Enhancing the effectiveness of diabetes self-management education: the diabetes literacy project.

Patient empowerment through self-management education is central to improving the quality of diabetes care and preventing Type 2 Diabetes. Although national programs exist, there is no EU-wide strategy for diabetes self-management education, and patients with limited literacy face barriers to effective self-management. The Diabetes Literacy project, initiated with the support of the European Commission, aims to fill this gap. The project investigates the effectiveness of diabetes self-management education, targeting people with or at risk of Type 2 Diabetes in the 28 EU Member States, as part of a comprehensive EU-wide diabetes strategy. National diabetes strategies in the EU, US, Taiwan, and Israel are compared, and diabetes self-management programs inventorized. The costs of the diabetes care pathway are assessed on a per person basis at national level. A comparison is made of the (cost)-effectiveness of different methods for diabetes self-management support, and the moderating role of health literacy, organization of the health services, and implementation fidelity of education programs are considered. Web-based materials are developed and evaluated by randomized trials to evaluate if interactive internet delivery can enhance self-management support for people with lower levels of health literacy. The 3-year project started in December 2012. Several literature reviews have been produced and protocol development and research design are in the final stages. Primary and secondary data collection and analysis take place in 2014. The results will inform policy decisions on improving the prevention, treatment, and care for persons with diabetes across literacy levels.

Experiences from longitudinal studies of aging: An international perspective.

A review of current longitudinal studies of aging was undertaken to obtain background information for the initiation of new studies. Through interviews with investigators information was obtained on the aspects of population and sampling, topic selection, data collection, data quality, and collaboration. All investigators emphasized the importance of broad, multidisciplinary data collection to meet future research interests. Differences between studies are mainly related to organization, sampling design, and monitoring of data quality.

[Comments on policy--elderly count for much, or counting the elderly? A new statement on policy for the elderly]. / Commentaar bij beleid--ouderen in tel, of ouderen geteld? Een nieuwe nota ouderenbeleid.

The Dutch government has published a new white paper 'Elderly count for much' on policy for the aged. In this document the central principle for social policy is the integration of the elderly in society. Old age policy is characterized as 'integral policy' that is it tries to integrate the traditional fields of social and economic policy, and as 'complementary' policy, that is it tries to complement general policy. The main characteristics of the action program 1990-1994 include: prevention, the integration of housing and services, care for elderly with chronic diseases, education, strengthening of labor-market participation of 50+, the position of elderly women and societal attitudes towards aging and the elderly. In this comment it is argued that this white paper initiates positive developments, but there remain several minor and major problems. We are critical about the role of education, the instruments for an active labor-market policy, the lack of attention for the European dimension, and about the lack of attention for future developments in generational equity and age-rationing of service allocation. We appreciate the attention for age discrimination, and possibilities for longitudinal research. We conclude that 'integrated policy' is only in its initial phase. In this white paper the government is only successful in an integrated policy in the fields of housing and care, not in other fields like technology, labor and education. 'Complementary' policy is not enough to create a firm infrastructure in the aging field. If initiatives in the field of aging are considered as 'extra's' this policy will soon be confronted with the boundaries it creates itself. Although attention for the challenges of graying is growing, old age policy is still marginal compared to the main general policy.

[Gerontologic research in the Netherlands in 1985. Basic data on the main issues of aging and senescence]. / Gerontologisch onderzoek in Nederland in 1985. Kerngegevens over de inzet in onderzoek naar ouder worden en ouderdom.

An inventory of the current gerontological research in the Netherlands has been made by the Steering Committee for Research on Aging (SOOM). The results are compared with data of 1977. In terms of effort in man-years (MY) the research has almost tripled. The investment in current research was 192 MY versus 71 in 1977. In biomedical research 49 MY were spent vs. 23 in 1977; in medical 60 vs. 19 in 1977; in social medical 8 (this category was not used in 1977); and in behavioral and social research 37 and in applied social 38 vs. 29 for all social gerontological research in 1977. 50% of all research is conducted by projects, 44% by projects within a program and 5% in programs, in which however a quarter of the total MY is spent. Applied social research is mainly project-bound (66%), biology only for 28%. The average duration of the research varies from 4.5 years (biology) to 1.5 years (applied social research). Almost 60% of the current research is carried out within universities. 5 of them invest more than 5 MY in gerontological research. The institute with the greatest effort in MY is a non-university institute (the Institute of Experimental Gerontology TNO, Rijswijk, with two extensive programs). In 70% of the university research the university contributes more or less financially. In (medical)biological gerontology the central and peripheral nervous system is the most frequently studied subject (especially dementia). In medical gerontology dementia is the main subject; and in social gerontology home care and extra- and intramural care.(ABSTRACT TRUNCATED AT 250 WORDS)

[Life course and institutionalization: the deceptive effect of the percentage]. / Levensloop en instituutsopname: de versluierende werking van het percentage.

At one moment in time the percentage of elderly people living in an old people's home (bejaardenoord) or nursing-home (verpleeghuis) is much higher in the Netherlands than in comparable western countries. About 11% of people 65 years of age and more are living in such institutions. However, in discussions about institutionalization, people are making the same fallacious statements based on the percentage at one moment in time as indicated in literature as "% fallacy" (Kastenbaum & Candy, 1973). In this article we have calculated that about 35% of all elderly people in the Netherlands will be institutionalized before before death. Although at one moment in time about 2% of the elderly are living in a Dutch nursing-home, the incidence is as high as in the old people's home. That is why almost the same number of elderly people will be institutionalized before death in both institutions. Three examples are given of the fallacious use of the percentage at one moment in time. An attempt is made to calculate the chance which persons have, at different ages, to be institutionalized in later life. We use the incidence-rate in 1977 and 1978 and the life expectancy inthe period 1970-1975. The results indicate high chances for elderly people at different ages to be institutionalized in later life in an old people's home.

[Research policy in gerontology: "Advice on programs and tools in gerontological research"]. / Onderzoeksbeleid in de gerontologie: het 'Advies inzake programma en instrumentarium voor gerontologisch onderzoek'.

The 'Planninggroup for Gerontological research' published in february 1981 the 'Research plan in gerontology in the Netherlands'. In this article attention is given to some characteristics of science policy in the Netherlands during the last few years. Some features of the history and methods of working of the Planninggroup are pointed out. Next the main recommendations of the research-plan are stated: The premises on which the programming is based; the considerations to obtain a balance in attention paid to several research-fields; criteria for priority-setting (both scientific and social relevance criteria). Based on symptoms and problems in processes of aging twelve research-fields are chosen. Within these fields principal topics are further developed. The premises and criteria result into the selection of 22 priority research-projects. Recommendations are made for execution of the research-plan. It is suggested to establish a so called 'Gerontology Research Commission'. The task is to coordinate execution of the program within a 5-year period. Ways to execute the research-plan are given. A significant governmental investment in research on aging (100 research-positions in the 5 year period) is needed. In the discussion some consideration is given to the investment in manpower in gerontological research in the Netherlands and the costs of making the research-plan. The relation of the plan with the existing research-situation is stressed.