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Influences on technology use and interpretation among young people living with type 1 diabetes 1型糖尿病患者对技术使用和解释的影响
Q3 Medicine
Lifestyle medicine (Hoboken, N.J.)
Pub Date : 2022-12-07 DOI: 10.1002/lim2.73
Laura N. Cushley, Aniela Krezel, Katie Curran, Kathryn Parker, Sarinda Millar, Tunde Peto

Aims

To characterise continuous glucose monitor and flash glucose monitor use and related issues (both positive and negative) in the population of children and young people living with type 1 diabetes in the Southern Health and Social Care Trust (SHSCT), Northern Ireland.

Methods

Four focus groups were conducted in the SHSCT with people with type 1 diabetes and their families, to assess opinions of diabetes technology. In addition, questionnaires were distributed to diabetes specialist nurses (DSNs), young people and their families about use and access to diabetes technology.

Results

Questionnaires were completed by 68 children, young people (0–18 years) and their parents/guardians. Nearly all (98.5%) had access to their own diabetes related data, and 70.6% used diabetes data systems, for example, Libreview. Most of those using these systems found them beneficial and easy for daily use and clinical review.

Most DSNs (83.9%) agreed that the systems were easy to use, and 82.3% were confident in interpreting the data accurately. DSNs felt virtual review was beneficial in over half of young people with 62.9% advising changes to diabetes management based on the data.

Focus groups participants deemed diabetes technology a ‘gamechanger’ and ‘lifechanging’. Some drawbacks included ‘disruptive’ alarms, self-confidence issues, visible diabetes technology and problems in school.

Conclusions

Most young people, their families and healthcare professionals reported they were confident in interpreting diabetes data and technology was easy to use. Diabetes technology could improve access to care through virtual clinics, improve clinical outcomes and enhance quality of life.

目的分析北爱尔兰南部健康和社会保健信托基金(SHSCT)儿童和青少年1型糖尿病患者中连续血糖监测仪和瞬时血糖监测仪的使用情况及相关问题(阳性和阴性)。方法在SHSCT中对1型糖尿病患者及其家属进行4个焦点小组的调查，评估对糖尿病技术的看法。此外，还向糖尿病专科护士(DSNs)、年轻人及其家人分发了关于糖尿病技术使用和获取的问卷。结果共对68名儿童、青少年(0 ~ 18岁)及其父母/监护人进行问卷调查。几乎所有(98.5%)的人都可以访问自己的糖尿病相关数据，70.6%的人使用糖尿病数据系统，例如Libreview。大多数使用这些系统的人发现它们有益且易于日常使用和临床审查。大多数dsn(83.9%)认为该系统易于使用，82.3%的人对准确解释数据有信心。dsn认为虚拟评价对超过一半的年轻人有益，62.9%的人根据数据建议改变糖尿病管理。焦点小组的参与者认为糖尿病技术“改变了游戏规则”和“改变了生活”。一些缺点包括“破坏性”警报、自信心问题、可见的糖尿病技术和学校问题。大多数年轻人、他们的家人和医疗保健专业人员报告说，他们对解释糖尿病数据有信心，而且技术易于使用。糖尿病技术可以通过虚拟诊所改善获得护理的机会，改善临床结果，提高生活质量。
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引用次数: 0
The effects of mantra-based AMI Meditation on burnout, secondary traumatic stress, and compassion satisfaction levels in healthcare providers 基于咒语的MI冥想对医护人员倦怠、继发性创伤压力和同情满意度的影响
Q3 Medicine
Lifestyle medicine (Hoboken, N.J.)
Pub Date : 2022-11-07 DOI: 10.1002/lim2.72
Mark Pettus, Beth Netter, Leonard Perlmutter, Jenness Cortez Perlmutter, Akiko S. Hosler

Importance

There is an abundance of research demonstrating the growing challenge of burnout in healthcare professionals. This has been further exacerbated by the COVID-19 pandemic. The use of meditation using various techniques has shown promising results in the reduction of stress and its sequelae.

Objective

To determine the efficacy of a mantra-based meditation protocol developed by the American Meditation Institute to reduce caregiver stress by evaluating changes in burnout and secondary traumatic stress (components of compassion fatigue) and compassion satisfaction with the application of the meditation protocol.

Design, Setting, and Participation

This pre–post cohort analysis was conducted on prospective enrollees of the Continuing Medical Education (CME)-accredited American Meditation Institute's annual Heart and Science of Yoga® Conference, a comprehensive training in Yoga Science as Holistic Mind/Body Medicine for physicians and other healthcare providers held in October in Lenox, Massachusetts. Enrollees were trained in mantra-based AMI Meditation at the conference and monitored during the 6-month period following the conference.

Interventions

The mantra-based AMI Meditation intervention included a 5-day in-person training, a daily practice of a guided mantra-based AMI Meditation using a 20-min CD or MP3 recording, and receipt of a monthly motivational letter. Study participants completed the Professional Quality of Life (ProQOL) Measure (a survey) and a demographic survey at baseline, and the ProQOL Measure and an informational survey at 3 and 6 months.

