Angela Li, Amir-Ali Golrokhian-Sani, Maya Morcos, Marc Morcos
Objectives
A physician's work environment varies greatly depending on their medical specialty. As such, it may dictate their stress levels, work-life balance, satisfaction, and, ultimately, expected age of death. This paper aims to determine trends in Canadian physician deaths and determine the median age of death for different specialties.
Methods
We examined physician obituaries from the Canadian Medical Association Journal (CMAJ) published between 2000 and 2023, extracting age at death and medical specialty.
Results
The median age of death for doctors had a steady incline between 1999 and 2023 with a median age of 80 years. Careers in psychiatry (p = 0.020, 95% confidence interval [CI] [1.00, 4.00]) and emergency medicine (p = 0.025, 95% CI [7.00, 26.00]) were associated with decreased average ages of death, while careers in surgery (p < 0.001, 95% CI [−4.00, −2.00]), internal medicine (p = 0.038, 95% CI [−3.00, −1.00]), and public health (p = 0.016. 95% CI [−9.00, −2.00]) correlated with older ages of death. Of the statistically significant specialties, emergency medicine physicians had the lowest median age at death (59 years) while surgery and public health had the highest (81.5 and 83.5, respectively).
Conclusion
Our findings indicate that the median age of death differs across different medical specialties. Moving forward, the CMAJ should report physician obituaries consistently in a standardized format as it holds the most extensive obituary dataset despite missing significant data between 2008 and 2022.
目标 医生的工作环境因其所从事的医疗专业而有很大不同。因此，这可能会决定他们的压力水平、工作与生活的平衡、满意度以及最终的预期死亡年龄。本文旨在确定加拿大医生的死亡趋势，并确定不同专业的中位死亡年龄。 方法 我们研究了《加拿大医学会杂志》（Canadian Medical Association Journal，CMAJ）在 2000 年至 2023 年间发表的医生讣告，提取了死亡年龄和医学专业。 结果 1999年至2023年间，医生死亡年龄的中位数呈稳定上升趋势，中位数年龄为80岁。精神病学（p = 0.020，95% 置信区间 [CI] [1.00, 4.00]）和急诊医学（p = 0.025，95% CI [7.00, 26.00]）职业与平均死亡年龄下降有关，而外科（p < 0.001，95% CI [-4.00，-2.00]）、内科（p = 0.038，95% CI [-3.00，-1.00]）和公共卫生（p = 0.016. 95% CI [-9.00，-2.00]）与较高的死亡年龄相关。在有统计学意义的专科中，急诊科医生的死亡年龄中位数最低（59 岁），而外科和公共卫生科的死亡年龄中位数最高（分别为 81.5 岁和 83.5 岁）。 结论 我们的研究结果表明，不同医学专业的中位死亡年龄是不同的。展望未来，《中国医学杂志》应该以标准化的格式持续报道医生讣告，因为它拥有最广泛的讣告数据集，尽管在 2008 年至 2022 年期间缺失了大量数据。
{"title":"Analysis of Canadian Physician Obituaries Between 2000 and 2023 to Investigate Trends in Death Between Specialties: A Retrospective Cross-Sectional Study","authors":"Angela Li, Amir-Ali Golrokhian-Sani, Maya Morcos, Marc Morcos","doi":"10.1002/lim2.114","DOIUrl":"https://doi.org/10.1002/lim2.114","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>A physician's work environment varies greatly depending on their medical specialty. As such, it may dictate their stress levels, work-life balance, satisfaction, and, ultimately, expected age of death. This paper aims to determine trends in Canadian physician deaths and determine the median age of death for different specialties.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We examined physician obituaries from the <i>Canadian Medical Association Journal</i> (<i>CMAJ</i>) published between 2000 and 2023, extracting age at death and medical specialty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median age of death for doctors had a steady incline between 1999 and 2023 with a median age of 80 years. Careers in psychiatry (<i>p</i> = 0.020, 95% confidence interval [CI] [1.00, 4.00]) and emergency medicine (<i>p</i> = 0.025, 95% CI [7.00, 26.00]) were associated with decreased average ages of death, while careers in surgery (<i>p</i> < 0.001, 95% CI [−4.00, −2.00]), internal medicine (<i>p</i> = 0.038, 95% CI [−3.00, −1.00]), and public health (<i>p</i> = 0.016. 