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Clinical Therapeutics Sep 2023Psoriatic arthritis (PsA) is a multisystem inflammatory disorder associated with significant mortality and morbidity, including functional impairment and psychological... (Review)
Review
PURPOSE
Psoriatic arthritis (PsA) is a multisystem inflammatory disorder associated with significant mortality and morbidity, including functional impairment and psychological disability. Although evidence-based treatment recommendations are available for the use of drug treatments in PsA, there is little guidance for health professionals on nonpharmacologic and psychological interventions that may be useful in PsA. The objective of this systematic review (SR) was to identify how lifestyle modifications and the use of nonpharmacologic and psychological interventions may improve the outcomes of patients with PsA.
METHODS
Studies were included if they evaluated adults diagnosed with PsA and included exposure to nonpharmacologic interventions, psychological interventions, and lifestyle modifications. The outcomes used needed to have been validated in PsA. A systematic literature search was run on May 28, 2021, in the Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine Database (AMED), EMBASE, Global Health, MEDLINE, and PsycINFO databases to identify articles related to lifestyle modifications and nonpharmacologic or psychological interventions for adults with PsA published between 2010 and 2021. Two review authors independently screened and selected full-text studies for inclusion in the SR. Risk of bias was assessed with either the Risk of Bias 2 (ie, RoB 2) tool or Critical Appraisal Skills Program checklist depending on the study type.
FINDINGS
The search strategy identified 26,132 references. Eight studies examining lifestyle modifications and the effect on PsA were eligible to be included in the SR. Three of the 8 studies were randomized controlled trials, and 5 were nonrandomized studies. Three studies assessed physical activity, 3 assessed diet, 1 study assessed smoking, and another study assessed mud bath therapy. There was large heterogeneity between studies, and the measures of disease activity, and psychological and functional outcomes varied widely between studies.
IMPLICATIONS
Although this SR identified 8 relevant studies, these studies did not provide high-quality evidence to guide patients for non-drug treatments of PsA. The effectiveness of these interventions has therefore not been established. We found that physical activity seems to have a positive impact on disease activity and psychological well-being. Further well-designed research studies are needed to develop treatment recommendations. PROSPERO identifier: CRD42021257404.
Topics: Adult; Humans; Arthritis, Psoriatic; Behavior Therapy; Life Style
PubMed: 37541907
DOI: 10.1016/j.clinthera.2023.05.009 -
Annals of Work Exposures and Health Mar 2023Physical and cognitive tasks occur together in many occupations. Previous reviews of combined tasks have mainly focused on their effects in a sports context. This review...
OBJECTIVES
Physical and cognitive tasks occur together in many occupations. Previous reviews of combined tasks have mainly focused on their effects in a sports context. This review investigated to which extent combinations (concurrent or alternating) of occupationally relevant physical and cognitive tasks influence responses reflecting biomechanical exposure, stress, fatigue, performance, and well-being.
METHODS
We searched Scopus, Pubmed, Cinahl, and Psychinfo for controlled experiments investigating the effects of combinations of occupationally relevant physical and cognitive tasks in participants aged 18 to 70. In total, we identified 12 447 records. We added recent papers that had cited these studies (n = 573) to arrive at a total of 13 020 publications. After screening for relevance, 61 studies remained, of which 57 were classified to be of medium or high quality. Of the 57 studies, 51 addressed concurrent tasks, 5 alternating tasks, and 1 both concurrent and alternating tasks.
RESULTS
Most studies of concurrent physical and cognitive tasks reported negative effects, if numerically small, on indicators of biomechanical exposure, fatigue, and performance, compared to a physical task alone. Results were mixed for stress indicators, and well-being was too little studied to justify any conclusions. Effects depended on the tasks, including their intensity and complexity. Alternating physical and cognitive tasks did not appear to influence outcomes much, compared to having passive breaks in-between physical tasks.
CONCLUSIONS
The reviewed evidence indicated that concurrent physical and cognitive work tasks have negative, yet small effects on biomechanical indicators, fatigue and performance, compared to performing the physical task alone, but only if the physical task is intense, and the cognitive task is complex. Alternating between physical and cognitive tasks may have similar effects as breaking up physical tasks by passive breaks, but studies were few. Future studies should address ecologically valid combinations of physical and cognitive tasks, in particular in controlled field studies devoted to the long-term effects of combined work.
