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Examination of Maternal Allostatic Load Among Postpartum Women With Distinct Postpartum Symptom Typologies. 具有明显产后症状类型的产后妇女产妇适应负荷的检查。
Pub Date : 2024-04-01 Epub Date: 2023-11-21 DOI: 10.1177/10998004231217680
Jihye Kim Scroggins, Qing Yang, Sarah K Dotters-Katz, Debra Brandon, Karin Reuter-Rice

Background: An increased allostatic load (cumulative physiologic wear and tear of the body) can lead to adverse health outcomes. Symptom experiences are known to influence allostatic load. Yet, the relationships between postpartum symptom typologies and maternal allostatic load remain unknown.

Methods: We used Community Child Health Network data and included participants with allostatic load data at 6, 12, or 24 months postpartum. Bivariate and multivariate analyses were conducted to examine associations between postpartum symptom typologies and (a) overall allostatic load, (b) allostatic load subscales for body systems (neuroendocrine, cardiovascular, metabolic, and inflammatory), and (c) individual biomarkers within the subscale.

Results: Overall allostatic load at 12 months postpartum was different by symptom typologies before (p = .042) and after adjusting for confounders (p = .029). Postpartum women in typology 5 (high overall) had the highest adjusted overall allostatic load (M = 4.18, SE = .27). At 12 months, adjusted allostatic load for the cardiovascular subscale was higher in typologies 3 (moderate-high sleep symptoms, M = 1.78, SE = .13) and 5 (high overall, M = 1.80, SE = .17). Within the cardiovascular subscale, those in typology 3 had higher adjusted odds for a clinically significant level of pulse rate (aOR = 2.01, CI = 1.22, 3.31).

Conclusion: Postpartum women who experienced high symptom severity across all symptoms (typology 5) at 6 months had higher overall allostatic load at 12 months postpartum. Typologies 3 and 5 had the highest symptom severity in sleep-related symptoms and higher cardiovascular subscale scores. Postpartum symptom management should target symptom burden in an effort to reduce allostatic load thereby improving postpartum women's health outcomes.

背景:增加的适应负荷(身体的累积生理磨损)可导致不良的健康结果。已知症状经历会影响适应负荷。然而,产后症状类型与产妇适应负荷之间的关系尚不清楚。方法:我们使用社区儿童健康网络的数据,并纳入了产后6、12或24个月的适应负荷数据。进行了双变量和多变量分析,以检查产后症状类型与(a)总体适应负荷,(b)身体系统(神经内分泌、心血管、代谢和炎症)适应负荷亚量表,以及(c)亚量表中的个体生物标志物之间的关系。结果:产后12个月的总适应负荷在调整混杂因素前(p = 0.042)和调整混杂因素后(p = 0.029)因症状类型不同而不同。类型5(总体高)的产后妇女调整后总体适应负荷最高(M = 4.18, SE = 0.27)。在12个月时,心血管亚量表调整后的适应负荷在类型3(中高睡眠症状,M = 1.78, SE = 0.13)和5(总体高,M = 1.80, SE = 0.17)中较高。在心血管亚量表中,3型患者的脉搏率达到临床显著水平的调整几率更高(aOR = 2.01, CI = 1.22, 3.31)。结论:在产后6个月所有症状(类型5)中症状严重程度较高的产后妇女在产后12个月的总适应负荷较高。类型3和5在睡眠相关症状中症状严重程度最高,心血管亚量表得分也较高。产后症状管理应针对症状负担,努力减少适应负荷,从而改善产后妇女的健康结果。
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引用次数: 0
Autobiographical Cerebral Network Activation in Older Adults Before and After Reminiscence Therapy: A Preliminary Report. 老年人回忆疗法前后自传性脑网络激活的初步报告。
Pub Date : 2024-04-01 Epub Date: 2023-10-31 DOI: 10.1177/10998004231210982
Armelle Viard, Andrew P Allen, Caoilainn M Doyle, Mikaël Naveau, Arun L W Bokde, Hervé Platel, Francis Eustache, Sean Commins, Richard A P Roche

Introduction: Reminiscence therapy (RT), which engages individuals to evoke positive memories, has been shown to be effective in improving psychological well-being in older adults suffering from PTSD, depression, and anxiety. However, its impact on brain function has yet to be determined. This paper presents functional magnetic resonance imaging (fMRI) data to describe changes in autobiographical memory networks (AMN) in community-dwelling older adults.