95% CI [−9.00, −2.00]) correlated with older ages of death. Of the statistically significant specialties, emergency medicine physicians had the lowest median age at death (59 years) while surgery and public health had the highest (81.5 and 83.5, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings indicate that the median age of death differs across different medical specialties. Moving forward, the <i>CMAJ</i> should report physician obituaries consistently in a standardized format as it holds the most extensive obituary dataset despite missing significant data between 2008 and 2022.</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142007212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Labros S Sidossis, Rob Lawson, Emmanuel Aprilakis, Bernardo C. Barata, Alicja Baska, Anastasia Beneka, Robert Bird, Fraser Birrell, Charistoula Chatzinikola, Maria Chondronikola, George P Chrousos, Russell Conduit, Constantina Constantinou, Barbora de Courten, Jelena Helene Cvejic, Andrew M Davis, Christiana A. Demetriou, Linda Errington, Jack Feehan, Catalina Figueroa, Mary M. Flynn, Beth Frates, Robel Hussen Kabthymer, Leonidas G Karagounis, Leila Karimi, Gerard A. Kennedy, Ourania Kolokotroni, Darinka Korovljev, Antigone Kouris-Blazos, Mehdi Kushkestani, Tassos C. Kyriakides, Emanuela Mercore Hutanu, Maria Cecilia Mosquera, Elena Nikiphorou, Nicola O'Brien, Elena Philippou, Karolina Piątek, Simon Poole, Dana Popescu-Spineni, Sue Radd-Vagenas, Amalia Sidossis, Magdalena Simonis, Helen Soultanakis, Aleksandra Telinga, Audrey Tierney, Anna Tkacz, Dimitris Vlachopoulos, Gulnur Yaman-Dent, Yang Yap, Zoe Zervides, Catherine Itsiopoulos
Introduction
The term “Mediterranean lifestyle” has gained increasing prominence in recent years, yet a specific definition remains elusive. In response, the Mediterranean Lifestyle Medicine Institute Board of Directors convened a multidisciplinary panel comprising international experts and leaders in lifestyle medicine. Their goal was to review existing literature and formulate a consensus definition of the “traditional Mediterranean lifestyle (tMedL),” referring to the historical way of living of the people in the Mediterranean region. This paper presents the agreed consensus statement and a comprehensive holistic definition of the term “traditional Mediterranean lifestyle.”
Methods
Major medical and social sciences electronic databases from inception to February 2023 were searched, employing keywords relevant to the Mediterranean lifestyle and its constituent elements (diet, physical activity, sleep, stress, socialization). Subsequently, definitions for each pillar were created and synthesized to derive a comprehensive definition of the “traditional Mediterranean lifestyle.”
Results
This proposed definition received ratification from the Mediterranean Lifestyle Medicine Institute's expert working group during the First International Mediterranean Lifestyle Medicine Conference held in June 2023 on the island of Leros, Greece. “The traditional Mediterranean lifestyle is characterized by its diverse and adaptable nature. Key facets encompass conviviality, lifelong social connectedness, purposeful living, strong community and familial bonds, harmony with nature and the environment, profound spirituality, adherence to religious practices, preservation of local customs, resilience cultivated through adversity, and a commitment to moderation across all spheres of life.”
Conclusions
This definition comprehensively outlines the primary lifestyle factors ingrained in Mediterranean inhabitants across generations. Its holistic nature furnishes a crucial conceptual framework for directing lifestyle medicine practitioners in assisting patients to mitigate diseases, promote overall well-being, devise research initiatives to investigate the health ramifications of this lifestyle, and inform curriculum development.
