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

In this commentary, we strive to illustrate common misconceptions of the dopamine fasting fad that has become popular among wellness enthusiasts and purported by health gurus. Here, we review the proposed Dopamine fasting technique for managing behavioral addictions as proposed by California psychiatrist Dr. Cameron Sepah. We first summarize correct and incorrect interpretations of what Dopamine fasting involves. Next, we contextualize the role of dopamine as it relates to behavioral modification interventions for addiction. Particularly, we discuss the role of dopamine in behavioral addiction and the effectiveness of cognitive behavioral therapy (CBT) techniques for various addictions which are the basis of the proposed dopamine fasting technique. While we see potential for dopamine fasting to offer significant benefits to individuals, we highlight the limitation of the self-guided aspect of dopamine fasting, which could pose physical and emotional harm to individuals if the guideline is misinterpreted or misused as the sole treatment for severe disorders which require clinician input. Future studies should aim to assess not only the scientific efficacy of dopamine fasting as a potential treatment approach for behavioral addiction, but also the needs and well-being of individuals who seek self-directed treatment from popular media trends.

Background: Understanding the clinical features of COVID-19 and duration for resolution of symptoms is crucial for isolation of patients and tailoring public health messaging, interventions and policy. Therefore, this study aims to assess the median duration of COVID-19 signs and symptoms' resolution and explore its predictors among symptomatic COVID-19 patients in Ethiopia.

Methods: A hospital-based prospective cohort study involving 124 COVID-19 cases was conducted at Eka Kotebe General Hospital, COVID-19 Isolation and Treatment Center. The study participants were all symptomatic COVID-19 adult patients admitted to the hospital from 18 March to 20 August 2020. Physicians at the centre recorded the data using a log sheet. Cox proportional-hazards regression model was conducted. Statistical significance was defined at P < 0.05.

Results: A total of 124 symptomatic COVID-19 patients with a mean age of 42 years (±17) were involved in the study. The median duration of symptom resolution of COVID-19 was seven days with a minimum of two and a maximum of sixty-eight days. Sex and body mass index (BMI) were statistically significant predictors of the symptom resolution. The hazard of having delayed sign or symptom resolution in males was 55% higher than in females (P = 0.039; CI: 0.22-0.96) and the hazard of delayed sign or symptom resolution in those with BMI ≥ 25 kg/m² was 35% higher than in those with BMI < 25 kg/m² (P = 0.041; CI: 0.44-0.98]).

Conclusions: The median duration of COVID-19 symptom resolution was seven days. Being male and/or having a BMI ≥ 25 kg/m² were predictors of a delayed sign or symptom resolution time. Therefore, it is important to consider proportion of males and those with BMI ≥ 25 kg/m² when preparing isolation and treatment centres. Males and individuals with BMI ≥ 25 kg/m² shall also be given priority when shielding from the COVID-19.

There is a rising burden of lifestyle-related non-communicable disease across all age groups around the world that is reaching epidemic proportions. Over half (58%) of the UK population over 60 is living with one or more long-term conditions,¹ and this prevalence is expected to increase significantly in the next decade. By their very nature, lifestyle-related conditions have an insidious onset and a protracted period of morbidity that negatively impacts quality of life. This places significant pressure on individuals, health systems, economies and society.

The current pandemic has highlighted how significantly more vulnerable people with long-term conditions are to other health challenges. Those living with diabetes and obesity have a higher risk of attending hospital and an increased case-fatality rate for COVID-19 when compared to non-diabetic and non-obese individuals of the same age.² Self-care and personal lifestyle behaviours that improve metabolic health could lead to better health outcomes from infectious disease and, as previously highlighted in this journal, at a population level are an important aspect of pandemic preparedness.³

A key question for healthcare practitioners and healthcare systems today is how to turn the tide on lifestyle-related conditions in a way that is person-centred. This challenge is even more prescient now in the context of the post-COVID era, as virtual care has quickly become the new normal.

There are more than 139 definitions of self-care in the academic literature.⁴ The Self Care Forum UK describes self-care as ‘the actions that individuals take for themselves, on behalf of and with others in order to develop, protect, maintain and improve their health, well-being or wellness.’⁵

The World Health Organisation (WHO) and the International Self-Care Foundation (ISF) have varying definitions of self-care. Perhaps more helpful is to conceptualise self-care as a series of activities, which can be conveniently grouped into the seven pillars of self-care⁶ as follows: (1) knowledge and health literacy, (2) mental well-being, (3) physical activity, (4) healthy eating, (5) risk avoidance, (6) good hygiene practices and (7) the rational service use of products and services.⁷ These bear very clear resemblance and overlap to the six pillars of lifestyle medicine such that the antecedents and interventions are closely related: (1) healthy eating, (2) physical activity, (3) avoiding toxins, (4) managing stress, (5) sleep and (6) nurturing relationships.⁸

Until recently, self-care was not much talked about in the context of healthcare. It was often implied that self-caring was tantamount to ‘no care’ due to an abdication of responsibility by health professionals, leaving patients to ‘fend for themselves’ w