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Multiple Sclerosis and Related Disorders Jul 2023Multiple sclerosis (MS) is an immune-mediated, neurodegenerative disease of the central nervous system that manifests in symptoms that compromise health-related quality... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Multiple sclerosis (MS) is an immune-mediated, neurodegenerative disease of the central nervous system that manifests in symptoms that compromise health-related quality of life (HRQOL). HRQOL focuses on a person's overall, subjective evaluation of health status primarily in the physical and mental domains. Exercise training is a form of rehabilitation for managing MS-related outcomes that might influence HRQOL. Reviews on exercise training are available, but we are unaware of a recent comprehensive review and meta-analysis of exercise effects for improving physical and mental domains of HRQOL. This analysis provides an updated review and meta-analysis of randomized controlled trials (RCTs) examining interventions consisting of aerobic, resistance and combined exercise training for improving HRQOL in persons with MS. This systematic review 1) assessed the overall strength of evidence for exercise interventions on HRQOL, 2) evaluated the relative effect of exercise interventions on physical and mental domains of HRQOL, and 3) determined moderators of exercise intervention effects on HRQOL.
METHODS
Seven databases were searched for RCTs evaluating physical and/or mental domains of HRQOL with adults diagnosed with MS and undergoing an intervention of aerobic, resistance or combined exercise training compared with a non-exercise comparator. Data extraction included participant and intervention characteristics, and pre- and post-intervention HRQOL outcome data. Effect sizes (ESs) were calculated as standardized mean differences (SMDs) and a multilevel random-effects model was used to generate an aggregated SMD that compared exercise with non-exercise control conditions.
RESULTS
Twelve RCTs met the inclusion criteria and yielded 23 ESs to be analyzed. Participants (N = 593; 308 intervention vs. 285 control conditions) had a mean (±standard deviation) age of 42.4 (6.5) years and 80% (18.3%) were female. Results generated a medium effect of exercise for improving overall HRQOL (ES=0.64, p = 0.0001) with high heterogeneity (Q=58.8, I=86.7%). Exercise training yielded a large effect on the physical domain (k = 12, ES=0.82, p<0.0009) and a medium effect on the mental domain (k = 11, ES=0.41, p<0.0001). Moderator analyses identified exercise modality, supervision level, intervention delivery and length, HRQOL tool, and number of participants with relapsing-remitting MS as significant influences of ES for HRQOL.
CONCLUSIONS
Exercise training is clinically effective for improving overall HRQOL in MS and produces greater improvements in the physical domain of HRQOL than the mental domain. The moderator analysis suggests that supervised, aerobic, and group-delivered exercise training of ≥3 months yields the most influence on HRQOL. Such results may have major implications for MS treatment and care.
Topics: Adult; Female; Humans; Male; Exercise; Quality of Life; Health Status; Exercise Therapy; Multiple Sclerosis
PubMed: 37172366
DOI: 10.1016/j.msard.2023.104746 -
BMJ Open Apr 2022To evaluate the patterns and demographic correlates of domain-specific physical activities (PAs) and their associations with dyslipidaemia among ethnic minorities in...
OBJECTIVE
To evaluate the patterns and demographic correlates of domain-specific physical activities (PAs) and their associations with dyslipidaemia among ethnic minorities in China.
DESIGN
Cross-sectional.
PARTICIPANTS
In total, 17 081 individuals were included.
PRIMARY AND SECONDARY OUTCOME MEASURES
Domain-specific PAs were assessed using a questionnaire related to occupational, transportation, housework and leisure-time PAs. Dyslipidaemia was measured using an automatic biochemical instrument. Demographic variables were self-reported.