{"title":"Defining the Traditional Mediterranean Lifestyle: Joint International Consensus Statement","authors":"Labros S Sidossis, Rob Lawson, Emmanuel Aprilakis, Bernardo C. Barata, Alicja Baska, Anastasia Beneka, Robert Bird, Fraser Birrell, Charistoula Chatzinikola, Maria Chondronikola, George P Chrousos, Russell Conduit, Constantina Constantinou, Barbora de Courten, Jelena Helene Cvejic, Andrew M Davis, Christiana A. Demetriou, Linda Errington, Jack Feehan, Catalina Figueroa, Mary M. Flynn, Beth Frates, Robel Hussen Kabthymer, Leonidas G Karagounis, Leila Karimi, Gerard A. Kennedy, Ourania Kolokotroni, Darinka Korovljev, Antigone Kouris-Blazos, Mehdi Kushkestani, Tassos C. Kyriakides, Emanuela Mercore Hutanu, Maria Cecilia Mosquera, Elena Nikiphorou, Nicola O'Brien, Elena Philippou, Karolina Piątek, Simon Poole, Dana Popescu-Spineni, Sue Radd-Vagenas, Amalia Sidossis, Magdalena Simonis, Helen Soultanakis, Aleksandra Telinga, Audrey Tierney, Anna Tkacz, Dimitris Vlachopoulos, Gulnur Yaman-Dent, Yang Yap, Zoe Zervides, Catherine Itsiopoulos","doi":"10.1002/lim2.115","DOIUrl":"https://doi.org/10.1002/lim2.115","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The term “Mediterranean lifestyle” has gained increasing prominence in recent years, yet a specific definition remains elusive. In response, the Mediterranean Lifestyle Medicine Institute Board of Directors convened a multidisciplinary panel comprising international experts and leaders in lifestyle medicine. Their goal was to review existing literature and formulate a consensus definition of the “traditional Mediterranean lifestyle (tMedL),” referring to the historical way of living of the people in the Mediterranean region. This paper presents the agreed consensus statement and a comprehensive holistic definition of the term “traditional Mediterranean lifestyle.”</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Major medical and social sciences electronic databases from inception to February 2023 were searched, employing keywords relevant to the Mediterranean lifestyle and its constituent elements (diet, physical activity, sleep, stress, socialization). Subsequently, definitions for each pillar were created and synthesized to derive a comprehensive definition of the “traditional Mediterranean lifestyle.”</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This proposed definition received ratification from the Mediterranean Lifestyle Medicine Institute's expert working group during the First International Mediterranean Lifestyle Medicine Conference held in June 2023 on the island of Leros, Greece. “The traditional Mediterranean lifestyle is characterized by its diverse and adaptable nature. Key facets encompass conviviality, lifelong social connectedness, purposeful living, strong community and familial bonds, harmony with nature and the environment, profound spirituality, adherence to religious practices, preservation of local customs, resilience cultivated through adversity, and a commitment to moderation across all spheres of life.”</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This definition comprehensively outlines the primary lifestyle factors ingrained in Mediterranean inhabitants across generations. Its holistic nature furnishes a crucial conceptual framework for directing lifestyle medicine practitioners in assisting patients to mitigate diseases, promote overall well-being, devise research initiatives to investigate the health ramifications of this lifestyle, and inform curriculum development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141994183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmed H. Mujamammi, Essa M. Sabi, Faisal M. Alsaawi, Naif A. Alfahed, Omar A. Alrajhi, Hamad A. Alshaalan, Mohamed F. Alqahtani, Mohammed A. Alamer
Aims
Lack of obstructive sleep apnea (OSA) awareness both directly and indirectly causes a medical and financial burden worldwide. The objective of this study is to provide new insights, focusing on type 2 diabetics and their knowledge levels about OSA in King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia, and to recognize obesity as a common risk factor contributing to OSA in type 2 diabetes mellitus (T2DM) participants.
Methods
An analytical cross-sectional study was conducted from July 2022 to December 2022 with a convenience sampling method of 386 participants (18 years old and above). The study was done face-to-face using an electronic questionnaire. The inclusion criterion was all T2DM patients at the waiting area of KKUH Diabetes Center in Riyadh, excluding participants with other metabolic disorders.
Results
Overall knowledge levels were poor, with 70.2% of participants not knowledgeable about the disease and 81.3% of participants having no knowledge concerning the bidirectional relationship between T2DM and OSA. Statistical significance was found between the risk of developing OSA symptoms and body mass index ≥30 (p ≤ 0.001).
Conclusion
The majority have very little to no knowledge regarding OSA and its bidirectional relationship with T2DM, indicating the need to put more effort into improving participant's awareness in this regard. Moreover, obesity should be considered as a common risk factor, recommending patients to practice healthier habits to minimize the risks and decrease mortality.
