Lifestyle medicine (Hoboken, N.J.)最新文献

Aims

To determine the impact of a multi-component exercise intervention on the cure rate of urinary incontinence (UI) among older women living in the community.

Method

A systematic search was conducted of five databases (Medline, Cumulative Index to Nursing and Allied Health Literature [CINAHL], Academic Search Complete, PubMed and Web of Science), grey literature and reference lists of relevant studies in December 2021– January 2022 and again between January 2023 and February 2023 when no additional new studies were identified. Key inclusion criteria were studies with female older adults above the age of 60, with any type of UI, residing in the community, addressing the effects of a multi-component exercise intervention combining pelvic floor muscle training (PFMT), strength and balance exercises. The primary outcome of interest was the cure rate of UI in community-dwelling older women (%).

Studies underwent quality appraisal using the RevMan Risk of Bias tool and the Evidence-based Librarianship tool, identifying significant biases. A narrative synthesis presents results for all outcomes; a meta-analysis was also performed for secondary outcomes.

Results

Following the PRISMA 2020 guidelines, a total of 596 records were identified from the systematic search. Five studies met the inclusion criteria. Participants receiving the intervention had a statistically significant mean cure rate of 44.0% (p < 0.05), which decreased at follow-up, except for participants with stress UI. Participants receiving the intervention had significantly decreased frequency of UI episodes (p < 0.00001) and increased maximum walking speed (p < 0.0003) at a 3-month follow-up.

Conclusion

A multi-component exercise, combining PFMT, strength and balance exercises, is effective in improving and curing UI, especially stress UI, in community-dwelling older women.

We developed a high-resolution and noninvasive multichannel urodynamic system combined with a novel signal-processing algorithm tailored to extract electromyographic (EMG) activity from the urinary bladder. We utilized a flexible noninvasive biopotential recording system to collect an array of EMG signals from the urinary bladder of human subjects. This study also presents the use of an existing artifact rejection methodology to autonomously extract an EMG signal from an environment prone to motion artifacts.

Introduction

Despite the increasing popularity of social media, little research has been conducted on its impact on lifestyle behaviors and health outcomes among adults. This study aimed to investigate whether more frequent social media screen time use is associated with poorer lifestyle behaviors, overweight or obesity, and depressive symptoms. Additionally, this study examined the potential use of social media to positively influence health.

Methods

An anonymous one-time survey was conducted among English-speaking social media users aged 18–34 in Southern California. Self-reported height and weight were used to calculate body mass index (BMI), and the Patient Health Questionnaire-9 (PHQ-9) was used to estimate the severity of depressive symptoms. A cumulative risk score for lifestyle behaviors was also tallied. Three focus groups were held with a subset of the survey population to gain insights on social media, lifestyle behaviors, and health. A mixed method analysis was used to analyze the data.

Results

The survey data of 86 complete cases showed a positive correlation (r = 0.421; p < 0.001; 95% confidence interval [CI] [0.223, 0.585]) among PHQ-9 depression scores and negative correlation (r = −0.230; p = 0.033; 95% CI [−0.426, −0.12]) for BMI compared to actual social media screen time usage, respectively. However, social media screen time usage ≥3 h showed no association for either BMI, depressive symptoms, or cumulative risk score. Participants viewed social media as a “double-edged sword,” providing benefits such as “connection” and “information sharing,” but also having a negative impact on mental health (theme 1). Participants also believed public health needs to take a more proactive role in using social media, while social media platforms should manage the “authenticity” of content and modify their “algorithms” to improve health and lifestyle practices (theme 2).

Conclusions

This study suggested that social media may have some protective benefits related to becoming overweight or obese as indicated by the focus group participants, but further research is needed on the relationship between social media screen time usage and adult mental health. Social media platforms may have the potential to promote positive lifestyle behaviors and improve health if used properly.

Background

Breast cancer is the most common type of cancer, accounting for 15% of all new cases. Hormone therapy (HT) is extremely effective in reducing breast cancer recurrence. However, adherence to HT medication is often poor due to negative side effects such as fatigue and sleep disturbances. Physical activity has been identified as a possible intervention to improve quality of life and reduce side effects of HT.

Objective

The objective of this systematic review was to summarise evidence of exercise interventions for women being treated with HT for breast cancer.

Method

Electronic searches were conducted from inception to March 2022 using Medline, SPORTdiscus, Embase, Scopus, PsycINFO and Web of Science databases. Searches included a combination of terms related to breast cancer, exercise, sleep disturbances, fatigue and HT.

Results

Ten eligible papers were identified, and their quality was assessed. Type, frequency, duration and intensity of exercise interventions varied. Exercise types included aerobics, strength/resistance training, walking and yoga. Heterogeneity of data made it difficult to draw conclusions. However, aerobic exercise interventions provide clear improvements in fatigue and sleep disturbances.