Main Outcomes and Measures

The primary outcome was a change from baseline in participants’ level of burnout using the ProQOL assessed at baseline and 3 and 6 months. Secondary outcomes included change from baseline in participants’ level of secondary traumatic stress and compassion satisfaction assessed at 3 and 6 months using the ProQOL Measure. Qualitative data were also collected from participant feedback, via the informational surveys, at 3 months and after completion of the program at 6 months.

Results

Of the 54 participants who en

重要性:有大量的研究表明，职业倦怠对医疗保健专业人员的挑战越来越大。COVID - 19大流行进一步加剧了这种情况。使用各种技巧进行冥想，在减轻压力及其后遗症方面显示出有希望的结果。目的:通过评估冥想方案在职业倦怠和继发性创伤压力(同情疲劳的组成部分)以及同情满意度方面的变化，确定美国冥想研究所开发的基于咒语的冥想方案在减少照顾者压力方面的效果。设计、环境和参与:这项前后队列分析是对继续医学教育(CME)认证的美国冥想协会年度瑜伽心脏和科学®会议的潜在参与者进行的，该会议是10月在马萨诸塞州莱诺克斯举行的针对医生和其他医疗保健提供者的瑜伽科学整体身心医学的全面培训。与会者在会议上接受了基于咒语的AMI冥想培训，并在会议后的6个月期间进行了监测。干预:基于咒语的AMI冥想干预包括为期5天的亲自培训，每天使用20分钟的CD或MP3录音进行指导的基于咒语的AMI冥想练习，以及每月收到一封激励信。研究参与者在基线时完成了职业生活质量(ProQOL)测量(一项调查)和人口统计调查，并在3个月和6个月时完成了ProQOL测量和信息调查。主要结果和测量:主要结果是在基线和3个月和6个月时使用ProQOL评估参与者的倦怠水平与基线相比的变化。次要结果包括受试者在3个月和6个月时使用ProQOL量表评估的继发性创伤应激水平和同情满意度的基线变化。定性数据也从参与者反馈中收集，通过信息调查，在3个月和6个月后完成项目。结果:入组并完成基线调查的54名参与者中，30名在3个月时完成随访，21名在6个月时完成随访。从基线到6个月，所有三个ProQOL量表的得分都有统计学上的显著改善。采用配对t检验，倦怠得分降低23.2% (p < 0.0001)，继发创伤应激得分降低19.9% (p = 0.001)，同情满意度得分提高11.2% (p < 0.0001)。对于继发性创伤应激和同情满意度评分，在3个月时看到大多数改善。对于倦怠，在3个月和6个月的随访中，改善是恒定的。结论:在这个医疗保健专业人员的小队列中，基于咒语的AMI冥想计划显著改善了照顾者压力的所有三个领域，改善了倦怠和继发性创伤压力，改善了同情心。越来越多的研究支持这些工具和技能在减轻照顾者压力方面的关键重要性。
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引用次数: 0
Embedding social relations into primary care: A population-based approach. What matters most? Population practice of social ecology in medicine and communities 将社会关系嵌入初级保健:基于人口的方法。什么最重要?社会生态学在医学和社区中的人口实践
Q3 Medicine
Lifestyle medicine (Hoboken, N.J.)
Pub Date : 2022-10-27 DOI: 10.1002/lim2.71
Helen Mary Kingston, Frances da Cunha

Background

The importance of social connectedness has long been an area of research in medical research. The damaging impact of social isolation is recognised and proven. This article describes our experiences of embedding routine enquiry about networks of support into routine clinical care.

Aims

The majority of care happens through the strength of bonds and support between the network of immediate family and friends. Acknowledging these networks and actively working to support them is central to health and wellbeing.

Results

In parallel, working to improve professional networks builds trust, shared understanding and stronger relationships that benefit us all. The strengthening of bonds across and between teams delivering health care can benefit those working within them and lead to improved outcomes for both staff and patients.

Conclusion

Developing Frome as a compassionate community has enabled improved patient care, improved staff wellbeing and financial savings for the health community.

社会联系的重要性长期以来一直是医学研究的一个研究领域。社会孤立的破坏性影响已得到承认和证实。这篇文章描述了我们在日常临床护理中嵌入关于支持网络的常规询问的经验。大多数关怀是通过直系亲属和朋友之间的纽带和支持来实现的。承认这些网络并积极努力支持它们对健康和福祉至关重要。与此同时，努力改善职业网络可以建立信任、共享理解和更牢固的关系，这对我们所有人都有利。加强医疗保健团队之间和团队之间的联系，可以使团队内部的工作人员受益，并为工作人员和患者带来更好的结果。作为一个富有同情心的社区，“发展中国家”改善了患者护理，改善了员工福利，并为卫生界节省了资金。
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引用次数: 0
Is the lack of appropriate cognitive demand the primary driver of dementia risk? 缺乏适当的认知需求是痴呆风险的主要驱动因素吗?
Q3 Medicine
Lifestyle medicine (Hoboken, N.J.)
Pub Date : 2022-10-09 DOI: 10.1002/lim2.70
Thomas R. Wood, Josh Turknett

With the general trend of increasing lifespan alongside population-level success in reducing the mortality from cardiovascular and cerebrovascular diseases, the population burden of Alzheimer's disease (AD) has steadily accelerated. In the United States, the mortality rate due to AD has increased from less than 0.5 per 100,000 in 1980 to approximately 30 per 100,000 in 2019.1 Worldwide, the number of individuals with dementia is expected to at least triple by 2050,2 with some reports suggesting that AD has the potential to bankrupt healthcare systems.3 At the same time, the development of, and investment in, multiple pharmacological agents directed toward modifying the pathological “hallmarks” of AD have yielded disappointing results. Existing pharmaceuticals offer modest symptomatic benefits, at best, without modifying the course of the disease. Taken together, these factors highlight the urgent need for a critical reappraisal of the underlying risk factors for AD and potential interventions.