目的 缺乏对阻塞性睡眠呼吸暂停（OSA）的认识直接或间接地给全世界造成了医疗和经济负担。本研究旨在提供新的见解，重点关注沙特阿拉伯利雅得哈立德国王大学医院（KKUH）的 2 型糖尿病患者及其对 OSA 的认知水平，并认识到肥胖是导致 2 型糖尿病（T2DM）患者发生 OSA 的常见风险因素。 方法 一项分析性横断面研究于 2022 年 7 月至 2022 年 12 月进行，采用方便抽样法，共抽取了 386 名参与者（18 岁及以上）。研究使用电子问卷进行面对面调查。纳入标准为利雅得 KKUH 糖尿病中心候诊区的所有 T2DM 患者，不包括患有其他代谢疾病的参与者。 结果 总体知识水平较低，70.2%的参与者不了解该疾病，81.3%的参与者不了解 T2DM 与 OSA 之间的双向关系。出现 OSA 症状的风险与体重指数≥30 之间存在统计学意义（P ≤ 0.001）。 结论 大多数人对 OSA 及其与 T2DM 的双向关系知之甚少甚至一无所知，这表明有必要加大力度提高参与者在这方面的认识。此外，肥胖也应被视为一种常见的风险因素，建议患者养成更健康的生活习惯，以最大限度地降低风险和死亡率。
{"title":"Type 2 Diabetic Patients and Their Awareness About Obstructive Sleep Apnea in Diabetic Centers of Riyadh City","authors":"Ahmed H. Mujamammi, Essa M. Sabi, Faisal M. Alsaawi, Naif A. Alfahed, Omar A. Alrajhi, Hamad A. Alshaalan, Mohamed F. Alqahtani, Mohammed A. Alamer","doi":"10.1002/lim2.116","DOIUrl":"https://doi.org/10.1002/lim2.116","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Lack of obstructive sleep apnea (OSA) awareness both directly and indirectly causes a medical and financial burden worldwide. The objective of this study is to provide new insights, focusing on type 2 diabetics and their knowledge levels about OSA in King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia, and to recognize obesity as a common risk factor contributing to OSA in type 2 diabetes mellitus (T2DM) participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An analytical cross-sectional study was conducted from July 2022 to December 2022 with a convenience sampling method of 386 participants (18 years old and above). The study was done face-to-face using an electronic questionnaire. The inclusion criterion was all T2DM patients at the waiting area of KKUH Diabetes Center in Riyadh, excluding participants with other metabolic disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall knowledge levels were poor, with 70.2% of participants not knowledgeable about the disease and 81.3% of participants having no knowledge concerning the bidirectional relationship between T2DM and OSA. Statistical significance was found between the risk of developing OSA symptoms and body mass index ≥30 (<i>p</i> ≤ 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The majority have very little to no knowledge regarding OSA and its bidirectional relationship with T2DM, indicating the need to put more effort into improving participant's awareness in this regard. Moreover, obesity should be considered as a common risk factor, recommending patients to practice healthier habits to minimize the risks and decrease mortality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141980290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cigarette smoking is the leading cause of preventable death in the United States. Although smoking rates have been declining, it is unclear how the COVID-19 pandemic impacted smoking behaviors.
Methods
With population-based data from the Behavioral Risk Factor Surveillance System (2010–2023), we will analyze four outcomes: (1) currently smoking, (2) started smoking in the past year, (3) number of cigarettes per day, and (4) quit smoking in the past year. By estimating a two-way fixed effect regression model to account for state-level factors and temporal trends, this study identifies the effect of exposure to the COVID-19 pandemic by comparing the change over time in an unexposed group (interviewed January 1–March 20, 2020) to the change over time in the exposed group (interviewed January 1–March 31, 2021–2023). This stage 1-registered report conducts a Power and pilot analysis with an exploratory outcome: being uninsured.
Pilot Results
Our power analysis calculates a minimum detectable effect size = 0.7%. The pilot analysis indicates that exposure to the COVID-19 pandemic was associated with a statistically significant decline in the probability of being uninsured (Est. = −2.2%; CI = −3.5, −1.1). There is little evidence that the early and late survey wave cohorts differed before the pandemic.
Implications
This registered report outlines a study aimed at investigating the direct impact of the COVID-19 pandemic on smoking behaviors related to prevalence, initiation, intensity, and cessation. The findings will provide valuable insights into the effects of public health crises on health-related behaviors and inform future public health interventions. The preregistration of the study design and analysis plan ensures transparency, trust, and replicability of the results. Quantifying whether and how smoking behaviors changed, and in whom, can inform ongoing tobacco control efforts to continue the downward trend in cigarette smoking.