Methods: This pilot study used a within-subject design to measure changes in AMN activation in 11 older adults who underwent 6 weeks of RT. In the scanner, participants retrieved autobiographical memories which were either recent or remote, rehearsed or unrehearsed. Participants also underwent a clinical interview to assess changes in memory, quality of life, mental health, and affect.

Findings: Compared to pretreatment, anxiety decreased (z = -2.014, p = .040) and activated significant areas within the AMN, including bilateral medial prefrontal cortex, left precuneus, right occipital cortex, and left anterior hippocampus.

Conclusion: Although RT had subtle effects on psychological function in this sample with no evidence of impairments, including depression at baseline, the fMRI data support current thinking of the effect RT has on the AMN. Increased activation of right posterior hippocampus following RT is compatible with the Multiple Trace Theory Theory (Nadel & Moscovitch, 1997).

引言:回忆疗法(RT)让个体唤起积极的记忆,已被证明能有效改善患有创伤后应激障碍、抑郁和焦虑的老年人的心理健康。然而,它对大脑功能的影响尚待确定。本文介绍了功能磁共振成像(fMRI)数据,以描述居住在社区的老年人自传体记忆网络(AMN)的变化。方法:这项试点研究使用受试者内部设计来测量11名接受6周RT的老年人AMN激活的变化。在扫描仪中,参与者检索到最近或远程、排练或未排练的自传体记忆。参与者还接受了一次临床访谈,以评估记忆、生活质量、心理健康和情感的变化。研究结果:与预处理相比,焦虑降低(z=-2.014,p=.040),并激活了AMN内的重要区域,包括双侧内侧前额叶皮层、左侧楔前叶、右侧枕叶皮层和左侧前海马。结论:尽管RT对该样本的心理功能有细微影响,没有证据表明有损伤,包括基线时的抑郁,但功能磁共振成像数据支持目前对RT对AMN影响的看法。RT后右后海马的激活增加符合多痕迹理论(Nadel&Moscovitch,1997)。
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引用次数: 0
The Effect of Lullabies and Classical Music on Preterm Neonates' Cerebral Oxygenation, Vital Signs, and Comfort During Orogastric Tube Feeding: A Randomized Controlled Trial. 摇篮曲和古典音乐对早产儿经口管喂养期间大脑氧合、生命体征和舒适度的影响:一项随机对照试验。
Pub Date : 2024-04-01 Epub Date: 2023-09-22 DOI: 10.1177/10998004231202404
Esra Bağli, Sibel Küçükoğlu, Hanifi Soylu

Objective: This study investigated the effect of lullabies and classical music on preterm neonates' cerebral oxygenation, vital signs, and comfort during orogastric (OG) tube feeding.

Methods: This was a parallel-group pretest-posttest randomized controlled study. The research was conducted between December 2020 and May 2022. The sample consisted of 51 preterm neonates hospitalized in the neonatal intensive care unit (NICU) of Selçuk University Faculty of Medicine Hospital in Konya, Türkiye. Participants were randomized into three groups (17 preterm infants in each group). The first group listened to lullabies sung by their mothers and the second group listened to classical music during OG tube feeding. The control group received routine care with no music. Data were collected using a Neonatal Identification Information Form, Physiological Parameters and rSO2 Monitoring Form, and the Newborn Comfort Behavior Scale (Comfort-Neo). The study was registered on the ClinicalTrials database (NCT05333575).

Results: The lullaby group had stable peak heart rates and oxygen saturation levels (p = .002). Both lullaby and classical music groups had significantly higher cerebral oxygenation levels than the control group. The classical music group had the highest cerebral oxygenation level (p = .001). Both lullaby and classical music groups had significantly higher mean Comfort-Neo scores than the control group. The classical music group had the highest mean Comfort-Neo score (p = .040).