Topics: Humans; Occupational Exposure; Fatigue; Cognition
PubMed: 36469430
DOI: 10.1093/annweh/wxac082 -
Journal of Cachexia, Sarcopenia and... Dec 2023Metabolic acidosis unfavourably influences the nutritional status of patients with non-dialysis dependent chronic kidney disease (CKD) including the loss of muscle mass... (Meta-Analysis)
Meta-Analysis Review
Metabolic acidosis unfavourably influences the nutritional status of patients with non-dialysis dependent chronic kidney disease (CKD) including the loss of muscle mass and functionality, but the benefits of correction are uncertain. We investigated the effects of correcting metabolic acidosis on nutritional status in patients with CKD in a systematic review and meta-analysis. A search was conducted in MEDLINE and the Cochrane Library from inception to June 2023. Study selection, bias assessment, and data extraction were independently performed by two reviewers. The Cochrane risk of bias tool was used to assess the quality of individual studies. We applied random effects meta-analysis to obtain pooled standardized mean difference (SMD) and 95% confidence intervals (CIs). We retrieved data from 12 intervention studies including 1995 patients, with a mean age of 63.7 ± 11.7 years, a mean estimated glomerular filtration rate of 29.8 ± 8.8 mL/min per 1.73 m , and 58% were male. Eleven studies performed an intervention with oral sodium bicarbonate compared with either placebo or with standard care and one study compared veverimer, an oral HCl-binding polymer, with placebo. The mean change in serum bicarbonate was +3.6 mEq/L in the intervention group and +0.4 mEq/L in the control group. Correcting metabolic acidosis significantly improved muscle mass assessed by mid-arm muscle circumference (SMD 0.35 [95% CI 0.16 to 0.54], P < 0.001) and functionality assessed with the sit-to-stand test (SMD -0.31 [95% CI -0.52 to 0.11], P = 0.003). We found no statistically significant effects on dietary protein intake, handgrip strength, serum albumin and prealbumin concentrations, and blood urea nitrogen. Correcting metabolic acidosis in patients with CKD improves muscle mass and physical function. Correction of metabolic acidosis should be considered as part of the nutritional care for patients with CKD.
Topics: Humans; Male; Middle Aged; Aged; Female; Dietary Proteins; Hand Strength; Renal Insufficiency, Chronic; Acidosis; Muscles
PubMed: 37728018
DOI: 10.1002/jcsm.13330 -
Antioxidants (Basel, Switzerland) Sep 2022A physical exercise program is one of the commonly used methods for improving an individual's antioxidative capacity. However, an inappropriate physical exercise program... (Review)
Review
A physical exercise program is one of the commonly used methods for improving an individual's antioxidative capacity. However, an inappropriate physical exercise program would induce extra oxidative stress (OS), and the relationship between the details of a physical exercise protocol and the severity of intracellular OS is still unclear. A systematic review and meta-analysis of randomized controlled trials were conducted by searching PubMed, Medline, and Web of Science with the eligibility criteria: (1) participants over 18 years old; (2) physical exercise interventions; (3) 8-hydroxydeoxyguanosine, F2-isoprostanes, and protein carbonyls (PCs) as outcome measures; (4) published in English and peer-reviewed. 12 studies were included, and the data of 8 in them were pooled together. The agreement between authors reached a kappa value of 0.73. The results of the meta-analysis showed that: (1) the level of OS did not depend on the absolute intensity of physical exercise but on both the intensity and the volume of exercise; (2) high-intensity aerobic exercise (HIAE) and a combined protocol of HIAE and resistance training had the highest potential to induce large OS in unhealthy people; (3) the OS induced by moderate-to-high intensity aerobic exercise was significantly larger than that induced by ordinary life activities in healthy adults; (4) high-intensity interval training and moderate-intensity aerobic exercise had the lowest and sub-lowest probabilities to induce high intracellular OS for unhealthy adults. activities induce OS in various tissues in the human body, and the severity of OS depends on many factors of physical exercises as well as the health condition of an individual. A high-intensity and high-volume physical exercise program has the largest possibility of inducing severe OS, while a moderate-intensity aerobic exercise program and a high-intensity interval training program with a relatively low volume might be beneficial to the redox balance for unhealthy individuals. In conclusion, continuous aerobic exercise under moderate-intensity or high-intensity interval training could be recommended to enhance the body's capacity for maintaining redox balance, especially for unhealthy individuals. The PROSPERO Registration Number is CRD42022349687.