{"title":"How Did the COVID-19 Pandemic Change Cigarette Smoking Behavior?","authors":"Jason Semprini","doi":"10.1002/lim2.117","DOIUrl":"https://doi.org/10.1002/lim2.117","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cigarette smoking is the leading cause of preventable death in the United States. Although smoking rates have been declining, it is unclear how the COVID-19 pandemic impacted smoking behaviors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>With population-based data from the Behavioral Risk Factor Surveillance System (2010–2023), we will analyze four outcomes: (1) currently smoking, (2) started smoking in the past year, (3) number of cigarettes per day, and (4) quit smoking in the past year. By estimating a two-way fixed effect regression model to account for state-level factors and temporal trends, this study identifies the effect of exposure to the COVID-19 pandemic by comparing the change over time in an unexposed group (interviewed January 1–March 20, 2020) to the change over time in the exposed group (interviewed January 1–March 31, 2021–2023). This stage 1-registered report conducts a Power and pilot analysis with an exploratory outcome: being uninsured.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Pilot Results</h3>\u0000 \u0000 <p>Our power analysis calculates a minimum detectable effect size = 0.7%. The pilot analysis indicates that exposure to the COVID-19 pandemic was associated with a statistically significant decline in the probability of being uninsured (Est. = −2.2%; CI = −3.5, −1.1). There is little evidence that the early and late survey wave cohorts differed before the pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>This registered report outlines a study aimed at investigating the direct impact of the COVID-19 pandemic on smoking behaviors related to prevalence, initiation, intensity, and cessation. The findings will provide valuable insights into the effects of public health crises on health-related behaviors and inform future public health interventions. The preregistration of the study design and analysis plan ensures transparency, trust, and replicability of the results. Quantifying whether and how smoking behaviors changed, and in whom, can inform ongoing tobacco control efforts to continue the downward trend in cigarette smoking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Preregistration</h3>\u0000 \u0000 <p>https://osf.io/vq8m4</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141967593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jimi Osinaike, Anna Myers, Anna Lowe, Robert J Copeland, Sarah J Hardcastle
Primary Aim
To describe the features of implementation in the setting of primary care (PC) for physical activity (PA) interventions that improved total and moderate to vigorous PA (MVPA).
Secondary Aim
To assess the scalability potential of effective PC PA interventions.
Method
A comprehensive search was conducted across multiple electronic databases to identify relevant studies published between 2012 and 2023. Implementation-related features were extracted, and the scalability potential of effective PC PA interventions was assessed using the Intervention Scalability Tool (ISAT) as a framework.
Results
Twenty-six studies met the inclusion criteria after screening. Analysis of the implementation-related features revealed that effective PC PA interventions showed promising reach with a mean participation rate of 43%. Effective PC PA interventions that increased PA were mostly delivered by nurses and were underpinned by the behavioural change techniques (BCTs) of goal setting, feedback and self-monitoring. The scalability assessment revealed that remote-based interventions and those delivered by nurses had moderate to high scores in the scalability domains of fidelity, reach and acceptability, delivery setting and workforce, implementation infrastructure and sustainability.
Conclusion
PC PA interventions, whether delivered remotely or face-to-face, show promise for increasing PA, especially when incorporating BCTs like goal setting and feedback. Using the ISAT, most interventions displayed promise for implementation at scale, but further examination is needed concerning the delivery setting, implementation infrastructure and sustainability of these interventions. Remote-based (automated PA advice and mailed instructions) PA interventions and those delivered in contact with a nurse showed high scalability potential. Further work that examines the acceptability and effectiveness of other healthcare professionals in intervention delivery would be worthwhile, and more work is needed to assess the utility and effectiveness of remote-based PA interventions in PC.
主要目的 描述在初级保健（PC）环境中实施体力活动（PA）干预的特点，以改善总的和中度到剧烈的体力活动（MVPA）。 次要目的 评估有效的初级保健体育锻炼干预措施的可扩展性。 方法 在多个电子数据库中进行全面检索，以确定 2012 年至 2023 年间发表的相关研究。提取与实施相关的特征，并以干预措施可扩展性工具 (ISAT) 为框架，评估有效 PC PA 干预措施的可扩展性潜力。 结果 经过筛选，26 项研究符合纳入标准。对实施相关特征的分析表明，有效的 PC PA 干预措施显示出良好的覆盖率，平均参与率为 43%。有效的 PC PA 干预措施大多由护士实施，并以目标设定、反馈和自我监控等行为改变技术 (BCT) 为基础，从而增加了 PA。可扩展性评估显示，远程干预和由护士实施的干预在保真度、覆盖面和可接受性、实施环境和劳动力、实施基础设施和可持续性等可扩展性领域的得分处于中上水平。 结论 PC PA 干预措施，无论是远程提供还是面对面提供，都显示出增加 PA 的前景，尤其是在纳入目标设定和反馈等 BCT 时。通过使用 ISAT，大多数干预措施都显示出了大规模实施的前景，但还需要进一步研究这些干预措施的实施环境、实施基础设施和可持续性。基于远程（自动 PA 咨询和邮寄指导）的 PA 干预措施和与护士联系提供的干预措施显示出较高的可扩展性。值得进一步研究其他医疗保健专业人员在提供干预措施时的可接受性和有效性，还需要开展更多工作来评估基于远程的个人防护干预措施在个人防护中的实用性和有效性。