In an attempt to reframe potential preventative and therapeutic approaches to AD, we recently proposed a model that suggests demand–function coupling in the brain is the critical upstream factor driving long-term cognitive function.4 In this model, we describe how the health and function of any tissue, including the brain, is shaped by the demands placed upon it. In the setting of increased demand, demand–function coupling drives increases in growth and function, but also upregulates processes of cellular repair and regeneration. The result is a tissue that is more resilient, plastic, and with a greater capacity for increased work output in the face of increased requirements. In this way, we propose that the structure and function of the brain are driven by the demands placed upon it, much as cardiac and skeletal muscles respond to exercise. And as muscle or cardiovascular function decline with bed rest or detraining, the structure and function of the brain decline in a coupled manner when adequate demands are not placed upon it. Cognitive decline is then essentially an expression of “frailty” of the brain - defined as lacking additional capacity to function above basic requirements - as a result of reduced demand. Although it may appear subtle, this reframing of the cascade may be critical in understanding the disease process and intervening as healthcare providers. Whereas the prevailing explanations to date have described cognitive activity as a mitigating force; in this model, we propose that cognitive demand instead impacts the primary pathogenetic process. In fact, given the established phenomenon of demand coupling in neural tissue, we believe that this model provides the most parsimonious account of disease pathogenesis.

In order to explain the approach, we first made two suggestions for a cognitive framework that we believe are essential i

