-related hospitalization (hazard ratio 0.98, 95% CI 0.96–0.99), and HF-related hospitalization at 6 months (risk ratio 0.96, 95% CI 0.92–0.995). Although results were not consistent across outcomes, interventions comprising standardized training of interventionists, peer contact, log keeping, or goal-setting skills appeared less effective than interventions without these characteristics. Conclusion No specific program characteristics were consistently associated with better effects of self-management interventions, but longer duration seemed to improve the effect of self-management interventions on several outcomes. Future research using factorial trial designs and process evaluations is needed to understand the working mechanism of specific program characteristics of self-management interventions in HF patients.

Conquerors, Brides and Concubines. Interfaith Relations and Social Power in Medieval Iberia.

As its title indicates, this book, which is divided into four chapters, seeks to provide an overview of “the diverse political, social and cultural functions that interfaith marriage alliances and other sexual encounters fulfilled within the overall dynamic of Christian- Muslim relations in the Iberian Peninsula during the medieval period, both within al- Andalus (…) and the expansionist Christian-dominated polities of the North” (4). In this sense, its chronological span reaches from the early eighth century (the conquest of the Iberian Peninsula by the Muslims) to 1492 (the Christian conquest of the Nasrid Kingdom of Granada)

Trans-national cooperation: an asset in the Portuguese overseas trade. Foreigners operating in the Portuguese overseas trade, 1580-1590

This paper aims to discuss the role of foreign merchants, operating from Portugal, in the Portuguese overseas trade, during the first ten years of Iberian Union. The focus is not in products or routes, but in the mechanisms of association of such merchants. Iberian Union created a legal framework which prohibited the interference and trade of Portuguese agents in the Spanish Empire and vice-versa. Due to the imperialist wars of the Habsburgs, the Portuguese Empire also suffered from Dutch and English rivalry both in the Indic and in the Atlantic and also from the embargos of Dutch and English products and ships in Iberian ports. In such conjuncture, how did merchants related with each other? What was the impact of the political union of the Portuguese and Spanish crowns in trading associations? The used data sources are the notarial contracts of Lisbon for the same period. The paper highlights the role of Castilian merchants in the Portuguese trade, but it also stresses that Iberian partnerships have prevailed before 1580. The role of other merchants, such as Flemish/Dutch, Germans, Italians and French, is also considered. The paper discusses how and why did these merchants join in trans-national partnerships and what was their role in the Portuguese trade network at the time.