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International Journal of Women's Health 2024Research demonstrates resistance training is not only safe but also beneficial for pregnant women. However, exercise recommendations for pregnant women still minimize... (Review)
Review
Research demonstrates resistance training is not only safe but also beneficial for pregnant women. However, exercise recommendations for pregnant women still minimize the importance of resistance exercise and provide minimal guidance. With a large increase in strength-focused sports among women, it is critical to re-evaluate the risk/benefit ratio of these exercises and ensure the latest recommendations reflect the latest clinical research. The purpose of this review is to highlight the safety and benefits of resistance training for both maternal and fetal health, particularly focusing on recent work. Relevant research involving resistance training during pregnancy was accessed and analyzed via a quasi-systematic search. Results demonstrate that appropriate prenatal resistance training can help alleviate some of the common symptoms of pregnancy, such as fatigue, back pain, and poor mental health. Resistance exercise can assist with glucose control in gestational diabetes mellitus, as well as decrease the risk of infant macrosomia and childhood metabolic dysfunction associated with uncontrolled gestational diabetes. Resistance training can also increase the likelihood of a vaginal delivery, which is beneficial for both mother and baby. Concerning fetal health, resistance training increases uterine blood flow, decreases the risk of neonatal macrosomia, and improves cognitive function and metabolic health in childhood. As with all forms of exercise, pregnant women should avoid resistance exercises that involve the supine position for extended bouts of time, trauma (or risk of trauma) to the abdomen, ballistic movements, movements that rely heavily on balance, and conditions that prohibit appropriate temperature control. With these considerations in mind, resistance training's benefits far surpass the lack of risk to the fetus. Resistance training is a safe and effective way to improve and maintain physical fitness during pregnancy and represents no risk to fetal health and development. Thus, healthcare providers should recommend resistance training for pregnant women.
PubMed: 38912201
DOI: 10.2147/IJWH.S462591 -
Iranian Journal of Public Health May 2024Compared with able-bodied people, speech disabilities are more prone to various mental health problems. We aimed to explore the impact of positive psychology-based...
BACKGROUND
Compared with able-bodied people, speech disabilities are more prone to various mental health problems. We aimed to explore the impact of positive psychology-based intervention strategies on emotional cognition, mental health, and recovery of speech function in speech disabilities.
METHODS
In May 2023, 306 cases of speech disabilities were selected from 112 village committees and 129 neighborhood committees in Jingmen City, China. The control group was given routine speech rehabilitation training, and the observation group was given an intervention strategies-based on positive psychology based on the above training. The Symptom Checklist-90 (SCL-90), Chinese Facial Emotion Test (CFET), Comprehensive Function Assessment for Disabled Children (CFADC), and Boston Diagnostic Aphasia Examination (BDAE) were used to evaluate the two groups of patients before and after intervention.
RESULTS
After the intervention, the mental state scores (psychotic, obsessive-compulsive symptoms, somatization, paranoia, terror, hostility, anxiety, and depression) of the observation group were lower than those of the control group (<0.05). The correct emotional scores in the observation group were higher than those in the control group were. However, the remote error scores of the observation group were lower than those of the control group were. The difference was also statistically significant (<0.05). The cognitive function score, speech function score, and BDAE score (retelling, writing, fluency, and reading comprehension) of the observation group were all higher than those of the control group (<0.05).
CONCLUSION
The intervention strategies-based on positive psychology could promote the improvement of health problems and speech function in speech disabilities.
PubMed: 38912140
DOI: 10.18502/ijph.v53i5.15588 -
Wellcome Open Research 2024The Mental Capacity Act 2005 of England and Wales is a ground-breaking piece of legislation with reach into healthcare, social care and legal settings. Professionals...
BACKGROUND
The Mental Capacity Act 2005 of England and Wales is a ground-breaking piece of legislation with reach into healthcare, social care and legal settings. Professionals have needed to develop skills to assess mental capacity and handle malign influence, but it is unclear how assessments are implemented in real world settings. Our previously reported survey found professionals juggling competing resources in complex systems, often struggling to stay up to date with law.The current follow-up study uses one-to-one interviews of professionals to characterise in detail six areas of uncertainty faced when assessing mental capacity, whilst suggesting ways to make improvements.