{"title":"Implementation and Scalability of Physical Activity Interventions Delivered Within Primary Care: A Narrative Review","authors":"Jimi Osinaike, Anna Myers, Anna Lowe, Robert J Copeland, Sarah J Hardcastle","doi":"10.1002/lim2.113","DOIUrl":"https://doi.org/10.1002/lim2.113","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Primary Aim</h3>\u0000 \u0000 <p>To describe the features of implementation in the setting of primary care (PC) for physical activity (PA) interventions that improved total and moderate to vigorous PA (MVPA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Secondary Aim</h3>\u0000 \u0000 <p>To assess the scalability potential of effective PC PA interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A comprehensive search was conducted across multiple electronic databases to identify relevant studies published between 2012 and 2023. Implementation-related features were extracted, and the scalability potential of effective PC PA interventions was assessed using the Intervention Scalability Tool (ISAT) as a framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-six studies met the inclusion criteria after screening. Analysis of the implementation-related features revealed that effective PC PA interventions showed promising reach with a mean participation rate of 43%. Effective PC PA interventions that increased PA were mostly delivered by nurses and were underpinned by the behavioural change techniques (BCTs) of goal setting, feedback and self-monitoring. The scalability assessment revealed that remote-based interventions and those delivered by nurses had moderate to high scores in the scalability domains of fidelity, reach and acceptability, delivery setting and workforce, implementation infrastructure and sustainability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PC PA interventions, whether delivered remotely or face-to-face, show promise for increasing PA, especially when incorporating BCTs like goal setting and feedback. Using the ISAT, most interventions displayed promise for implementation at scale, but further examination is needed concerning the delivery setting, implementation infrastructure and sustainability of these interventions. Remote-based (automated PA advice and mailed instructions) PA interventions and those delivered in contact with a nurse showed high scalability potential. Further work that examines the acceptability and effectiveness of other healthcare professionals in intervention delivery would be worthwhile, and more work is needed to assess the utility and effectiveness of remote-based PA interventions in PC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.113","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141966571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Meditation and related relaxation techniques are good means of alleviating stress and maintaining good health. Osho dynamic meditation decreases several psychopathological variables such as anxious-depressive syndrome, aggressive behaviors, and depression which is practiced in Nepal and all over the world. Various studies have shown alteration in different hormone levels due to meditation by strengthening adaptive mechanisms.
Aim
The aim of this study was to evaluate the effect of Osho meditation on serum hormonal levels in pre- and postmeditation participants.
Methods
A pre–post study was conducted among 70 healthy volunteers (42 male and 28 female) where various types of Osho dynamic meditation techniques were incorporated together to understand their combined effects on serum hormone levels in participants attending the 7 days meditation camp. Serum hormones such as cortisol, estrogen, progesterone, free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone (TSH), testosterone, and growth hormone were measured by chemiluminescence immunoassay.
Results
Out of 70 participants, 68 participants (97%) had subjective opinion of Osho dynamic meditation being effective in alleviating stress, depression, and anger. Also, there was a significant decline in body weight and body mass index in both male and female populations after a strict vegetarian diet and meditation. Likewise, a significant rise in the level of estrogen (p < 0.001), progesterone (p < 0.001), growth hormone (p < 0.001), testosterone (p = 0.002), and fT3 (p = 0.049) in postmeditation male participants indicates the importance of Osho dynamic meditation on elevating sex hormones such as estrogen, progesterone, testosterone as well as fT3, and growth hormones among Osho meditation practicing participants.
Conclusion
Our findings suggest significant changes in the hormonal levels and improvement in stress and depression in participants undergoing Osho meditation.
