PowerPoint Slides for: Effects of High Density Lipoprotein Raising Therapies on Cardiovascular Outcomes in Patients with Type 2 Diabetes Mellitus, with or without Renal Impairment: The Action to Control Cardiovascular Risk in Diabetes Study

<p><b><i>Background:</i></b> The role of high density lipoprotein-raising interventions in addition to statin therapy in patients with diabetes remains controversial. Chronic kidney disease (CKD) is a strong modifier of cardiovascular (CV) outcomes. We therefore investigated the impact of CKD status at baseline on outcomes in patients with diabetes randomized to standard statin or statin plus fenofibrate treatment in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) lipid trial. <b><i>Methods:</i></b> Among 5,464 participants in the ACCORD lipid trial, 3,554 (65%) were free of CKD at baseline, while 1,910 (35%) had mild to moderate CKD. Differences in CV outcomes during follow-up between CKD and non-CKD subgroups were examined. In addition, the effect of fenofibrate as compared to placebo on CV outcomes was examined for both subgroups. <b><i>Results:</i></b> All CV outcomes were 1.4-3 times higher among patients with CKD as compared to non-CKD patients. In patients with CKD, the addition of fenofibrate had no effect on any of the primary or secondary outcomes. In patients without CKD, however, the addition of fenofibrate was associated with a significant 36% reduction of CV mortality (hazards ratio [HR] 0.64; 95% CI 0.42-0.97; <i>p</i> value for treatment interaction <0.05) and 44% lower rate of fatal or non-fatal congestive heart failure (CHF; HR 0.56; 95% CI 0.37-0.84; <i>p</i> value treatment interaction <0.03). <b><i>Conclusions:</i></b> For patients with type 2 diabetes at high CV risk but no CKD, fenofibrate therapy added to statin reduced the CV mortality and the rate of fatal and non-fatal CHF.</p

The Development and Evaluation of an Interactive System for Age Related Musculoskeletal Rehabilitation in the Home

Abstract. This paper describes a series of user studies carried out to investigate the usability, significance, and acceptance of two visualization tools designed to improve the quality of, and adherence to home-based exercise programmes for musculoskeletal rehabilitation. The core functionality of these visualization tools enabled the users to observe the optimal way to perform their exercises via a mannequin, and receive feedback on their own movements through the use of body worn sensors. Before full deployment in the home, two user studies were carried out in the laboratory, and then two in the home with seniors who had recently undergone musculoskeletal rehabilitation using a standard care paper based booklet in the home. Our key findings suggest that by using the visualization tools the participants were able to overcome the major limitations of standard care; and that these tools were considered by the users to be useful in encouraging participation in home exercise