METHODS
Forty-four healthcare, social care and legal professionals were interviewed, using a semi-structured topic guide. Transcripts were analysed using framework analysis: a qualitative technique built to investigate healthcare policy.
RESULTS
Our topic guide generated 21 themes. In relation to the six areas of uncertainty: 1) Many participants stressed the importance of capturing a holistic view, adding that their own profession was best-placed for this - although a medical diagnosis was often needed. 2) The presumption of capacity was a laudable aim, though not always easy to operationalise and occasionally being open to abuse. 3) There was cautious interest in psychometric testing, providing a cognitive context for decisions. 4) Undue influence was infrequent, but remained under-emphasised in training. 5) Multi-professional assessments were common, despite doubts about fitting these within local resources and the law. 6) Remote assessment was generally acceptable, if inadequate for identifying coercion.
CONCLUSIONS
Practical constraints and competing demands were reported by professionals working within real world systems. Assessment processes must be versatile, equally applicable in routine and emergency settings, across diverse decisional types, for both generalist and specialist assessors, and able to handle coercion. Recognising these challenges will guide development of best practices in assessment and associated policy.
PubMed: 38911900
DOI: 10.12688/wellcomeopenres.20952.1 -
Palliative Care and Social Practice 2024The growing burden of life-threatening illnesses and advancements in care interventions call for the intentional integration of palliative care services into existing...
BACKGROUND
The growing burden of life-threatening illnesses and advancements in care interventions call for the intentional integration of palliative care services into existing care systems. The absence of active, functioning palliative care services in most hospitals in Ghana is a major concern. This study explored the factors influencing the integration of palliative care services in one of such institutions.
OBJECTIVES
The aim of the study was to explore the institutional drivers of palliative care integration in a military health facility.
DESIGN
Exploratory qualitative study.
METHODS
We employed a qualitative exploratory study design situated within a constructivist paradigm. A purposive sampling method was used to select and interview 11 healthcare professionals. A semistructured interview was used to conduct face-to-face, in-depth interviews with participants between April and May 2022. A thematic data analysis was done based on the Braun and Clarke analysis process with the aid of QSR NVivo-12.
RESULTS
The six themes that describe the institutional driving factors for integrating palliative care services were cognitive restructuring, supportive logistics and infrastructure, staffing, healthcare professional skills, institutional policies and priorities, and utilization of focal persons. It was observed that a paradigm shift in the mindset of healthcare professionals and administrators was a major driver that would determine the integration of palliative care services. A cognitive restructuring will facilitate a more aggressive integration of palliative care services because logistics, staffing, and medication access will be prioritized.
CONCLUSION
Institutions have the responsibility of aligning with the WHO policy on palliative care service access and must invest in training, staffing, prioritizing palliative care needs and policies, procurement of essential drugs, and the provision of logistics and supportive infrastructure to scale up the implementation of palliative care services.
PubMed: 38911601
DOI: 10.1177/26323524241262327 -
Frontiers in Human Neuroscience 2024People who regularly exercise and receive training perform better when actioning unconscious cognitive tasks. The information flow triggered by a single unconscious...
INTRODUCTION
People who regularly exercise and receive training perform better when actioning unconscious cognitive tasks. The information flow triggered by a single unconscious visual stimulus has been extensively investigated, but it remains unclear whether multiple unconscious visual stimuli interact. This study aimed to explore the relationship between three simultaneous subliminal arrow stimuli (pointing in same or different directions), focusing on how they interact with each other and the subsequent priming effect on the target arrow in active and sedentary groups.
METHODS
We used a priming paradigm combining flanker task to test the hypothesis. A total of 42 participants were recruited. Of these, 22 constituted the active group and 20 constituted the sedentary group.