Conclusion: Preterm neonates who listen to lullabies and classical music are likely to have higher cerebral oxygen and comfort levels. Listening to lullabies helps stabilize vital signs. These results suggest that healthcare professionals should encourage parents to get their preterm neonates to listen to lullabies and classical music.

目的:研究摇篮曲和古典音乐对早产儿经口管喂养时脑氧合、生命体征和舒适度的影响。方法:这是一项平行组的前测后测随机对照研究。该研究于2020年12月至2022年5月期间进行。样本包括51名在土耳其科尼亚塞尔库克大学医学院医院新生儿重症监护室(NICU)住院的早产儿。参与者被随机分为三组(每组17名早产儿)。第一组听母亲唱的摇篮曲,第二组在OG管饲期间听古典音乐。对照组在没有音乐的情况下接受常规护理。使用新生儿识别信息表、生理参数和rSO2监测表以及新生儿舒适行为量表(Comfort Neo)收集数据。该研究已在临床试验数据库(NCT05333575)中注册。结果:摇篮曲组有稳定的峰值心率和血氧饱和度水平(p=0.002)。摇篮曲组和古典音乐组的脑氧合水平均显著高于对照组。古典音乐组的大脑氧合水平最高(p=0.001)。摇篮曲组和古典音乐组都显著高于对照组的Comfort Neo平均得分。古典音乐组的Comfort Neo平均得分最高(p=0.040)。结论:听摇篮曲和古典音乐的早产儿可能有更高的脑氧和舒适水平。听摇篮曲有助于稳定生命体征。这些结果表明,医疗保健专业人员应该鼓励父母让早产儿听摇篮曲和古典音乐。
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引用次数: 0
Nasal Irrigation Improves the Nasal Related Quality of Life in Patients Undergoing Transsphenoidal Resection of Pituitary Adenoma. 鼻腔冲洗可改善经蝶垂体腺瘤切除术患者与鼻腔相关的生活质量。
Pub Date : 2024-04-01 Epub Date: 2023-12-11 DOI: 10.1177/10998004231221548
Aiping Mu, Zhuojun Ni, Chen Ma

Background: After transsphenoidal pituitary adenoma resection patients have reduced olfactory function and quality of life. This study aimed to evaluate the effects of nasal irrigation on the nasal related quality of life in patients undergoing transsphenoidal pituitary adenoma resection. Methods: Patients undergoing transsphenoidal resection of pituitary adenomas in a tertiary hospital in China were included. The patients were randomly divided into a control group and nasal irrigation group according to the random sequence generated by the SPSS22.0 software. The 22-item sino-nasal outcome test (SNOT-22) was used to evaluate nasal related quality of life; lower SNOT-22 scores indicate a higher quality of life. The Toyota and Takagi (T&T) olfactometer test was used to evaluate the olfactory function of patients. Results: A total of 82 patients were finally included. The SNOT-22 scores of both groups after surgery were significantly higher than those before surgery (p < .05). The total SNOT-22 score of nasal irrigation group at one month (23.45 ± 3.72 vs. 27.48 ± 4.07) and three months (15.83 ± 2.86 vs. 21.82 ± 3.36) after surgery was lower than that in the control group (p < .05). There was no significant difference in olfactory function between the two groups at one month and three months after surgery (p > .05). The nasal mucosal score in the nasal irrigation group was significantly improved compared with the control group at one month and three months after surgery (p < .05). Conclusion: Nasal irrigation is associated with improved quality of life in patients undergoing transsphenoidal pituitary adenoma resection compared with the control group.