随着人类寿命不断延长的大趋势以及人口水平在降低心脑血管疾病死亡率方面的成功，阿尔茨海默病(AD)的人口负担稳步增加。在美国，阿尔茨海默病的死亡率从1980年的每10万人不到0.5人增加到2019年的每10万人约30人。1在世界范围内，痴呆症患者的数量预计到2050年将至少增加两倍，2一些报告表明，阿尔茨海默病有可能使医疗系统破产与此同时，针对改变阿尔茨海默病病理“特征”的多种药物的开发和投资却产生了令人失望的结果。现有的药物最多只能提供适度的对症治疗，而不能改变疾病的进程。综上所述，这些因素突出了迫切需要对阿尔茨海默病的潜在危险因素和潜在干预措施进行关键的重新评估。为了重新构建AD的潜在预防和治疗方法，我们最近提出了一个模型，该模型表明大脑中的需求-功能耦合是驱动长期认知功能的关键上游因素在这个模型中，我们描述了包括大脑在内的任何组织的健康和功能是如何被施加在它身上的需求所塑造的。在需求增加的背景下，需求-功能耦合驱动生长和功能的增加，但也上调细胞修复和再生过程。其结果是一种更有弹性、可塑性的组织，在面对增加的需求时，具有更大的工作输出能力。通过这种方式，我们提出大脑的结构和功能是由施加在它身上的需求驱动的，就像心脏和骨骼肌对运动的反应一样。当肌肉或心血管功能随着卧床休息或去训练而下降时，当没有适当的需求时，大脑的结构和功能也会以一种耦合的方式下降。因此，认知能力下降本质上是大脑“脆弱”的一种表现——定义为缺乏超出基本需求的额外功能——这是需求减少的结果。虽然它可能看起来很微妙，但这种级联的重构可能对理解疾病过程和作为医疗保健提供者进行干预至关重要。鉴于迄今为止的主流解释将认知活动描述为一种缓解力量;在这个模型中，我们提出认知需求反而影响了原发性发病过程。事实上，考虑到神经组织中需求耦合的既定现象，我们认为该模型提供了疾病发病机制的最简洁的解释。为了解释这种方法，我们首先对认知框架提出了两个建议，我们认为如果我们要更好地理解痴呆症的机制基础并试图干预疾病过程，这两个框架是必不可少的。第一个建议是，我们应该将迟发性或“散发性”AD与早发性家族性AD区分开来。尽管在历史上，由于在尸检中有共同的神经病理特征，它们都被标记为AD的形式，但就其危险因素和病程而言，它们是完全不同的疾病。因此，我们的模型只讨论了晚发性阿尔茨海默病，我们称之为年龄相关性痴呆(ARD)，在此之前会出现一段与年龄相关的认知衰退(ARCD)。第二个建议是，我们应该抓住机会从不同的生物组织水平探索ARD的病因和干预点。每一种生物现象都可以在生物组织的多个层面上进行描述和表征，从细胞和分子的层面到种群和生态系统的层面因此，每种疾病现象都有一个最适合连贯解释发病机制的分析和表征水平，这通常是因果链中最上游的水平。在较低层次的组织中对下游结果的描述，不管其详细程度如何，都不一定赋予额外的或更大的解释力。在ARD的情况下，该领域通常集中在颗粒，较低水平的分子和神经病理细节。尽管有越来越多的证据表明，生活方式和环境——代表生物组织的有机体或社会层面——是导致ARD的最终原因。如果情况确实如此，那么机体水平的干预措施可能是最有效的，这也解释了(迄今为止)针对AD和ARD的分子水平干预措施的普遍失败。改变我们干预疾病过程的组织水平的一个问题是，它要求我们放弃纯粹从定义良好的生化机制的角度来思考。 在开发药物制剂时，关键是要针对单一机制，同时尽量减少脱靶效应。相比之下，当在有机体层面进行干预时，干预可能会产生强大的结果，而无需完全了解其生化效应。事实上，当试图在医疗系统的社会层面建立生活方式医学时，在组织的分子或细胞水平上缺乏单一的机制似乎是一个根本问题，因为医疗系统只关注特定干预的作用机制。这方面的一个很好的例子是身体活动，它可能是治疗和预防非传染性疾病的最有效的单一干预措施尽管我们仍然不能完全确定体育活动是如何“起作用”的，但所有政府、非政府组织和健康相关组织都一致建议增加锻炼和非锻炼性体育活动。几十年来，许多将身体活动与健康联系起来的机制，包括对运动的急性和慢性功能适应，已经得到阐明和记录。然而，即使在最近几年，我们继续发现运动调节全身健康和功能的机制，包括涉及鸢尾素、MOTS-c (12S rRNA型c的线粒体开放阅读框架)和Lac-Phe (n -乳酸基苯丙氨酸)的新途径，这只是在高影响力期刊上发表的几个例子，引起了大量相关媒体和媒体的兴趣。7-9如果我们接受具有多效性(有时尚未完全理解)效果的机体层面干预可能对人类健康的某些方面有最大的益处，这将使我们能够重新构建迄今为止尚未取得进展的疾病的方法，例如ARD。在与临床医生和研究人员讨论ARD的需求模型时，他们通常会询问其他已确定的风险因素，特别是与一般健康和环境相关的风险因素。因此，我们必须非常清楚地表明，我们认为ARCD和ARD的环境成分是完善的，10-14，应该是任何疾病病因学或干预模型的重要组成部分。这包括与身体活动减少、10,15 -17睡眠不足、10,18,19代谢疾病、20,21营养缺乏、14,22激素不足、23身体组成改变、24-27和社会孤立或社会支持不足相关的痴呆症风险显著增加的证据越来越多的早期证据表明，生活方式和环境的改变有可能预防甚至逆转ARD，特别是在疾病过程的早期开始。14,29,30这方面的一个主要例子是David Smith教授及其同事的开创性工作，他们表明，用B族维生素来降低高同型半胱氨酸的干预可以减缓脑萎缩和认知能力下降的速度，特别是在omega-3脂肪酸充足的情况下重要的是，环境对ARD风险的影响直接映射到生活方式医学的六个基于证据的支柱(图1)。因此，我们警告不要认为因素是相互排斥的，相反，我们认为上述生活方式和环境因素是大脑中最佳需求-功能耦合所需的关键组成部分。为了适应组织中增加的需求，该组织还必须有足够的营养供应，激素和营养支持，血管供应，以及缺乏有毒物质暴露和睡眠恢复和适应的机会(例如睡眠)。这些因素中的任何一个不足都可能破坏对认知需求的健康促进适应。回到与运动的比较上来，一个人可能拥有建立健康肌肉组织所需的所有要素——营养、荷尔蒙状态、睡眠等——但如果缺乏体育锻炼，他们就不会提高健康水平。我们相信所有的证据都指向大脑功能，毫不奇怪，是一样的。超越假设，认知需求的首要重要性的证据是什么，这对未来的AD研究和干预可能意味着什么?Yu等人最近的一项荟萃分析发现，晚年的认知需求是对抗AD的唯一最具保护作用的因素。同样，多项流行病学研究表明，退休导致的与工作相关的认知刺激的丧失导致认知能力下降的风险同时增加，即使在调整了可能解释提前退休和认知能力下降的混杂因素(如合并症)之后也是如此。 31-33丧失认知刺激的负面影响也是可逆的，丧失感觉功能(如视觉、嗅觉或听觉)的人认知能力下降的风险增加就证明了这一点，这可以通过恢复受损感觉的干预措施来克服。34-38其他类型的有益认知需求包括双语能力或演奏乐器，对那些练习更具挑战性的人的大脑结构有更大的好处。39-45与没有协调成分的高强度运动相比，协调性运动(如瑜伽、太极或舞蹈)似乎对大脑结构和功能有更大的好处。46,47即使是结构化的大脑训练也可以延续到现实生活中记忆和执行功能的改善。39,48 -5
{"title":"Is the lack of appropriate cognitive demand the primary driver of dementia risk?","authors":"Thomas R. Wood,&nbsp;Josh Turknett","doi":"10.1002/lim2.70","DOIUrl":"10.1002/lim2.70","url":null,"abstract":"<p>With the general trend of increasing lifespan alongside population-level success in reducing the mortality from cardiovascular and cerebrovascular diseases, the population burden of Alzheimer's disease (AD) has steadily accelerated. In the United States, the mortality rate due to AD has increased from less than 0.5 per 100,000 in 1980 to approximately 30 per 100,000 in 2019.<span><sup>1</sup></span> Worldwide, the number of individuals with dementia is expected to at least triple by 2050,<span><sup>2</sup></span> with some reports suggesting that AD has the potential to bankrupt healthcare systems.<span><sup>3</sup></span> At the same time, the development of, and investment in, multiple pharmacological agents directed toward modifying the pathological “hallmarks” of AD have yielded disappointing results. Existing pharmaceuticals offer modest symptomatic benefits, at best, without modifying the course of the disease. Taken together, these factors highlight the urgent need for a critical reappraisal of the underlying risk factors for AD and potential interventions.</p><p>In an attempt to reframe potential preventative and therapeutic approaches to AD, we recently proposed a model that suggests demand–function coupling in the brain is the critical upstream factor driving long-term cognitive function.<span><sup>4</sup></span> In this model, we describe how the health and function of any tissue, including the brain, is shaped by the demands placed upon it. In the setting of increased demand, demand–function coupling drives increases in growth and function, but also upregulates processes of cellular repair and regeneration. The result is a tissue that is more resilient, plastic, and with a greater capacity for increased work output in the face of increased requirements. In this way, we propose that the structure and function of the brain are driven by the demands placed upon it, much as cardiac and skeletal muscles respond to exercise. And as muscle or cardiovascular function decline with bed rest or detraining, the structure and function of the brain decline in a coupled manner when adequate demands are not placed upon it. Cognitive decline is then essentially an expression of “frailty” of the brain - defined as lacking additional capacity to function above basic requirements - as a result of reduced demand. Although it may appear subtle, this reframing of the cascade may be critical in understanding the disease process and intervening as healthcare providers. Whereas the prevailing explanations to date have described cognitive activity as a mitigating force; in this model, we propose that cognitive demand instead impacts the primary pathogenetic process. In fact, given the established phenomenon of demand coupling in neural tissue, we believe that this model provides the most parsimonious account of disease pathogenesis.</p><p>In order to explain the approach, we first made two suggestions for a cognitive framework that we believe are essential i","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":"3 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.70","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45996131","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}
引用次数: 0
Understanding ground-up community development from a practice perspective 从实践角度理解基层社区发展
Q3 Medicine
Lifestyle medicine (Hoboken, N.J.)
Pub Date : 2022-09-02 DOI: 10.1002/lim2.69
Cormac Russell