RESULTS
Housework accounted for most PAs in the study. Elderly people were more likely to participate in housework and leisure-time PA, whereas the mean level of PA in people with low education level and household income was high. With G3-G4 levels of occupational PA, Dong men (G4: OR=0.530, 95% CI 0.349 to 0.806), Miao women (G3: OR=0.698, 95% CI 0.524 to 0.931; G4: OR=0.611, 95% CI 0.439 to 0.850) and Bouyei women (G3: OR=0.745, 95% CI 0.566 to 0.981; G4: OR=0.615, 95% CI 0.440 to 0.860) tended to have a low risk of dyslipidaemia. With G2 levels of transportation, PA could reduce the risk of dyslipidaemia in Bouyei women (G2: OR=0.747, 95% CI 0.580 to 0.962). G2-G3 levels of leisure-time PA could reduce the risk of dyslipidaemia in Miao men (G2: OR=0.645, 95% CI 0.446 to 0.933; G3: OR=0.700, 95% CI 0.513 to 0.954). However, a high risk of dyslipidaemia was observed with G4 levels of leisure-time PA among Bouyei women (G4: OR=.353, 95% CI 1.001 to 1.905) and with transportation PA among Dong men (G4: OR=1.591, 95% CI 1.130 to 2.240).
CONCLUSION
The main PA of the ethnic minorities in Guizhou Province involved housework. Domain-specific PAs varied with demographic factors, and active domain-specific PAs were associated with a reduced risk of dyslipidaemia.
Topics: Aged; China; Cohort Studies; Cross-Sectional Studies; Demography; Dyslipidemias; Exercise; Female; Humans; Leisure Activities; Male
PubMed: 35418424
DOI: 10.1136/bmjopen-2021-052268 -
International Journal of Environmental... Oct 2022Quality of life (QoL) is closely linked to the health status of the individual. In turn, health status strongly depends on lifestyle. Health behavior, which is defined...
UNLABELLED
Quality of life (QoL) is closely linked to the health status of the individual. In turn, health status strongly depends on lifestyle. Health behavior, which is defined as the actions and attitudes of a person that affect their physical and mental health, is one of many lifestyle components. The nursing community, which is exposed to a range of dangers associated with the job position and responsibilities of the nursing profession, has to contend with several negative impacts. This results in a decreased quality of life among the nursing staff and reduced effectiveness in providing care services to patients.
METHODS
This study was conducted using an online Google questionnaire, which was completed by 312 nurses nationwide. The questionnaire included questions about the respondents' socio-demographic survey and included the Health Behavior Inventory (HBI) by Juczyński and the WHOQoL-BREF questionnaire.
RESULTS
The mean QoL reported by respondents was 3.65 points (SD = 0.67), meaning that QoL ranked between good and average results. The respondents' mean rating of their own health was 3.58 points (SD = 0.79), indicating that they rated their health status between satisfactory and average. Low health-behavior prevalence was reported by 139 of the 312 survey participants (44.55%), while 111 respondents (35.58%) had average health-behavior prevalence and 62 (19.87%) had high health-behavior prevalence. Each of the QoL domains correlated significantly ( ˂ 0.05) and positively (r ˃ 0) with the total HBI score and all its subscales.
CONCLUSIONS
Higher quality of life improves the level of health behavior by nursing staff. Obesity lowers the quality of life in physical, psychological, and social domains. The psychological sphere was the best-rated quality of life domain by nurses. A good material situation for nurses has a positive effect on their quality of life.
Topics: Health Behavior; Health Status; Humans; Nurses; Quality of Life; Surveys and Questionnaires
PubMed: 36232229
DOI: 10.3390/ijerph191912927 -
Saudi Journal of Kidney Diseases and... 2020The purpose of this study was to investigate the relation between selected demographic and clinical characteristics and quality of life (QOL) scores in patients with...
The purpose of this study was to investigate the relation between selected demographic and clinical characteristics and quality of life (QOL) scores in patients with end-stage renal disease who receive dialysis. We conducted the study at one hemodialysis (HD) unit in Bahrain from May 2018 to July 2018. We used standard QOL Index (QOLI) score instrument in Arabic form. This study included 100 patients (66 men and 34 women), aged 22 to 80 years on treatment with maintenance HD for four to 190 months. Inclusion criteria were as follows: those aged >18 years with no severe morbidities or psychological diseases and were on dialysis for at least three months. The following QOL scores were recorded: the health and functioning domain (64.8 ± 15.3), the social and economic domain (65.6 ± 14.1), the psychological/spiritual domain (74.9 ± 14.3), and the family subscale domain (75.9 ± 14.5). Male patients had reduced QOL though not statistically significant and younger patients had better QOL scores. The QOL scores revealed a decreasing trend with decreasing level of education, and they were higher among those who were not working and stayed at home. In addition, the family subclass scores were significantly higher among the married patients. Correlations between the demographic characteristics and QOL scores showed that there was a significant negative correlation between family domain and educational level and marital status, while there was a significant positive correlation between residence and psychological domain. Age, gender, marital status, residence, ethnicity, education level, employment status, income, and duration on HD nonsignificantly affected one or more domains of QOLI scores in such patients. Adequate management of these factors could influence patient outcomes.
