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

Introduction

Loneliness can have a negative impact on people's physical and psychological well-being; building social capital is a potential means of addressing this connection. Community initiatives (e.g. groups, clubs, neighbourhood activities) may be a route that enables people to build social capital to tackle loneliness. Understanding what is known, and where gaps in knowledge exist, is important for advancing research on this topic.

Methods

A scoping review was undertaken to explore the question – What community initiatives, with a focus on well-being, have been evaluated in the United Kingdom that include information about social capital and loneliness? Four databases (Medline, CINAHL, ASSIA and Embase) were searched for relevant research papers. References were screened by two researchers to identify if they met the review's inclusion criteria. Data were summarised as a narrative and in tables.

Results

Five papers met the review's inclusion criteria. They all used qualitative methods. Findings suggested that social capital could be developed through creating a sense of trust, group cohesion and reciprocity among participants in the community initiatives. This connection enabled people to experience a sense of belonging and to feel they had a meaningful relationship with others, which appeared to alleviate feelings of loneliness.

Conclusion

More research is warranted on the review topic, including studies that have employed quantitative or mixed methods. Clarity around definitions of social capital and loneliness in future research is required. Engagement with community initiatives can provide a formalised route to help people develop connections and counteract limitations in their social networks. However, individuals may be wary about attending community initiatives, needing support and encouragement to do so. Social prescribing link workers are one means of motivating people to access groups, events or organisations that could improve their well-being.

Introduction

The behaviour change technique taxonomy version 1 was developed to identify the smallest active ingredients of a lifestyle intervention, that is, behaviour change techniques (BCTs) based on a written description. By participation and direct observation of an intervention, we intend to not only identify BCTs but also assess exposure time for each BCT. Adding the dimension of exposure time should enable us to make quantitative comparisons between the different BCTs employed. We intend to demonstrate this by studying the hypotheses that exposure to information-related BCTs is similar for all targeted lifestyle modalities but decreases in the course of the intervention.

Methods

During 5-week intensive multimodal lifestyle interventions at a Swedish clinic for lifestyle medicine, we identified BCTs according to behaviour change technique taxonomy version 1 and noted exposure times to BCTs in all mandatory parts of the behaviour change intervention.

Results

Two hundred thirty-one independent intervention components were evaluated. BCTs 8.1 Behavioural practice/rehearsal (126 h), 4.1 Instruction on how to perform the behaviour (98 h) and 6.1 Demonstration of the behaviour (65 h) were the most common in terms of exposure time. Relative exposure to BCTs with an informative nature was similar for the different treatment phases (33%−37%−28%; p = 0.09) but higher for physical activity compared to food habits, stress management and unspecific lifestyle medicine (63%−25%−22%−25%; p < 0.001).

Conclusions

The behaviour change technique taxonomy version 1 can be extended by adding exposure time for different BCTs. The resulting BCT–exposure profile can be used for assessing the relative importance of different behaviour change strategies.

Introduction

With the rapid growth of urbanization globally and in the UK, increasing attention is now being directed towards urban green spaces (UGS). The appeal of UGS to policymakers lies in their capacity to address multiple policy objectives, including improving physical and mental wellbeing, mitigating noncommunicable diseases (NCDs), combating climate change through carbon sequestration, providing climate adaptation measures, and enhancing biodiversity.

Method

This narrative review gives an overview of the current literature and UK policy relating to urban green and blue spaces, with a particular focus on the use of UGS to increase physical activity levels.

Results

UGS have a profound impact on public health, with evidence indicating their positive effect on both physical and psychological health. Thirty-eight percent of adults in the UK do not live within 15 minutes of UGS, so policy makers at national and international level are aiming to address this gap. One reason for the health benefits of UGS is associated increased physical activity, a vital component needed to address the burden of non-communicable disease. To effectively harness UGS to promote physical activity various factors must be considered; proximity and diversity of urban green spaces, and the presence of suitable infrastructure features. Tailoring UGS to meet the needs and preferences of different population demographics is essential, as is ensuring safety, and addressing barriers to access particularly for lower socio-economic groups. The careful planning of UGS must avoid potential gentrification effects and displacement of vulnerable communities, whilst utilising the equigenic nature of UGS.

Conclusions

To create a brighter future and capitalize on the potential of UGS, a collaborative approach is needed, involving communities, local governments, and national authorities. Primary-care professionals, represented by organizations like the Royal College of General Practitioners (RCGP), can play a crucial role in advocating for UGS and physical activity, promoting their use, and providing guidance and support.

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.