PubMed: 36139825
DOI: 10.3390/antiox11091751 -
International Journal of Environmental... Feb 2023It is well known that there is an obvious 24 h diurnal variation in the individual's mood state and physiological activity, and training at different times of the day... (Review)
Review
PURPOSE
It is well known that there is an obvious 24 h diurnal variation in the individual's mood state and physiological activity, and training at different times of the day may lead to different exercise performance and metabolic outcomes; however, the time-dependent effect of emotional state on physical activity and the influence of its circadian rhythm on exercise performance are still not comprehensively understood. Based on this, this study summarizes the rhythmic experimental research in the field of sport psychology, and it aims to provide the basis for coaches to optimize sports training scientifically and to improve the mental health of the related crowd to the greatest extent.
METHODS
The systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched the PubMed, Web of Science, Medline, and CNKI databases for relevant literature; the search scope was research before September 2022.
RESULTS
13 studies comprising 382 subjects examined the effects of exercise timing on mood responses to exercise or the effects of circadian rhythms of mood on exercise performance, which included 3 RCTs and 10 Non-RCTs. The subjects included athletes (both training or retired), college students, and healthy adults. Two studies were designed for long-term exercise intervention (aerobic training and RISE) and the rest for acute intervention (CrossFit training, HIIT, aerobic combined with muscle conditioning training, constant power exhaustion training, and cycling) or physical function tests (RSA + BTV tests, 30 s Wingate test, muscle strength + CMJ + swimming performance test, RSSJA, shooting accuracy tests + 10 × 20 m dribbling sprint, 200 m time trials). All trials reported specific exercise timing; of these, 10 studies reported subjects' chronotypes, most commonly using the MEQ scale, while 1 recorded with the CSM. Mood responses were assessed with the POMS scale in 10 studies, while 3 other studies used the UMACL, PANAS, and GAS scales, respectively.
CONCLUSION
There was much inconsistency between the results, with subjects likely to be exposed to more sunlight (the main timing factor of the circadian rhythm) during early morning exercise, resulting in feeling more positive emotions; however, following a night's rest, delayed responses and poor functioning of the various organ systems of the human body may also lead to higher feelings of fatigue and negative emotions indirectly. Conversely, for athletes, their physical function tests are also more susceptible to the circadian rhythm of emotions, suggesting the importance of synchronizing them. In addition, night owls' emotional state during physical activity seems to be more susceptible to exercise timing than that of early birds. In order to achieve the best emotional state, it is suggested that night owls arrange courses in the afternoon or evening in future training.
Topics: Adult; Humans; Chronotype; Circadian Rhythm; Athletes; Rest; Swimming
PubMed: 36833520
DOI: 10.3390/ijerph20042822 -
Medicina (Kaunas, Lithuania) Sep 2021Coffee is rich in phenolic acids, such as caffeic acid and chlorogenic acid (CGA). Polyphenol-rich diets were shown to reduce the risk of metabolic syndrome (MeTS). :... (Meta-Analysis)
Meta-Analysis Review
Effects of Caffeinated and Decaffeinated Coffee Consumption on Metabolic Syndrome Parameters: A Systematic Review and Meta-Analysis of Data from Randomised Controlled Trials.