背景:经蝶垂体腺瘤切除术后,患者的嗅觉功能和生活质量下降。本研究旨在评估鼻腔冲洗对经鼻垂体瘤切除术患者鼻腔相关生活质量的影响。研究方法纳入在中国一家三甲医院接受经鼻垂体腺瘤切除术的患者。根据 SPSS22.0 软件生成的随机序列将患者随机分为对照组和鼻腔冲洗组。采用 22 项鼻腔结果测试(SNOT-22)来评估与鼻腔相关的生活质量;SNOT-22 分数越低,表示生活质量越高。丰田和高木(T&T)嗅觉测试用于评估患者的嗅觉功能。结果:最终共纳入 82 名患者。两组患者术后的 SNOT-22 评分均明显高于术前(P .05)。鼻腔灌流组术后一个月(23.45 ± 3.72 vs. 27.48 ± 4.07)和三个月(15.83 ± 2.86 vs. 21.82 ± 3.36)的 SNOT-22 总分低于对照组(P .05)。两组患者术后一个月和三个月的嗅觉功能无明显差异(P > .05)。与对照组相比,鼻腔灌洗组的鼻粘膜评分在术后一个月和三个月有明显改善(P .05)。结论:与对照组相比,鼻腔冲洗可改善经蝶垂体腺瘤切除术患者的生活质量。
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引用次数: 0
Biomarkers of Stress and Inflammation in Children. 儿童应激和炎症的生物标志物。
Pub Date : 2023-10-01 Epub Date: 2023-04-03 DOI: 10.1177/10998004231168805
Sara L Davis, Mary Latimer, Marti Rice

Background: Children are increasingly exposed to stressors that can affect their immune function. Given the possible negative effects of stress and inflammation on health, researchers need to use appropriate biomarkers to measure both the effects of stress and subsequent inflammatory responses. Purpose: The purpose of this paper is to briefly review stress and inflammatory pathways, identify biomarkers used to measure chronic stress and chronic inflammation particularly in children in clinical and community settings, and to discuss methodological considerations when measuring stress and inflammation in children. Discussion: Biomarkers of chronic stress can be classified as central, meaning they are made in the brain, or peripheral, meaning they are made in the peripheral tissues in response to central signals. The peripheral biomarker, cortisol, is most frequently used in the community setting. In addition, indirect measures, such as oxytocin, may complement the assessment of stress. Common biomarkers of chronic inflammation in children are C-reactive protein (CRP), TNF-α, and IL-6. Similarly, indirect biomarkers of chronic inflammation, such as IL-2 and IL-1β, may also be considered. Conclusions: Various types of specimens can be used to measure these biomarkers of stress and inflammation including blood, saliva, urine, sweat, hair, nails, and tears. Each type of specimen has different requirements for collection, storage, and assay. Future research would benefit from standardized biomarker levels across age and development in children and incorporation of other biomarkers.

背景:儿童越来越多地暴露在可能影响其免疫功能的压力源中。考虑到压力和炎症可能对健康产生的负面影响,研究人员需要使用适当的生物标志物来测量压力的影响和随后的炎症反应。目的:本文的目的是简要回顾压力和炎症途径,确定用于测量慢性压力和慢性炎症的生物标志物,特别是在临床和社区环境中的儿童,并讨论测量儿童压力和炎症时的方法考虑因素。讨论:慢性应激的生物标志物可以分为中枢,意味着它们是在大脑中产生的,也可以分为外周,意味着他们是在外周组织中对中枢信号做出反应而产生的。外周生物标志物皮质醇在社区环境中使用最频繁。此外,间接测量,如催产素,可以补充压力评估。儿童慢性炎症的常见生物标志物是C反应蛋白(CRP)、TNF-α和IL-6。同样,也可以考虑慢性炎症的间接生物标志物,如IL-2和IL-1β。结论:各种类型的标本可用于测量这些应激和炎症的生物标志物,包括血液、唾液、尿液、汗液、头发、指甲和眼泪。每种类型的标本对采集、储存和化验都有不同的要求。未来的研究将受益于儿童年龄和发育的标准化生物标志物水平以及其他生物标志物的结合。
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引用次数: 0
Influencing Factors and Nomogram for the Development of Epilepsy in Advanced Lung Cancer Patients With Brain Metastases. 晚期癌症脑转移患者癫痫发生的影响因素及脑电图。
Pub Date : 2023-10-01 Epub Date: 2023-05-03 DOI: 10.1177/10998004231173425
Niu Yuan, Zhang-Hong Lv, Ting-Yu Tao, Dan Qian