Topics: Adult; Aged; Aged, 80 and over; Bahrain; Cross-Sectional Studies; Female; Functional Status; Health Status; Humans; Kidney Failure, Chronic; Male; Mental Health; Middle Aged; Quality of Life; Renal Dialysis; Risk Assessment; Risk Factors; Social Determinants of Health; Socioeconomic Factors; Surveys and Questionnaires; Time Factors; Treatment Outcome; Young Adult
PubMed: 32394920
DOI: 10.4103/1319-2442.284022 -
Transfusion Medicine Reviews Apr 2018Antigens of the Gerbich blood group system are expressed on glycophorin C (GPC) and glycophorin D (GPD), minor sialoglycoproteins of human erythrocytes. GPC and GPD help... (Review)
Review
Antigens of the Gerbich blood group system are expressed on glycophorin C (GPC) and glycophorin D (GPD), minor sialoglycoproteins of human erythrocytes. GPC and GPD help maintain erythrocyte shape of and contributes to the stability of its membrane. There are six high-prevalence Gerbich antigens: Ge2, Ge3, Ge4, GEPL (GE10), GEAT (GE11), GETI (GE12) and five low-prevalence Gerbich antigens: Wb (GE5), Ls (GE6), An (GE7), Dh (GE8), GEIS (GE9). Some Gerbich antigens (Ge4, Wb, Dh, GEAT) are expressed only on GPC, two (Ge2, An) are expressed only on GPD, while others (Ge3, Ls, GEIS, GEPL, GETI) are expressed on both GPC and GPD. Antibodies recognizing GPC/GPD may arise naturally (so-called "naturally-occurring RBC antibodies") or as the result of alloimmunization, and some of them may be clinically relevant. Gerbich antibodies usually do not cause serious hemolytic transfusion reactions (HTR); autoantibodies of anti-Ge2- or anti-Ge3 specificity can cause autoimmune hemolytic anemia (AIHA).
Topics: Anemia, Hemolytic, Autoimmune; Antibodies, Monoclonal; Blood Group Antigens; Erythrocyte Membrane; Erythrocytes; Glycophorins; Hemolysis; Humans; Ligands; Malaria; Plasmodium; Plasmodium falciparum; Plasmodium vivax; Prevalence; Protein Domains
PubMed: 29540278
DOI: 10.1016/j.tmrv.2018.02.004 -
Asia-Pacific Journal of Public Health Oct 2017The purpose of this study was to examine the factors contributing to achieving successful aging (SA) among the Korean older population and identified the strength of... (Meta-Analysis)
Meta-Analysis Review
The purpose of this study was to examine the factors contributing to achieving successful aging (SA) among the Korean older population and identified the strength of each factor's contribution to SA. We extensively searched 4 Korean and 3 English online databases, extracting a total of 64 studies for the analysis. Finally, 42 associated factors and 347 correlation coefficients were found, which were then categorized into 5 domains: functional, psychological, familial, social, and demographic. The psychological domain had the highest effect size. This was followed, in descending order, by the social, functional and familial, and demographic domains. Importantly, the familial domain, which has not been explored in many existing SA models, emerged as a notable predictor. This study is meaningful in terms of understanding one of the minority older populations more deeply and providing stronger evidence for developing evidence-based intervention programs for Korean older adults.