Conclusions

This review identified a lack of consistency in exercise recommendations for women being treated for breast cancer. It identifies that aerobic exercise can successfully improve fatigue and sleep disturbances, consistent with existing literature. Exercise has a range of benefits for this population, including improving psychological well-being and quality of life. Clinicians should strongly advocate for engagement in exercise to promote overall physical and psychological well-being in women being treated for breast cancer.

Introduction

Multiple domains of cognitive function decline with age, resulting in a significant burden on quality of life and the healthcare system. Recent studies increasingly point to links between muscle mass, particularly low muscle mass, and risk of cognitive decline. However, complex relationships exist between muscle mass, muscle function, physical activity, and overall health.

Methods

Data from 1,424 adults 60+ years old in the 1999-2000 and 2001-2002 editions of the National Health and Nutrition Examination Survey (NHANES) were used to investigate the relationship between low muscle mass and cognitive function after accounting for strength, physical activity, and nutritional and metabolic risk factors for cognitive decline.

Results

Muscle strength and physical activity independently predicted performance in the digit symbol substitution test, with muscle mass and muscle strength explaining 0.5% and 5% of the variance in cognitive function, respectively. In graphical network analyses, the association between low muscle mass and cognitive function appeared to be primarily mediated by neuromuscular function. Physical activity was associated with strength but, surprisingly, not muscle mass, which was instead more closely related to total mass.

Conclusions

Low muscle mass is a relatively poor predictor of cognitive function after accounting for physical activity and strength in older individuals from a representative population dataset in the US. Future studies should account for the way in which muscle mass is accrued, which is likely to confound any association between muscle mass and health outcomes.

Background

The production and consumption of red and processed meat negatively impacts individual and planetary health. The 2021 Lancet countdown on health and climate change report stated that 842,000 deaths annually are due to excess red meat consumption, whilst its production is responsible for more than 50% of food-related greenhouse gas emissions. As part of the National Health Service's net-zero emissions strategy, King's College Hospital has committed to transitioning to a plant-based food environment and removing processed red meat from menus.

Aims

To ascertain patients' attitudes to the removal of processed and unprocessed red meat from menus

Material and methods

We conducted a survey of 118 patients using in-person interviews.

Results

Most patients did not consider serving processed red meat (74%) or unprocessed red meat (66.1%) important to them and most patients (77.9%) were neutral or supportive of removing processed red meat from menus to reduce the risk of cancer. Most patients (67%) were also supportive of removing unprocessed red meat from menus to combat climate change. The majority would choose chicken or fish in place of red meat.

Conclusion

These data show that patients would support the removal of red meat from hospital menus, but more education is required to support patients to select plant-based options.

Introduction

Patient partnerships are vitally important in improving healthcare delivery, however they are underutilised for this purpose.

Methods

Here, I discuss how the COVID-19 pandemic has presented challenges for health equity but has also presented unique opportunities for enhancing the role of the service user in driving evidence generation, tackling inequality and service design.

Results

The COVID-19 pandemic has highlighted and exacerbated inequality in healthcare. Existing legislation and literature on patient involvement and inequality is largely limited in scope. However, co-production of evidence with service users and carers, as well as incorporating advocacy and involving these groups in service design, all have significant potential to achieve meaningful integration of their views and preferences in healthcare.

Conclusion

There is significant scope to move beyond ‘lip service’ in patient involvement within healthcare. The COVID-19 pandemic has highlighted the importance of, as well as the potential for, substantive participation of patients and the public in healthcare design and delivery.

The objective

to provide an overview of the literature on the barriers and facilitators to physical activity (PA) promotion in primary care, as experienced by practitioners and patients.

Method

A search strategy of the English-language literature was conducted in EMBASE, MEDLINE and the COCHRANE LIBRARY. Search terms were primary care OR general practice OR family medicine OR family practitioner AND physical activity OR exercise AND barriers OR facilitators. Databases were searched from inception until 21 October 2022.

Results

After screening, 63 articles were included within the summary and content analysis of this review. Analysis of the barriers to the implementation of PA highlighted four main themes perceived by practitioners: time, knowledge/skills, resources/support and financial implications. Analysis of the patient perspective identified themes which were categorised into individual (pre-existing health conditions, knowledge of benefits of PA, time/capacity), societal (social support and cultural norms) and environmental (availability of facilities and weather).

Conclusions

As the importance of PA increases through the manifestation of sedentary behaviour-related disease, a combined primary care and public health approach to increase PA is required. By identifying the main barriers to PA promotion in primary care, resources and funding can be directed to address this. This is particularly relevant in the United Kingdom, with the re-negotiation of the primary care contract and the changes to healthcare delivery as a consequence of the Covid-19 pandemic. Throughout this review, we have explored ways of addressing the identified barriers through evidence-based interventions.