Background: Epilepsy is a prevalent comorbidity in patients with brain metastases (BM) and could result in sudden and accidental damage, as well as increased disease burden due to its rapid onset. Foreseeing the potential for the development of epilepsy may permit timely and efficient measures. This study aimed to analyze the influencing factors of epilepsy in advanced lung cancer (ALC) patients with BM and construct a nomogram model to predict the likelihood of developing epilepsy.

Methods: Socio-demographic and clinical data of ALC patients with BM were retrospectively collected from the First Affiliated Hospital of Zhejiang University School of Medicine between September 2019 and June 2021. Univariate and multivariate logistic regression analyses were applied to determine the influencing factors for epilepsy in ALC patients with BM. Based on the results of the logistic regression analysis, a nomogram was built to represent the contribution of each influencing factor in predicting the probability of epilepsy development in ALC patients with BM. The Hosmer-Lemeshow test and receiver operating characteristic (ROC) curve were utilized to evaluate the goodness of fit and prediction performance of the model.

Results: The incidence of epilepsy among 138 ALC patients with BM was 29.7%. On the multivariate analysis, having a higher number of supratentorial lesions (odds ratio [OR] = 1.727; p = 0.022), hemorrhagic foci (OR = 4.922; p = .021), and a high-grade of peritumoral edema (OR = 2.524; p < .001) were independent risk factors for developing epilepsy, while undergoing gamma knife radiosurgery (OR = .327; p = .019) was an independent protective factor. The p-value of the Hosmer-Lemeshow test was .535 and the area under the ROC curve (AUC) was .852 (95% CI: .807-.897), suggesting the model had a good fit and exhibited strong predictive accuracy.

Conclusion: The nomogram was constructed that can predict the probability of epilepsy development for ALC patients with BM, which is helpful for healthcare professionals to identify high-risk groups early and allows for individualized interventions.

背景:癫痫是脑转移瘤(BM)患者的常见合并症,可能会导致突然和意外的损伤,并因其发病迅速而增加疾病负担。预见癫痫发展的潜力可以及时采取有效的措施。本研究旨在分析患有BM的晚期癌症(ALC)患者癫痫的影响因素,并构建列线图模型来预测癫痫发生的可能性。方法:回顾性收集2019年9月至2021年6月浙江大学医学院第一附属医院ALC BM患者的社会人口学和临床数据。应用单变量和多变量逻辑回归分析来确定患有BM的ALC患者癫痫的影响因素。基于逻辑回归分析的结果,建立列线图来表示每个影响因素在预测患有BM的ALC患者癫痫发展概率方面的贡献。利用Hosmer-Lemeshow检验和受试者工作特性(ROC)曲线来评估模型的拟合优度和预测性能。结果:138例ALC BM患者的癫痫发生率为29.7%。在多变量分析中,幕上病变数量较高(比值比[OR]=1.727;p=0.022)、出血灶(OR=4.922;p=0.021)和肿瘤周围水肿程度较高(OR=2.524;p<.001)是发生癫痫的独立危险因素,而接受伽玛刀放射外科治疗(OR=0.327;p=.019)是一个独立的保护因素。Hosmer-Lemeshow检验的p值为.535,ROC曲线下面积(AUC)为.852(95%CI:0.807-.897),表明该模型具有良好的拟合性,并表现出很强的预测准确性。结论:构建的列线图可以预测患有BM的ALC患者发生癫痫的概率,这有助于医护人员早期识别高危人群,并允许个体化干预。
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引用次数: 0
Composite Biomarkers, Behavioral Symptoms, and Comorbidities in Axial Low Back Pain: A Systematic Review. 轴性腰痛的复合生物标志物、行为症状和合并症:系统综述。
Pub Date : 2023-10-01 Epub Date: 2023-05-04 DOI: 10.1177/10998004231171146
Anitha Saravanan, Jinbing Bai, Prempreet Bajaj, Elizabeth Sterner, Mahalakshmi Rajagopal, Sameera Sanders, Anne Luckose, Michael Kushnick, Angela Starkweather