Topics: Aged; Aging; Humans; Personal Satisfaction; Quality of Life; Republic of Korea
PubMed: 28669196
DOI: 10.1177/1010539517717021 -
Frontiers in Public Health 2023No study has comprehensively quantified the individual and collective contributions of various risk factors to the growing burden of diabetes in the United States.
INTRODUCTION
No study has comprehensively quantified the individual and collective contributions of various risk factors to the growing burden of diabetes in the United States.
METHODS
This study aimed to determine the extent to which an increase in the prevalence of diabetes was related to concurrent changes in the distribution of diabetes-related risk factors among US adults (aged 20 years or above and not pregnant). Seven cycles of series of cross-sectional National Health and Nutrition Examination Survey data between 2005-2006 and 2017-2018 were included. The exposures were survey cycles and seven domains of risk factors, including genetic, demographic, social determinants of health, lifestyle, obesity, biological, and psychosocial domains. Using Poisson regressions, percent reduction in the β coefficient (the logarithm used to calculate the prevalence ratio for prevalence of diabetes in 2017-2018 vs. 2005-2006) was computed to assess the individual and collective contribution of the 31 prespecified risk factors and seven domains to the growing burden of diabetes.
RESULTS
Of the 16,091 participants included, the unadjusted prevalence of diabetes increased from 12.2% in 2005-2006 to 17.1% in 2017-2018 [prevalence ratio: 1.40 (95% CI, 1.14-1.72)]. Individually, genetic domain [17.3% (95% CI, 5.4%-40.8%)], demographic domain [41.5% (95% CI, 24.4%-76.8%)], obesity domain [35.3% (95% CI, 15.8%-70.2%)], biological domain [46.2% (95% CI, 21.6%-79.1%)], and psychosocial domain [21.3% (95% CI, 9.5%-40.1%)] were significantly associated with a different percent reduction in β. After adjusting for all seven domains, the percent reduction in β was 97.3% (95% CI, 62.7%-164.8%).
CONCLUSION
The concurrently changing risk factors accounted for the increasing diabetes prevalence. However, the contribution of each risk factor domain varied. Findings may inform planning cost-effective and targeted public health programs for diabetes prevention.
Topics: Adult; Humans; Pregnancy; United States; Female; Nutrition Surveys; Prevalence; Cross-Sectional Studies; Diabetes Mellitus; Risk Factors; Obesity
PubMed: 37213641
DOI: 10.3389/fpubh.2023.1174632 -
Zeitschrift Fur Gerontologie Und... Feb 2019Socioeconomic differences in health and life expectancy are key issues for public health and health policy. In the course of demographic change, in addition to... (Review)
Review
BACKGROUND
Socioeconomic differences in health and life expectancy are key issues for public health and health policy. In the course of demographic change, in addition to childhood, adolescence and middle adulthood, old age is increasingly becoming the focus of attention in research on health inequalities, with a special emphasis on the transition from working age to retirement.
OBJECTIVE
How do health inequalities change in the transition from middle to older age and then to very old age?
MATERIAL AND METHODS
This article reviews the studies available for Germany, supplemented with new analyses based on the German Health Update study and the German Socioeconomic Panel study. In order to set the findings in the context of international research on health inequalities in old age, selected studies from other countries and international comparative studies are additionally considered.
RESULTS
Social differences in health and remaining life-expectancy also exist in older age, although to a slightly lesser extent than in middle age. There is evidence that as age progresses, health inequalities narrow in some health domains but there is also isolated evidence that health inequalities may widen with age.
CONCLUSION
The existence of health inequalities in old age indicates that older people from disadvantaged social groups have a particular need for healthcare and support. This poses special challenges for the medical, nursing and psychosocial care system as well as for the social security systems.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Aging; Child; Germany; Health Status; Health Status Disparities; Humans; Life Expectancy; Middle Aged; Retirement; Social Class; Socioeconomic Factors
PubMed: 30569288
DOI: 10.1007/s00391-018-01487-y -
Journal of Cystic Fibrosis : Official... May 2022There is no data exclusively on the relationship between health-related quality-of-life (HRQOL) and lung disease severity in early school-aged children with cystic...