This article offers a practice perspective on Community Development from the ground up regarding health and well-being. It advocates for a departure from traditional Community Engagement approaches, arguing that they fall short of relocating authority to communities as influential health producers. The author affirms that Asset-Based Community Development (ABCD) approaches are preferable Community Engagement practices, as they offer more authentic pathways toward community-centred population health and wellbeing. The article concludes that once effective ground-up community development has been initiated supplementary efforts at reform and relief are more likely to have desired and sustained impact.

这篇文章提供了一个关于社区发展的实践视角，从基础到健康和福祉。它主张脱离传统的社区参与方法，认为它们无法将权力作为有影响力的卫生生产者转移到社区。作者肯定，基于资产的社区发展(ABCD)方法是更可取的社区参与实践，因为它们为以社区为中心的人口健康和福祉提供了更真实的途径。文章的结论是，一旦开始了有效的基层社区发展，改革和救济方面的补充努力就更有可能产生理想和持久的影响。
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引用次数: 3
The pediatric global burden of stunting: Focus on Latin America 全球儿童发育迟缓的负担：关注拉丁美洲
Q3 Medicine
Lifestyle medicine (Hoboken, N.J.)
Pub Date : 2022-08-03 DOI: 10.1002/lim2.67
Clara Rojas Montenegro, Gabriel Gomez, Oscar Hincapie, Svyatoslav Dvoretskiy, Tiffany DeWitt, Daniela Gracia, Juan Diego Misas

Introduction

Stunting is a devastating consequence of poor nutrition from before birth to early childhood. While the prevalence of stunting is decreasing over the past 30 years, approximately 144 million children still suffer from stunting globally and 5 million in Latin America (LATAM).

Method

The purpose of this review is to provide an overview of stunting globally, with a focus on LATAM. Stunting can impact child development, lead to greater susceptibility to infections, increase functional impairments, and increase mortality risks. Furthermore, the economic negative impact of stunting is large, as stunted children will likely suffer from productivity losses due to chronic diseases in adulthood. The reduction in per capita income of the labor force due to stunting is close to 5% in LATAM; therefore, there is a continued need for comprehensive approaches to address stunting in this region and around the globe.

Conclusions

A multisectoral comprehensive approach to address stunting is required, with nutritional intervention being a key part of that process.

