RESUMEN
Research on the role of behavior change as an efficacious intervention for adults with type 2 diabetes is evolving. Searching PubMed and Ovid Medline, we identified and reviewed primarily randomized controlled trials from 2010 to 2013 of adults managing type 2 diabetes without insulin. All studies are evaluated in terms of the rigor of their design and their impact on glycosylated hemoglobin. The most efficacious interventions appear to be low-carbohydrate/glycemic load diets, combined aerobic and resistance training, and self-monitoring of blood glucose, which educates patients about the impact of their food selections and physical activity on their blood glucose.
Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/terapia , Adulto , Glucemia , Diabetes Mellitus Tipo 2/metabolismo , Conducta Alimentaria , Hemoglobina Glucada/metabolismo , Humanos , Estilo de VidaRESUMEN
OBJECTIVES: To present a pilot study of valerian to explore issues of feasibility and efficacy in studies of sedative herbs for arthritis-related sleep disturbance. METHODS: Fifteen persons with arthritis and mild sleep disturbance were randomized to receive 600 mg valerian (Valeriana officinalis, n = 7) or placebo (n = 8) for five nights. RESULTS: Protocol adherence (dosing and data collection) was high. Allocation concealment was successful using a novel approach for matching the placebo on the distinctive odor of valerian. Nonsignificant differences between the groups were found on all sleep outcomes, measured by daily diaries and wrist actigraphy. CONCLUSION: The study methods were feasible, except for recruitment issues (addressed in the discussion), and may guide the testing of other sedative herbs for persons with arthritis. Although efficacy outcomes were inconclusive due to the small sample size of this study, recent evidence from larger trials of valerian also does not support its efficacy.
Asunto(s)
Artritis/complicaciones , Fitoterapia/métodos , Trastornos del Sueño-Vigilia/tratamiento farmacológico , Valeriana , Actividades Cotidianas/psicología , Adulto , Análisis de Varianza , Actitud Frente a la Salud , Investigación en Enfermería Clínica , Método Doble Ciego , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fitoterapia/efectos adversos , Fitoterapia/psicología , Proyectos Piloto , Extractos Vegetales/uso terapéutico , Polisomnografía , Índice de Severidad de la Enfermedad , Trastornos del Sueño-Vigilia/diagnóstico , Trastornos del Sueño-Vigilia/etiología , Trastornos del Sueño-Vigilia/psicología , Encuestas y Cuestionarios , Resultado del TratamientoRESUMEN
BACKGROUND: Although the benefits of guided imagery are now more widely recognized, the definitions of imagery used by various health science disciplines are inconsistent. PURPOSE: To conduct an analysis of the concept of imagery as understood among the health science professions. METHODS: An inductive, descriptive means of inquiry was used to clarify the concept of imagery. Data were analyzed by categories: surrogates, attributes, contextual information (antecedents; consequences), related terms, and references. FINDINGS: The prevailing surrogate term for mental imagery is visualization. Attributes of imagery include psychophysiological, mental, quasi-reality, dynamic, and process. References include therapeutic settings. CONCLUSIONS: This concept analysis has led to the following working definition: "Imagery, a mental function, is a lived experience that is a dynamic, quasi-real, psychophysiological process." The analysis was intended to identify consensus on the concept of imagery within the health professions, and provide a foundation for further research.