Coffee is rich in phenolic acids, such as caffeic acid and chlorogenic acid (CGA). Polyphenol-rich diets were shown to reduce the risk of metabolic syndrome (MeTS). : This systematic review and meta-analysis discusses the effects of coffee consumption and its dose-response on MeTS parameters. : PubMed and Scopus were searched for relevant articles published between 2015 and 2020. This review focused on randomised controlled trials (RCTs) investigating the effect of coffee consumption on anthropometric measurements, glycaemic indices, lipid profiles, and blood pressure. Data from relevant studies were extracted and analysed using random, fixed, or pooled effects models with 95% confidence intervals (CIs). : Green coffee extract (GCE) supplementation (180 to 376 mg) was found to reduce waist circumference (weighted mean difference (WMD) = -0.39; 95% CI: -0.68, -0.10), triglyceride levels (WMD = -0.27; 95% CI: -0.43, -0.10), high-density lipoprotein-cholesterol levels (WMD = 0.62; 95% CI: 0.34, 0.90), systolic blood pressure (WMD = -0.44; 95% CI: -0.57, -0.32), and diastolic blood pressure (WMD = -0.83; 95% CI: -1.40, -0.26). Decaffeinated coffee (510.6 mg) reduced fasting blood glucose levels (WMD = -0.81; 95% CI: -1.65, 0.03). The meta-analysis showed that the intake of GCE containing 180 to 376 mg of CGA (administered in a capsule) and liquid decaffeinated coffee containing 510.6 mg of CGA improved the MeTS outcomes in study participants. : The findings of the review suggested that the effect of coffee on MeTS parameters varies depending on the types and doses of coffee administered. A more detailed RCT on specific coffee doses (with adjustment for energy and polyphenol intake) and physical activity is needed to further confirm the observed outcomes.
Topics: Coffee; Humans; Lipids; Metabolic Syndrome; Plant Extracts; Randomized Controlled Trials as Topic; Waist Circumference
PubMed: 34577880
DOI: 10.3390/medicina57090957 -
Journal of Physical Activity & Health Apr 2021The measurement of daily physical activity (DPA) is important for the prognosis and quantifying clinical outcomes in individuals with heart disease. The measurement of... (Review)
Review
BACKGROUND
The measurement of daily physical activity (DPA) is important for the prognosis and quantifying clinical outcomes in individuals with heart disease. The measurement of DPA is more feasible using subjective measures when compared with objective measures. The purpose of this systematic review of the literature was to identify the subjective measures of DPA that have established reliability and validity in individuals with heart disease to assist clinician and researcher instrument selection.
METHODS
A systematic search of PubMed, CINAHL, MEDLINE, and ProQuest databases was performed. Methodological rigor was assessed using 3 different quality appraisal tools. Qualitative synthesis of included studies was performed.
RESULTS
Twenty-two unique studies covering 19 subjective DPA measures were ultimately included. Methodological rigor was generally fair, and validity coefficients were moderate at best.
CONCLUSIONS
Only 4 subjective measures that have established test-retest reliability and that provide an estimate of energy expenditure, metabolic equivalents, or minutes of DPA were compared against accelerometry or a DPA diary in patients with heart disease: SWISS Physical Activity Questionnaire, Total Activity Measure 1 and 2, and Mobile Physical Activity Logger. Depending on the clinician or researcher needs, instrument selection would depend on the recall period and the DPA construct being measured.
Topics: Accelerometry; Exercise; Heart Diseases; Humans; Reproducibility of Results
PubMed: 33668019
DOI: 10.1123/jpah.2020-0661 -
Journal of Urban Health : Bulletin of... Feb 2022We reviewed research that examines racism as an independent variable and one or more health outcomes as dependent variables in Black American adults aged 50 years and... (Review)
Review
We reviewed research that examines racism as an independent variable and one or more health outcomes as dependent variables in Black American adults aged 50 years and older in the USA. Of the 43 studies we reviewed, most measured perceived interpersonal racism, perceived institutional racism, or residential segregation. The only two measures of structural racism were birth and residence in a "Jim Crow state." Fourteen studies found associations between racism and mental health outcomes, five with cardiovascular outcomes, seven with cognition, two with physical function, two with telomere length, and five with general health/other health outcomes. Ten studies found no significant associations in older Black adults. All but six of the studies were cross-sectional. Research to understand the extent of structural and multilevel racism as a social determinant of health and the impact on older adults specifically is needed. Improved measurement tools could help address this gap in science.
Topics: Black or African American; Aged; Black People; Humans; Middle Aged; Racism; Social Segregation; Systemic Racism
PubMed: 34997433
DOI: 10.1007/s11524-021-00591-6 -
International Journal of Nursing Studies Nov 2022Being active in old age is vital for health and well-being. Inactivity decreases functional ability, mobility, and increases care dependence and risk of falling.... (Review)
Review
BACKGROUND
Being active in old age is vital for health and well-being. Inactivity decreases functional ability, mobility, and increases care dependence and risk of falling. Worryingly, older individuals in long-term care settings spend most of their waking day sitting or lying down. The environment should be of special interest considering active life in long-term care. This review aimed to synthesize evidence and provide a comprehensive understanding of the environmental aspects related to the physical activity of older individuals in long-term care settings.