BACKGROUND
There is no data exclusively on the relationship between health-related quality-of-life (HRQOL) and lung disease severity in early school-aged children with cystic fibrosis (CF). Using data from the Australian Respiratory Early Surveillance Team for Cystic Fibrosis (AREST CF) we assessed the relationships between HRQOL, lung function and structure.
METHODS
125 children aged 6.5-10 years enrolled in the AREST CF program were included from CF clinics at Royal Children's Hospital (RCH), Melbourne (n = 66) and Perth Children's Hospital (PCH), Perth (n = 59), Australia. Demographics, HRQOL measured by Cystic Fibrosis Questionnaire-Revised (CFQ-R), spirometry, multiple-breath washout (MBW) and chest CT were collected across two years. Correlation between CFQ-R scores and lung structure/function parameters and agreement between parent-proxy and child-reported HRQOL were evaluated.
RESULTS
No correlation was observed between most CFQ-R domain scores and FEV1 z-scores, excepting weak-positive correlation with parent CFQ-R Physical (rho = 0.21, CI 0.02-0.37), and Weight (rho = 0.21, CI 0.03-0.38) domain and child Body domain (rho = 0.26, CI 0.00-0.48). No correlation between most CFQ-R domain scores and LCI values was noted excepting weak-negative correlation with parent Respiratory (rho = -0.23, CI 0.41-0.05), Emotional (rho = -0.24, CI 0.43-0.04), and Physical (-0.21, CI 0.39-0.02) domains. Furthermore, structural lung disease on CT data demonstrated little to no association with CFQ-R parent and child domain scores. Additionally, no agreement between child self-report and parent-proxy CFQ-R scores was observed across the majority of domains and visits.
CONCLUSION
HRQOL correlated poorly with lung function and structure in early school-aged children with CF, hence clinical trials should consider these outcomes independently when determining study end-points.
Topics: Australia; Child; Cystic Fibrosis; Health Status; Humans; Lung; Quality of Life; Severity of Illness Index
PubMed: 34801433
DOI: 10.1016/j.jcf.2021.11.005 -
International Journal of Colorectal... Aug 2017Deciding to defunction after anterior resection can be difficult, requiring cognitive tools or heuristics. From our previous work, increasing age and risk-taking...
PURPOSE
Deciding to defunction after anterior resection can be difficult, requiring cognitive tools or heuristics. From our previous work, increasing age and risk-taking propensity were identified as heuristic biases for surgeons in Australia and New Zealand (CSSANZ), and inversely proportional to the likelihood of creating defunctioning stomas. We aimed to assess these factors for colorectal surgeons in the British Isles, and identify other potential biases.
METHODS
The Association of Coloproctology of Great Britain and Ireland (ACPGBI) was invited to complete an online survey. Questions included demographics, risk-taking propensity, sensitivity to professional criticism, self-perception of anastomotic leak rate and propensity for creating defunctioning stomas. Chi-squared testing was used to assess differences between ACPGBI and CSSANZ respondents. Multiple regression analysis identified independent surgeon predictors of stoma formation.
RESULTS
One hundred fifty (19.2%) eligible members of the ACPGBI replied. Demographics between ACPGBI and CSSANZ groups were well-matched. Significantly more ACPGBI surgeons admitted to anastomotic leak in the last year (p < 0.001). ACPGBI surgeon age over 50 (p = 0.02), higher risk-taking propensity across several domains (p = 0.044), self-belief in a lower-than-average anastomotic leak rate (p = 0.02) and belief that the average risk of leak after anterior resection is 8% or lower (p = 0.007) were all independent predictors of less frequent stoma formation. Sensitivity to criticism from colleagues was not a predictor of stoma formation.
CONCLUSIONS
Unrecognised surgeon factors including age, everyday risk-taking, self-belief in surgical ability and lower probability bias of anastomotic leak appear to exert an effect on decision-making in rectal surgery.
Topics: Adult; Bias; Demography; Female; Heuristics; Humans; Male; Middle Aged; Rectum; Regression Analysis; Risk Factors; Surgeons; Surgical Stomas; Surveys and Questionnaires
PubMed: 28444507
DOI: 10.1007/s00384-017-2823-7