{"title":"Effect of Hormonal Changes Through 7 Days of Osho Dynamic Meditation Among Healthy Nepalese Participants","authors":"Vijay Kumar Sharma, Apeksha Niraula, Eans Tara Tuladhar, Raju Kumar Dubey, Aseem Bhattarai, Mithileshwer Raut, Nikita Kharal, Anuradha Kadel, Srijana Sapkota, Prakash Pokhrel, Namrata Sharma","doi":"10.1002/lim2.112","DOIUrl":"https://doi.org/10.1002/lim2.112","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>Meditation and related relaxation techniques are good means of alleviating stress and maintaining good health. Osho dynamic meditation decreases several psychopathological variables such as anxious-depressive syndrome, aggressive behaviors, and depression which is practiced in Nepal and all over the world. Various studies have shown alteration in different hormone levels due to meditation by strengthening adaptive mechanisms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this study was to evaluate the effect of Osho meditation on serum hormonal levels in pre- and postmeditation participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A pre–post study was conducted among 70 healthy volunteers (42 male and 28 female) where various types of Osho dynamic meditation techniques were incorporated together to understand their combined effects on serum hormone levels in participants attending the 7 days meditation camp. Serum hormones such as cortisol, estrogen, progesterone, free triiodothyronine (fT3), free thyroxine (fT4), thyroid-stimulating hormone (TSH), testosterone, and growth hormone were measured by chemiluminescence immunoassay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 70 participants, 68 participants (97%) had subjective opinion of Osho dynamic meditation being effective in alleviating stress, depression, and anger. Also, there was a significant decline in body weight and body mass index in both male and female populations after a strict vegetarian diet and meditation. Likewise, a significant rise in the level of estrogen (<i>p</i> < 0.001), progesterone (<i>p</i> < 0.001), growth hormone (<i>p</i> < 0.001), testosterone (<i>p</i> = 0.002), and fT3 (<i>p</i> = 0.049) in postmeditation male participants indicates the importance of Osho dynamic meditation on elevating sex hormones such as estrogen, progesterone, testosterone as well as fT3, and growth hormones among Osho meditation practicing participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings suggest significant changes in the hormonal levels and improvement in stress and depression in participants undergoing Osho meditation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.112","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141967531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lifestyle has become a major and well-recognized aspect of modern healthcare, but there is little awareness of the origins of lifestyle medicine.
Results
This paper shows that a major contribution to lifestyle medicine was made by Greco-Roman physicians. Ancient Greek and Roman doctors placed considerable emphasis on the role lifestyle played in determining the state of their patients’ health.
{"title":"The Greco-Roman Contribution to Lifestyle Medicine","authors":"Konstantine Panegyres","doi":"10.1002/lim2.111","DOIUrl":"https://doi.org/10.1002/lim2.111","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lifestyle has become a major and well-recognized aspect of modern healthcare, but there is little awareness of the origins of lifestyle medicine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This paper shows that a major contribution to lifestyle medicine was made by Greco-Roman physicians. Ancient Greek and Roman doctors placed considerable emphasis on the role lifestyle played in determining the state of their patients’ health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141967528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Callum J. Leese, Hussain Al-Zubaidi, Blair H. Smith
The escalating burden of lifestyle-related diseases stands as a critical global public health challenge, contributing substantially to the prevalence of chronic conditions and a large portion of premature mortality. Despite this, concise evidence-based lifestyle interventions targeting physical inactivity, nutrition, alcohol and smoking continue to be underutilised. Although good evidence exists for addressing the four lifestyle-related risk factors independently, rarely do these present in isolation. Evidence is lacking regarding how to integrate interventions targeting multiple risk factors. Consequently, this paper aims to provide an overview of the evidence for delivering multiple interventions in primary healthcare settings.
Different lifestyle factors are inter-related, with decisions around ordering of the delivery of multiple lifestyle interventions an important consideration. There is evidence supporting the effectiveness of addressing some lifestyle factors simultaneously (e.g., physical activity and nutrition), although smoking cessation may be delivered best in a sequential approach. While the World Health Organisation highlights four key lifestyle factors (nutrition, physical activity, alcohol and smoking), incorporating additional elements such as sleep, mental well-being and social connectedness offers a holistic framework for promoting well-being.
Despite the presentation of multiple behaviour risk factors being commonplace in healthcare settings, the evidence (outlined in the paper) for how best to deliver interventions to address this is limited, with further research and subsequent clinical guidance required.
In order to address the barriers to delivering lifestyle interventions in primary care, innovation will be required. The use of non-medical personnel, social prescribers and health coaches has the potential to alleviate time constraints, whilst mounting evidence exists for group consultations for addressing lifestyle-related non-communicable diseases (NCDs). If the challenges to implementation can be addressed, and if healthcare systems can adapt for the promotion of healthy lifestyles, the impact of NCDs can be mitigated.