发育迟缓是从出生前到幼儿期营养不良造成的毁灭性后果。虽然在过去30年里，发育迟缓的发生率有所下降，但全球仍有约1.44亿儿童患有发育迟缓，拉丁美洲约有500万儿童患有发育迟缓。方法本综述的目的是提供全球发育迟缓的概述，重点是拉美地区。发育迟缓会影响儿童发育，导致更容易受到感染，增加功能障碍，并增加死亡风险。此外，发育迟缓对经济的负面影响很大，因为发育迟缓的儿童在成年后可能会因慢性病而丧失生产力。在拉丁美洲，由于发育迟缓导致的劳动力人均收入减少接近5%;因此，继续需要采取综合办法来解决本区域和全球的发育迟缓问题。需要采取多部门综合方法来解决发育迟缓问题，营养干预是这一进程的关键部分。
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引用次数: 4
Juggling two pandemics: The simultaneous necessity and difficulty of practising lifestyle medicine during the COVID-19 era 应对两大流行病:COVID-19时代实践生活方式医学的必要性和难度并存
Q3 Medicine
Lifestyle medicine (Hoboken, N.J.)
Pub Date : 2022-08-03 DOI: 10.1002/lim2.68
Alexandra Shipley, Ellen Fallows

Since early 2020, COVID-19 has dominated headlines, claimed millions of lives, crippled global economies, overwhelmed health services, attracted multi-disciplinary scientific attention and transformed our daily lives. Unsurprisingly, the Lifestyle Medicine field has not been immune to the pandemic's wide-reaching influence. Although COVID-19 highlighted the necessity of maintaining healthy behaviours, the associated lockdowns and social distancing measures challenged our ability to do so. Attempts to mitigate the spread of COVID-19 may, therefore, have exacerbated the obesity pandemic and other diseases associated with unhealthy lifestyle habits. One hopes this devastating virus provides the impetus for policymakers, clinicians and patients to collaborate in tackling the diseases of modern life. This commentary explores how lifestyle-correlated conditions (which are closely intertwined with socioeconomic factors) rendered much of the UK population vulnerable to COVID-19 infection, morbidity and mortality. Subsequently, we consider the impact of lockdown measures on the accessibility of healthy living, focussing on eating behaviours, physical activity, relationships, sleep and substance abuse, as well as the social demographics particularly affected. Approaching the aftermath of this vicious cycle with optimism, we discuss why the post-Covid era presents a unique opportunity for Lifestyle Medicine, as an evidence-based approach to supporting patients to adopt and sustain healthy behaviours.

自2020年初以来，新冠肺炎占据了头条新闻，夺走了数百万人的生命，使全球经济瘫痪，卫生服务不堪重负，吸引了多学科的科学关注，并改变了我们的日常生活。不出所料，生活方式医学领域也未能免受疫情的广泛影响。尽管新冠肺炎强调了保持健康行为的必要性，但相关的封锁和保持社交距离措施挑战了我们这样做的能力。因此，缓解新冠肺炎传播的努力可能加剧了肥胖和其他与不健康生活习惯相关的疾病。人们希望这种毁灭性的病毒能推动政策制定者、临床医生和患者合作应对现代生活中的疾病。这篇评论探讨了与生活方式相关的条件（与社会经济因素密切交织在一起）如何使英国大部分人口容易受到新冠肺炎感染、发病率和死亡率的影响。随后，我们考虑了封锁措施对健康生活的影响，重点关注饮食行为、身体活动、人际关系、睡眠和药物滥用，以及特别受影响的社会人口统计。乐观地对待这一恶性循环的后果，我们讨论了为什么后新冠时代为生活方式医学提供了一个独特的机会，作为支持患者采取和维持健康行为的循证方法。
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引用次数: 0
Insights into optimising education for patients living with diabetes mellitus: A model for the post-pandemic era, informed by survey data 优化糖尿病患者教育的见解:大流行后时代的模型，由调查数据提供信息
Q3 Medicine
Lifestyle medicine (Hoboken, N.J.)
Pub Date : 2022-07-31 DOI: 10.1002/lim2.64
Petra Hanson, Dilan Parmar, Pranay Deo, Daniella Whyteoshodi, Charlotte Gotts, Paul J. O'Hare, Harpal Randeva, Thomas M. Barber

Background

Patient education represents the key element in the management of diabetes mellitus (DM) and has changed dramatically during the last 3 years. Uptake of structured education is poor, and patient perception of received education varies greatly. The purpose of this study was to assess patients’ perception of adequacy of delivered education, barriers to attending structured courses and preferences for ongoing DM-related education.

Methods

Patients living with Type 2 DM attending diabetes clinics were invited to complete a questionnaire about their understanding of DM, adequacy of offered education and desired features of future courses, following their clinic appointment at University Hospitals Coventry and Warwickshire (UHCW). Those interested (n = 146) completed this questionnaire.

Results

Participants’ mean age was 58.2 years (standard deviation [SD] 13.6, median 59, interquartile range [IQR] 50–66), mean body mass index 34.5 Kgm–2 (SD 9.1, median 33.7 Kgm–2, IQR 29.8–41.7) and duration of T2DM was 13 years (SD 10, median 10 years, IQR 3–19). Thirty-one per cent of participants received no education at the time of their diagnosis with 51% of participants reporting no ongoing DM-related education. Thirty-seven per cent of participants did not understand the meaning of HbA1c. Preference for face-to-face versus remote delivery of DM-related education was roughly split, with 51% preferring the former. Attention to self-compassion and mental health needs were identified as key elements currently missing from DM-related education.