METHODS
A mixed-method systematic review, registered in PROSPERO (CRD42021251899; May 30th, 2021) was conducted using four international scientific databases (CINAHL, PubMed, Cochrane, PsychInfo). The searches were conducted from the earliest possible date till Dec 31st, 2020. All empirical peer-reviewed studies published in the English language in scientific journals were included if they had investigated environmental aspects (physical, social, and/or symbolic) in relation to the physical activity of older individuals in long-term care facilities providing full-time care. Critical appraisal was conducted using Joanna Briggs Institute's Critical Appraisal tools, and the Mixed Method Appraisal Tool. Abductive thematic analysis and a conceptual map were used to synthesize the evidence.
RESULTS
Altogether 838 original articles were assessed for eligibility, resulting in 30 included studies. No studies were excluded based on quality. The mean age of residents was over 75 when reported. Their cognitive and physical functioning varied. The most frequent setting was nursing home. Three themes and corresponding descriptive themes were formulated, including 1) Physical environment: accessible and safe living environment, activating physical environment, 2) Social environment: supportive professionals, the role of other people, adequate activities to socialize and be active, and 3) Symbolic environment: policy at multiple levels, values of organizations and professionals. Different environmental aspects within and between the dimensions of the physical, social, and symbolic environment were related to each other.
CONCLUSIONS
A comprehensive synthesis of current evidence was provided and may be used for the assessment and development of long-term care settings. However, some aspects may have been missed because they have been addressed with terminology not identified with the word environment or similar concepts. As increasing activity may require actions in multiple dimensions, experimental research should be conducted to develop and test the effects of widescale modifications to existing environments from the needs of residents and fitting for each context. The evidence should be used for the design of new facilities.
TWEETABLE ABSTRACT
New mixed methods systematic review develops a concept map of environmental aspects influencing the physical activity of older individuals in long-term care.
Topics: Exercise; Humans; Long-Term Care; Nursing Homes
PubMed: 36116327
DOI: 10.1016/j.ijnurstu.2022.104350 -
Medicines (Basel, Switzerland) Apr 2023: Cannabis use by physicians can be detrimental for them and their patients. We conducted a systematic review and meta-analysis on the prevalence of cannabis use by... (Review)
Review
: Cannabis use by physicians can be detrimental for them and their patients. We conducted a systematic review and meta-analysis on the prevalence of cannabis use by medical doctors (MDs)/students. : PubMed, Cochrane, Embase, PsycInfo and ScienceDirect were searched for studies reporting cannabis use in MDs/students. For each frequency of use (lifetime/past year/past month/daily), we stratified a random effect meta-analysis depending on specialties, education level, continents, and periods of time, which were further compared using meta-regressions. : We included 54 studies with a total of 42,936 MDs/students: 20,267 MDs, 20,063 medical students, and 1976 residents. Overall, 37% had used cannabis at least once over their lifetime, 14% over the past year, 8% over the past month and 1.1 per thousand (‱) had a daily use. Medical students had a greater cannabis use than MDs over their lifetime (38% vs. 35%, < 0.001), the past year (24% vs. 5%, < 0.001), and the past month (10% vs. 2%, < 0.05), without significance for daily use (0.5% vs. 0.05%, NS). Insufficient data precluded comparisons among medical specialties. MDs/students from Asian countries seemed to have the lowest cannabis use: 16% over their lifetime, 10% in the past year, 1% in the past month, and 0.4% daily. Regarding periods of time, cannabis use seems to follow a U-shape, with a high use before 1990, followed by a decrease between 1990 and 2005, and a rebound after 2005. Younger and male MDs/students had the highest cannabis use. : If more than a third of MDs tried cannabis at least once in their lifetime, this means its daily use is low but not uncommon (1.1‱). Medical students are the biggest cannabis users. Despite being common worldwide, cannabis use is predominant in the West, with a rebound since 2005 making salient those public health interventions during the early stage of medical studies.
PubMed: 37233605
DOI: 10.3390/medicines10050029