Purpose: Proinflammatory cytokines play a critical role in chronic inflammation and pain and contribute to behavioral symptoms (depressive symptoms, anxiety, fatigue, sleep disturbance) and comorbidities (diabetes, cardiac diseases, cancer). Evidence is lacking on the specific proinflammatory cytokines associated with these behavioral symptoms/comorbidities co-occurring with axial low back pain (aLBP). This review aimed to systematically analyze the following: (1) specific proinflammatory cytokines associated with aLBP in adults, (2) associations among proinflammatory cytokines and behavioral symptoms in aLBP, and (3) relationships among proinflammatory cytokines and comorbidities in aLBP, to develop a new clinical framework for future diagnostic and intervention targets for patients with aLBP.

Methods: Electronic databases, including PubMed/MEDLINE, ProQuest Nursing & Allied Health Source, and CINAHL Complete (EBSCO) were searched for the period January 2012 to February 2023. Eligible studies included cross-sectional, case-control, longitudinal, and cohort studies in which proinflammatory cytokines were reported in adults above 18 years with aLBP. Intervention studies and randomized controlled trails were excluded. The Joanna Briggs Institute (JBI) criteria were used for quality evaluation.

Results: Findings from 11 studies showed 3 proinflammatory cytokines associated with pain intensity in adult patients with aLBP: C-Reactive Protein (CRP), Tumor Necrosis Factor (TNF-α), and Interleukin (IL-6). Some studies assessed associations between proinflammatory cytokines and depressive symptoms; none explored the association of proinflammatory cytokines with fatigue, anxiety, sleep disturbance, or comorbidities (diabetes, cardiac diseases, and cancer) in aLBP.

Conclusions: Proinflammatory cytokines in aLBP can serve as composite biomarkers for pain, associated symptoms, and comorbidities and may serve as a target for future interventions. There is need for well-designed studies assessing associations among chronic inflammation, behavioral symptoms, and comorbidities.

目的:炎性细胞因子在慢性炎症和疼痛中起着关键作用,并导致行为症状(抑郁症状、焦虑、疲劳、睡眠障碍)和合并症(糖尿病、心脏病、癌症)。缺乏与这些行为症状/并发轴性腰痛(aLBP)的合并症相关的特异性促炎细胞因子的证据。这篇综述旨在系统地分析以下内容:(1)成人中与aLBP相关的特异性促炎细胞因子,为aLBP患者的未来诊断和干预目标开发一个新的临床框架。方法:检索2012年1月至2023年2月期间的电子数据库,包括PubMed/MEDLINE、ProQuest Nursing&Allied Health Source和CINAHL Complete(EBSCO)。符合条件的研究包括横断面、病例对照、纵向和队列研究,其中在18岁以上患有aLBP的成年人中报告了促炎细胞因子。干预研究和随机对照试验被排除在外。乔安娜·布里格斯研究所(JBI)标准用于质量评估。结果:11项研究显示,aLBP成年患者的3种促炎细胞因子与疼痛强度相关:C-反应蛋白(CRP)、肿瘤坏死因子(TNF-α)和白细胞介素(IL-6)。一些研究评估了促炎细胞因子与抑郁症状之间的关系;没有研究促炎细胞因子与aLBP中疲劳、焦虑、睡眠障碍或合并症(糖尿病、心脏病和癌症)的关系。需要进行精心设计的研究,评估慢性炎症、行为症状和合并症之间的关系。
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引用次数: 0
Synergistic Interactions of Insufficient Physical Activity and a High Systemic Immune-Inflammation Index on Psychological Problems in Indonesians With Type 2 Diabetes Mellitus. 体力活动不足和高系统免疫炎症指数对印尼2型糖尿病患者心理问题的协同作用。
Pub Date : 2023-10-01 Epub Date: 2023-03-09 DOI: 10.1177/10998004231162050
Yohanes Andy Rias, Hsiu Ting Tsai, Ratsiri Thato, Bagus Sholeh Apriyanto, Kuei Ru Chou, Shu Chuan Ho, Chia Hsuan Sun

Background: High-grade inflammation represents a critical contribution to the onset of depression and might be manageable by physical activity (PA). Nevertheless, no study has examined synergistic interactions of insufficient PA and high values of the systemic immune-inflammation index (SII) on psychological problems.

