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The study demonstrated that a psychoeducational multiple-family group intervention was more effective than standard care in managing negative symptoms over a 12-month period. The results are particularly relevant because negative symptoms are associated with relapse, poor social and occupational functioning, cognitive impairment, and lower subjective quality of life.

Diabetes education programs can have long term benefits on knowledge, psychosocial functioning, and glycemic control for older diabetic patients. The addition of support groups enhances diabetes knowledge and psychosocial functioning.

Improvements in diabetes knowledge, psychosocial functioning, and metabolic control were assessed following a six-week diabetes education program for older male patients (aged 65 to 82 years) and their spouses. Before and after the program, scored questionnaires were administered to patients and their wives regarding knowledge, quality of life, stress, family involvement in diabetes care, and patient involvement in social activities. The patients were again assessed six months later. Results were compared to those of younger adult male patients (aged 28 to 64 years). The older patients significantly increased their knowledge of diabetes (P less than .05), and to an extent equal to that of younger individuals. Reduction in stress correlated with their increase in knowledge (r = 0.9; P less than .05) and their improved diet-related quality of life (r = 0.7; P less than .02). A decrease in stress was still evident six months after the program P less than .01). Perceived quality of life for areas requiring greater life-style modification (diet and exercise) increased (P less than .01), and was maintained at six months. In contrast, younger patients reported decreases in perceived quality of life (P less than .05). Older patients with participating spouses, compared to those without, showed greater improvement in knowledge (P less than .02), increase in family involvement (P less than .05), less stress (P less than .02), and improvement in metabolic control of diabetes (P less than .001). The program increased spouses' knowledge and perceived involvement in the care of their diabetic partners (P less than .01). This study suggests that diabetes education is an effective intervention for elderly patients and their spouses.(ABSTRACT TRUNCATED AT 250 WORDS)

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Research priorities to reduce Appalachian health disparities should focus on reducing disparities in the coalfields. The human cost of the Appalachian coal mining economy outweighs its economic benefits.

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Aims/hypothesis Obesity is a risk factor for type 2 diabetes, yet little is known about how timing and cumulative exposure of obesity are related to disease risk. The aim of this study was to examine the associations between BMI trajectories, age of onset of obesity and obese-years (a product of degree and duration of obesity) over early adulthood and subsequent risk of type 2 diabetes. Methods Women aged 18-23 years at baseline (n = 11,192) enrolled in the Australian Longitudinal Study on Women's Health (ALSWH) in 1996 were followed up about every 3 years via surveys for up to 19 years. Self-reported weights were collected up to seven times. Incident type 2 diabetes was self-reported. A growth mixture model was used to identify distinct BMI trajectories over the early adult life course. Cox proportional hazards regression models were used to examine the associations between trajectories and risk of diabetes. Results One hundred and sixty-two (1.5%) women were newly diagnosed with type 2 diabetes during a mean of 16 years of follow-up. Six distinct BMI trajectories were identified, varying by different initial BMI and different slopes of increase. Initial BMI was positively associated with risk of diabetes. We also observed that age at onset of obesity was negatively associated with risk of diabetes (HR 0.87 [95% CI 0.79, 0.96] per 1 year increment), and number of obese-years was positively associated with diabetes (p for trend <0.0001). Conclusions/interpretation Our data revealed the importance of timing of obesity, and cumulative exposure to obesity in the development of type 2 diabetes in young women, suggesting that preventing or delaying the onset of obesity and reducing cumulative exposure to obesity may substantially lower the risk of developing diabetes.