ABSTRACT
BACKGROUND: With one in five individuals aged 65 or older living with type 2 diabetes worldwide, it is crucial to acknowledge and address the challenges faced by this population. In this context, our study aims to evaluate the efficacy of a behavioral intervention model delivered through a smart speaker on mental health and diabetes self-care in the elderly with diabetes. METHODS: This is a single-center, pragmatic, parallel two-arm open randomized clinical trial involving elderly patients with type 2 diabetes. We plan to enroll a total of 112 individuals who will be randomized 1:1 to receive the Smart Speaker EchoDot 3rd Gen device (Amazon Echo®) for home use (intervention arm) or to maintain usual care (control arm). The primary outcome is mental distress, assessed using the 20-item Self Reporting Questionnaire (SRQ-20) after a 12-week intervention period. Secondary outcomes include quality of life, adherence to diabetes self-care behaviors, perception of stress, glycemic control, blood pressure, and lipid profile. Analysis of covariance (ANCOVA) will be used to evaluate the effects of the intervention on the outcomes. DISCUSSION: This study assesses the effectiveness of an interactive virtual assistance system for enhancing mental health and glycemic control among elderly individuals with type 2 diabetes. The findings may introduce smart speakers as a valuable tool for promoting diabetes-related self-care in this population. TRIAL REGISTRATION: ClinicalTrials.gov NCT05329376. Registered on 15 April 2022. Enrollment began on 20 June 2023 and the last update of protocol was on 13 December 2023.
Subject(s)
Diabetes Mellitus, Type 2 , Mental Disorders , Aged , Humans , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/therapy , Diabetes Mellitus, Type 2/psychology , Quality of Life , Self Care , Health Promotion , Randomized Controlled Trials as TopicABSTRACT
Objetivos: Revisar as evidências atuais sobre diagnóstico e manejo da dissecção aórtica aguda. Métodos: Revisão da literatura por meio de consulta a artigos científicos e diretrizes selecionados nos bancos de dados Medline e PubMed, em junho de 2017, sendo excluídos os estudos publicados antes de 2012. Resultados: O sintoma mais característico é a dor torácica ou dorsal súbita, intensa e migratória. O diagnóstico é feito com exames de imagem como a tomografia computadorizada e a ecocardiografia transesofágica. O tratamento inicial baseia-se na analgesia e no controle da pressão arterial e da frequência cardíaca. O manejo da dissecão aórtica tipo A é cirúrgico ao passo que no tipo B é clínico, salvo na ocorrência de complicações. Conclusões: A dissecção aórtica aguda apresenta alta mortalidade, sendo necessária alta suspeição e diagnóstico precoce. A classificação da dissecção aórtica e as suas manifestações direcionam o tratamento.
Aims: To review the current evidence on diagnosis and management of acute aortic dissection. Methods: Literature review through consultation of articles and guidelines selected in the Medline and PubMed databases, in June 2017, excluding studies published before 2012. Results: The most characteristic symptom is sudden, severe, migratory thoracic or dorsal pain. The diagnosis is made through imaging tests such as computed tomography and transesophageal echocardiography. Initial treatment is based on analgesia and control of blood pressure and heart rate. The management of type A aortic dissection is surgical whereas in type B it is clinical, except in the occurrence of complications. Conclusions: Acute aortic dissection presents high mortality, requiring high suspicion and early diagnosis. The classification of aortic dissection and its manifestations direct the treatment.