Objective: We investigated independent and synergistic interactions of insufficient PA and high SII levels on stress, anxiety, and depression in T2DM patients.

Methods: A cross-sectional research design with 294 T2DM patients was conducted. An XP-100 automated hematology analyzer was used to evaluate inflammatory biomarkers. Depression, Anxiety, and Stress Scale-21 items and a standardized questionnaire about PA were respectively used to measure psychological problems and metabolic equivalent of task (MET)-h/week.

Results: A multiple linear regression demonstrated that patients with insufficient PA were significantly more likely to have higher stress (β = 1.84, 95% confidence interval (CI) = 1.03-2.65), anxiety (β = 1.88, 95% CI = 1.81-2.96), and depression (β = 2.53, 95% CI = 0.82-4.24) than those with active PA. A high SII level was a key predictor and was most strongly associated with stress (β = 2.61, 95% CI = 2.02-3.20), anxiety (β = 3.16, 95% CI = 2.37-3.94), and depression (β = 3.72, 95% CI = 2.49-4.96) compared to those who had low SII levels. Notably, additive interaction results showed that combining insufficient PA and a high SII level had a significantly escalated 1.71-fold risk of stress, 1.82-fold risk of anxiety, and 2.69-fold risk of depression.

Conclusions: Active PA and a low SII had a positive synergistic effect of decreasing psychological problems.

背景:高度炎症是抑郁症发作的关键因素,可能通过体育活动(PA)来控制。然而,没有研究检测到PA不足和系统免疫炎症指数(SII)高值对心理问题的协同作用。目的:我们研究了PA不足和高SII水平对T2DM患者压力、焦虑和抑郁的独立和协同作用。方法:对294例T2DM患者进行横断面研究设计。XP-100自动血液分析仪用于评估炎症生物标志物。抑郁、焦虑和压力量表-21项和PA标准化问卷分别用于测量心理问题和代谢任务当量(MET)-h/周。结果:多元线性回归表明,PA不足的患者更容易产生更高的压力(β=1.84,95%置信区间(CI)=1.03-2.65),与活动性PA患者相比,高SII水平是一个关键的预测因素,与低SII水平的患者相比,与压力(β=2.61,95%CI=2.02-3.20)、焦虑(β=3.16,95%CI=2.37-3.94)和抑郁(β=3.72,95%CI=2.49-4.96)最为密切相关。值得注意的是,加性交互作用结果显示,PA不足和高SII水平相结合,压力风险显著增加1.71倍,焦虑风险显著增加1.82倍,抑郁风险显著增加2.69倍。结论:积极的PA和低SII在减少心理问题方面具有积极的协同作用。
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引用次数: 1
The Roles of Stress, Sleep, and Fatigue on Depression in People with Visual Impairments. 压力、睡眠和疲劳在视觉障碍患者抑郁中的作用。
Pub Date : 2023-10-01 Epub Date: 2023-03-17 DOI: 10.1177/10998004231165022
Soyoung Choi, Tracie Harrison

The study aimed to investigate the mediating effect of fatigue and the moderating effect of sleep quality on stress and depressive symptoms among people with visual impairments. A total of 155 participants completed the online survey. The Perceived Stress Scale, the Fatigue Symptom Inventory, the Centre for Epidemiological Studies-Depression Inventory (CES-D), and the Pittsburgh Sleep Quality Index (PSQI) were used. Descriptive analysis, correlations, and moderated mediation modelling were conducted using R software. From the mediator variable (FSI) model (F = 22.427, R2 = 56.5, p < .001) and the dependent variable (CES-D) model (F = 35.912, R2 = 70.5, p < .001), after controlling for age, sex, employment, and education, sleep quality positively predicted fatigue levels (β = 2.422, p = .009), and fatigue positively predicted depressive symptoms (β = .152, p < .001). Sleep quality is an essential component of psychological well-being in people with visual impairments.