Conclusion

The provision of DM-related education pre-pandemic did not meet patients’ needs. Gaining insight and understanding into the gaps within current DM-related educational provision and patient preferences for its delivery are key strategies in the development of reformed DM-related education that will ultimately equip patients with improved self-management skills.

背景:患者教育是糖尿病(DM)管理的关键因素，在过去3年中发生了巨大变化。对结构化教育的接受程度较差，患者对所接受教育的感知差异很大。本研究的目的是评估患者对所提供教育的充分性、参加结构化课程的障碍以及对正在进行的dm相关教育的偏好。方法:在考文垂和沃里克大学医院(UHCW)的诊所预约后，邀请2型糖尿病患者填写一份关于他们对糖尿病的了解、所提供教育的充分性和未来课程的期望特征的问卷。感兴趣的人(n = 146)完成了这个测试
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引用次数: 2
Promoting physical activity within eyecare: Addressing the research–policy gap 在眼科保健中促进身体活动:解决研究与政策差距
Q3 Medicine
Lifestyle medicine (Hoboken, N.J.)
Pub Date : 2022-07-04 DOI: 10.1002/lim2.66
Rosie K. Lindsay, Peter M. Allen, Lee Smith

On 3 April 2018, Eye published a review titled ‘Physical activity, visual impairment, and eye disease’. The review concluded there was evidence that physical activity may protect against vision loss, and that vision loss causes a decline in physical activity.1 There is also undisputed evidence that physical activity is generally good for us.2 Regular physical activity reduces the risk of several leading chronic conditions, and the risk of premature mortality by 20%–30%.3

However, both the ‘Standards of practice for optometrists and dispensing opticians’4 and ‘The College of Optometrists clinical guidance’5 do not explicitly state that eyecare professionals should discuss physical activity with patients. Similarly, whilst the Royal College of Ophthalmologists guidance document titled ‘low vision: the essential guide for ophthalmologists’ references physical activity, by stating ‘four modifiable behaviours – smoking, physical inactivity, poor diet and drinking alcohol have been shown to be associated with reduced vision’, the preceding article focuses on smoking cessation with no further mention of physical activity.6 This is the research–policy gap. There is research to support that physical activity is good for patients; however, there are limited policies designed to promote physical activity to patients within eyecare.

As of 12 June 2022, if you search PubMed for ‘healthcare policy change’, you will get 69,885 results; if you run the same search replacing ‘healthcare’ with the term ‘eyecare’, you will get eight results. Of course, there are more rigorous methods of searching the literature, but the point is that compared to research exploring how to implement policy change within general healthcare, there is surprisingly scarce literature that focuses on implementing policy change within eyecare. Perhaps it is not surprising then that there is a research–policy gap in the promotion of physical activity within eyecare. However, eyecare can learn from research conducted in other healthcare settings. The following article proposes how to get from stage 1: evidence that physical activity is good for patients, to stage 2: eyecare professionals promoting physical activity to patients.

However, persuading eyecare professionals to promote physical activity should not stop in the elevator. People are diverse, and messages reach and resonate with different people dependent on their delivery. For example, sharing patient's stories of how physical activity benefited them, visual infographics depicting the benefits of physical activity, physical activity champions (peers who support their fellow colleagues to promote physical activity to patients), and social media can be used to encourage professionals to promote physical activity.9