{"title":"Delivery of Interventions for Multiple Lifestyle Factors in Primary Healthcare Settings: A Narrative Review Addressing Strategies for Effective Implementation","authors":"Callum J. Leese, Hussain Al-Zubaidi, Blair H. Smith","doi":"10.1002/lim2.110","DOIUrl":"https://doi.org/10.1002/lim2.110","url":null,"abstract":"<p>The escalating burden of lifestyle-related diseases stands as a critical global public health challenge, contributing substantially to the prevalence of chronic conditions and a large portion of premature mortality. Despite this, concise evidence-based lifestyle interventions targeting physical inactivity, nutrition, alcohol and smoking continue to be underutilised. Although good evidence exists for addressing the four lifestyle-related risk factors independently, rarely do these present in isolation. Evidence is lacking regarding how to integrate interventions targeting multiple risk factors. Consequently, this paper aims to provide an overview of the evidence for delivering multiple interventions in primary healthcare settings.</p><p>Different lifestyle factors are inter-related, with decisions around ordering of the delivery of multiple lifestyle interventions an important consideration. There is evidence supporting the effectiveness of addressing some lifestyle factors simultaneously (e.g., physical activity and nutrition), although smoking cessation may be delivered best in a sequential approach. While the World Health Organisation highlights four key lifestyle factors (nutrition, physical activity, alcohol and smoking), incorporating additional elements such as sleep, mental well-being and social connectedness offers a holistic framework for promoting well-being.</p><p>Despite the presentation of multiple behaviour risk factors being commonplace in healthcare settings, the evidence (outlined in the paper) for how best to deliver interventions to address this is limited, with further research and subsequent clinical guidance required.</p><p>In order to address the barriers to delivering lifestyle interventions in primary care, innovation will be required. The use of non-medical personnel, social prescribers and health coaches has the potential to alleviate time constraints, whilst mounting evidence exists for group consultations for addressing lifestyle-related non-communicable diseases (NCDs). If the challenges to implementation can be addressed, and if healthcare systems can adapt for the promotion of healthy lifestyles, the impact of NCDs can be mitigated.</p>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141608001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anke H. C. Gielen, Britt J. M. Thomassen, Tim J. Bult, Jarno Melenhorst, Merel L. Kimman, Stephanie O. Breukink
Background
Colorectal cancer is identified as a lifestyle-related type of cancer. There is an increasing emphasis on lifestyle interventions targeting pivotal lifestyle factors such as excess weight, cigarette smoking, alcohol consumption, poor diet and physical inactivity as primary and tertiary prevention. Furthermore, modifying these lifestyle factors has the potential to improve quality of life for cancer patients. We aim to identify, appraise and synthesise the available evidence regarding the effect of combined lifestyle interventions on quality of life in colorectal cancer survivors.
Methods
Pubmed, Ovid Embase and the Cochrane Library were searched for studies reporting on quality of life in post-treatment colorectal cancer patients. The systematic literature search was performed according to the Preferred Reporting Items for systematic reviews and meta-analysis (PRISMA) guidelines.
Results
Five articles reporting on 719 individual patients were included. Two studies reported significantly better results in (cancer-specific) quality-of-life questionnaires for patients after combined lifestyle interventions.
Conclusion
We conclude that there is some evidence that combined lifestyle interventions could have beneficial effects on the quality of life of colorectal cancer survivors. Future randomised controlled trials reporting on quality of life of combined lifestyle interventions in colorectal cancer survivors are warranted.
{"title":"The Effect of Post-Treatment Combined Lifestyle Interventions on Quality of Life in Colorectal Cancer Patients – A Systematic Review","authors":"Anke H. C. Gielen, Britt J. M. Thomassen, Tim J. Bult, Jarno Melenhorst, Merel L. Kimman, Stephanie O. Breukink","doi":"10.1002/lim2.109","DOIUrl":"https://doi.org/10.1002/lim2.109","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Colorectal cancer is identified as a lifestyle-related type of cancer. There is an increasing emphasis on lifestyle interventions targeting pivotal lifestyle factors such as excess weight, cigarette smoking, alcohol consumption, poor diet and physical inactivity as primary and tertiary prevention. Furthermore, modifying these lifestyle factors has the potential to improve quality of life for cancer patients. We aim to identify, appraise and synthesise the available evidence regarding the effect of combined lifestyle interventions on quality of life in colorectal cancer survivors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Pubmed, Ovid Embase and the Cochrane Library were searched for studies reporting on quality of life in post-treatment colorectal cancer patients. The systematic literature search was performed according to the Preferred Reporting Items for systematic reviews and meta-analysis (PRISMA) guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five articles reporting on 719 individual patients were included. Two studies reported significantly better results in (cancer-specific) quality-of-life questionnaires for patients after combined lifestyle interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We conclude that there is some evidence that combined lifestyle interventions could have beneficial effects on the quality of life of colorectal cancer survivors. Future randomised controlled trials reporting on quality of life of combined lifestyle interventions in colorectal cancer survivors are warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.109","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141536612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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