该研究旨在调查疲劳的中介作用和睡眠质量对视觉障碍患者压力和抑郁症状的调节作用。共有155名参与者完成了在线调查。使用感知压力量表、疲劳症状量表、流行病学研究中心抑郁量表(CES-D)和匹兹堡睡眠质量指数(PSQI)。使用R软件进行描述性分析、相关性和适度中介建模。从中介变量(FSI)模型(F=22.427,R2=56.5,p<.001)和因变量(CES-D)模型(F=35.912,R2=70.5,p<.001)来看,在控制了年龄、性别、就业和教育后,睡眠质量正预测疲劳水平(β=2.422,p=.009),疲劳正预测抑郁症状(β=.152,p<.001)。睡眠质量是视觉障碍患者心理健康的重要组成部分。
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引用次数: 0
Frailty and Polypharmacy in Primary Care. 初级保健中的虚弱和多药治疗。
Pub Date : 2023-10-01 Epub Date: 2023-05-26 DOI: 10.1177/10998004231179485
Baki Derhem, Süleyman Özsari

Introduction: The Clinical Frailty Scale (CFS) is a clinical judgement-based frailty tool developed from the Canadian Study of Health and Aging. Many studies on the measurement of frailty and its effect on clinical outcomes have been conducted on patients hospitalized, especially in intensive care units. The purpose of this study is to examine the relationship between polypharmacy and frailty on outpatient older adult patients in primary care.

Materials and method: This cross-sectional study included 298 patients who were aged ≥65 years and admitted to Yenimahalle Family Health Center between May-2022 and July-2022. Frailty was evaluated by using CFS. Polypharmacy was defined as five medications or more and "excessive polypharmacy" as 10 medications or more. The medications below five are grouped as "no polypharmacy".

Results: There was a statistically significance between age groups, gender, smoking status, marital status, polypharmacy status, and FS (p = .003 and η2: .20; p < .001 and Cohen d: .80; p = .018 and Cohen d: .35; p < .001 and Cohen d: 1.10 and p < .001 and η2: 1.45 respectively). A strong, positive correlation was found between polypharmacy and the frailty score.

Conclusion: Polypharmacy, especially excessive polypharmacy, may be a promising adjunct to frailty in identifying older patients whose health is more likely to worsen. Providers in primary care should also consider frailty when prescribing drugs.

简介:临床虚弱量表(CFS)是根据加拿大健康与老龄化研究开发的一种基于临床判断的虚弱工具。许多关于虚弱程度及其对临床结果影响的研究都是在住院患者身上进行的,尤其是在重症监护室。本研究的目的是检验初级保健门诊老年患者的多药治疗与虚弱之间的关系。材料和方法:这项横断面研究包括298名年龄≥65岁的患者,他们于2022年5月至2022年7月期间入住Yenimahalle家庭健康中心。使用CFS评估脆弱性。多药治疗定义为5种或5种以上药物,“过度多药治疗”定义为10种或10种以上药物。结果:年龄组、性别、吸烟状况、婚姻状况、多药治疗状况和FS之间具有统计学意义(p=0.003和η2:.20;p=0.001和Cohen d:.80;p=0.018和Cohen d:.35;.001和Cohen分别为1.10和.001和η2:1.45)。发现多药治疗与虚弱评分之间存在强烈的正相关。结论:多药治疗,特别是过度多药治疗可能是一种很有前途的治疗虚弱的辅助手段,可以识别健康状况更可能恶化的老年患者。初级保健提供者在开药时也应该考虑到虚弱。
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引用次数: 0
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Biological research for nursing
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