Eyecare professionals nee

2018年4月3日，Eye发表了一篇题为“身体活动、视力障碍和眼病”的综述。这篇综述的结论是，有证据表明，体育锻炼可以预防视力下降，而视力下降会导致体育锻炼的减少也有无可争议的证据表明，体育活动通常对我们有益有规律的身体活动可使患几种主要慢性病的风险降低20%-30%，并使过早死亡的风险降低20%-30%。然而，《验光师和配镜师执业标准》和《验光师学院临床指导》都没有明确指出，眼科专业人员应该与患者讨论身体活动。同样，虽然皇家眼科学院的指导文件标题为“低视力:眼科医生的基本指南”，通过指出“四种可改变的行为-吸烟，不运动，不良饮食和饮酒已被证明与视力下降有关”，提到了身体活动，但前面的文章侧重于戒烟，没有进一步提到身体活动这就是研究与政策的差距。有研究支持体育活动对病人有好处;然而，在眼科护理中，促进患者身体活动的政策有限。截至2022年6月12日，如果你在PubMed上搜索“医疗保健政策变化”，你会得到69,885个结果;如果你用“眼保健”来替换“医疗保健”，你会得到8个结果。当然，有更严格的方法来搜索文献，但重点是，与探索如何在一般医疗保健中实施政策变化的研究相比，令人惊讶的是，很少有文献关注于在眼科保健中实施政策变化。因此，在促进眼保健中的体育活动方面存在研究和政策差距，这也许并不令人惊讶。然而，眼科护理可以从其他医疗机构的研究中学习。下面的文章提出了如何从第1阶段:证据表明体育锻炼对患者有益，到第2阶段:眼科专业人员向患者推广体育锻炼。然而，说服眼科专业人士促进体育锻炼不应止步于电梯。人是多种多样的，信息的传递方式不同，不同的人也会产生共鸣。例如，分享患者关于体育活动如何使他们受益的故事，描绘体育活动益处的视觉信息图表，体育活动倡导者(支持同事向患者促进体育活动的同行)，以及社交媒体可以用来鼓励专业人士促进体育活动。眼保健专业人员需要能力和机会来促进身体活动先前的研究发现，卫生保健专业人员在实践中促进体育活动的最常见障碍是缺乏时间，缺乏促进体育活动的知识或培训，对提供有关体育活动的具体建议感到不舒服，以及在改变患者行为方面缺乏成功相比之下，培训是医疗保健专业人员向患者推广体育活动的关键促进因素先前评估移动医疗保健专业人员计划效果的研究报告称，40%接受过促进身体活动培训的专职医疗人员在培训后与患者进行了更多关于身体活动的对话因此，为了尽量减少眼保健中促进身体活动的障碍，应对眼保健专业人员进行培训。培训应确保眼保健专业人员有信心，他们可以有效地促进体育活动。为了使这种培训有效，它需要在一个组织内提供，让从业者有时间促进体育活动作为他们实践的一部分，并鼓励人们合作工作，以尽量减少个人的时间负担。培训应提供明确的目标，对眼科专业人员的期望应是可以实现的。14此外，环境资源应促进在眼保健环境中促进身体活动。例如，应该提供易于阅读的信息，描述当地的体育活动团体或服务，眼科保健专业人员可以将患者转介给他们。先前的研究表明，瑜伽、平衡训练、太极拳和以舞蹈为基础的干预措施可以改善视力障碍患者的平衡和活动能力，15这些可能是患者可以参考的身体活动团体或服务的例子，特别是对于那些被确定有跌倒风险的患者。
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引用次数: 0
Lifestyle Medicine List of Reviewers 生活方式医学评审员名单
Q3 Medicine
Lifestyle medicine (Hoboken, N.J.)
Pub Date : 2022-04-22 DOI: 10.1002/lim2.58

Lifestyle Medicine would like to thank the following people for their invaluable contribution to the peer-review process during 2021.

Allan, R. United Kingdom

Amusa, Ganiyu Adeniyi Nigeria

Anderson, Hermione United Kingdom

Barata, Bernardo Portugal

Barua, Lingkan Bangladesh

Chowdhury, M. A. B. United States

Ehrlich, Anna United Kingdom

El-Hamd, Mohammed Abu Egypt

Fair, Cynthia D. United States

Falloon, Karen New Zealand

Fayet-Moore, Flávia Australia

Findlater, Hannah United Kingdom

Haq, Shah Md Atiqul Bangladesh

Heath, Rory United Kingdom

Jóhannsson, Guðmundur Iceland

Junghans Minton, Connie United Kingdom

Lawson, Rob United Kingdom

Manger, Sam Australia

Maniatopoulos, Greg United Kingdom

Maselli, Luigi Italy

Massahikhaleghi, Parissa Iran (the Islamic Republic of)

Massey, Heather United Kingdom

Mercore, Emanuela Romania

Mineviciene, Egle Lithuania

Mishu, Masuma United Kingdom

Monye, Ifeoma Nigeria

Nadolsky, Spencer United States

Ribeiro, Sandra Brazil

Scanlon, Jack United Kingdom

Schmitt-Egenolf, Marcus Sweden

Sholl, Jonathan France

Sizear, Monaemul Islam Netherlands

Sumego, Marianne United States

Symington, Emily United Kingdom

Thomson, Richard United Kingdom

Tokell, Marisa United Kingdom

Ulasoglu, Celal Turkey

Ullah, Rahamat Bangladesh

Wardle, Jon Australia

Warmbrunn, Moritz V. Netherlands

Wilmore, Ellis

Yadav, Amit India

Zaman, Mostafa Bangladesh

Lifestyle Medicine感谢以下人士在2021年对同行评审过程做出的宝贵贡献。Allan，R.United KingdomAmusa、Ganiyu Adeniyi Nigeria Anderson、Hermien United Kingdom Barata、Bernardo Portugal Barua、Lingkan Bangladesh Chowdhury、M.A.B.United StatesHerlich、Anna United Kingdom El Hamd、Mohammed Abu EgyptFair、Cynthia D.United StatesFalloon，Karen New Zealand Fayet Moore，Flávia Australia Findlater，Hannah United KingdomHaq，Shah Md Atiqul Bangladesh Heath，Rory United Kingdom Jó，Emanuela Romania Mineviciene、Egle Lithuania Mishu、Masuma United KingdomMonye、Ifeoma Nigeria Nadolsky、Spencer United States Ribeiro、Sandra BrazilScanlon、Jack United Kingdom Schmitt Egenolf、Marcus SwedenSholl、Jonathan FranceSizear、Monaemul Islam Netherlands Sumego、Marianne United StatesSymington、Emily United KingdomThomson、Richard United KingtomTokell、Marisa United KingdomUlasoglu，Celal TurkeyUllah、Rahamat Bangladesh Wardle、Jon Australia Warmbrunn、Moritz V.Netherlands Wilmore、Ellis Yadav、Amit IndiaZaman、Mostafa Bangladesa
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