RESULTS
Behavioral data results revealed that the main effects of group and prime-target compatibility were significant. In the neurophysiological data, prime-target compatibility significantly influenced the latency of PP1. The amplitude of TP1 and TN2 mainly influenced the prime-flanker congruency. The prime-flanker congruency and groups interacted when the prime-target showed sufficient compatibility. The prime-flanker congruency, and the prime-target compatibility considerably influenced the TP3 amplitude in the anterior central frontal region (CZ electrode point).
CONCLUSION
Event-related potentials revealed the interactions between conscious processing and subliminal conflict in the early stages of perceptual and attention processing (target-related P1 potential component). These results suggest that exercise is helpful for coping with unconscious cognitive conflict.
PubMed: 38911228
DOI: 10.3389/fnhum.2024.1400930 -
Frontiers in Human Neuroscience 2024Brain fog is associated with significant morbidity and reduced productivity and gained increasing attention after COVID-19. However, this subjective state has not been...
IMPORTANCE
Brain fog is associated with significant morbidity and reduced productivity and gained increasing attention after COVID-19. However, this subjective state has not been systematically characterised.
OBJECTIVE
To characterise self-reported brain fog.
DESIGN
We systematically studied the cross-sectional associations between 29 variables with the presence of "brain fog." The variables were grouped into four categories: demographics, symptoms and functional impairments, comorbidities and potential risk factors (including lifestyle factors), and cognitive score. Univariate methods determined the correlates of brain fog, with long-COVID and non-long-COVID subgroups. XGBoost machine learning model retrospectively characterised subjective brain fog. Bonferroni-corrected statistical significance was set at 5%.
SETTING
Digital application for remote data collection.
PARTICIPANTS
25,796 individuals over the age of 18 who downloaded and completed the application.
RESULTS
7,280 of 25,796 individuals (28.2%) reported experiencing brain fog, who were generally older (mean brain fog 35.7 ± 11.9 years vs. 32.8 ± 11.6 years, < 0.0001) and more likely to be female (OR = 1.2, < 0.001). Associated symptoms and functional impairments included d (OR = 3.3), (OR = 1.6), (OR = 1.2, all < 0.0001), (OR = 2.2), (OR = 1.9), and performing (ORs = 1.8, all < 0.0001). Comorbidities included long-COVID-19 (OR = 3.8, < 0.0001), concussions (OR = 2.4, < 0.0001), and higher migraine disability assessment scores (MIDAS) (+34.1%, all < 0.0001). Cognitive scores were marginally lower with brain fog (-0.1 std., < 0.001). XGBoost achieved a training accuracy of 85% with cross-validated accuracy of 74%, and the features most predictive of brain fog in the model were difficulty focusing and following conversations, long-COVID, and severity of migraines.
CONCLUSIONS AND RELEVANCE
This is the largest study characterising subjective brain fog as an impairment of concentration associated with functional impairments in activities of daily living. Brain fog was particularly associated with a history of long-COVID-19, migraines, concussion, and with 0.1 standard deviations lower cognitive scores, especially on modified Stroop testing, suggesting impairments in the ability to inhibit cognitive interference. Further prospective studies in unselected brain fog sufferers should explore the full spectrum of brain fog symptoms to differentiate it from its associated conditions.
PubMed: 38911226
DOI: 10.3389/fnhum.2024.1409250 -
Journal of Alzheimer's Disease Reports 2024Slower walking is associated with changes in cortical volume and thickness. Computerized cognitive training (CCT) and exercise improve cortical volume and thickness and...
The Effect of Computerized Cognitive Training, with and without Exercise, on Cortical Volume and Thickness and Its Association with Gait Speed in Older Adults: A Secondary Analysis of a Randomized Controlled Trial.
BACKGROUND
Slower walking is associated with changes in cortical volume and thickness. Computerized cognitive training (CCT) and exercise improve cortical volume and thickness and thus, may promote gait speed. Slowing of gait is predictive of Alzheimer's disease.
OBJECTIVE
To examine: 1) the effect of CCT, with or without physical exercise, on cortical volume and thickness and; 2) the association of changes in cortical volume and thickness with changes in gait speed.
METHODS
A subset of 124 adults ( = 53), aged 65-85 years, enrolled in an 8-week randomized controlled trial and completed T1-weighted MRI and 4-meter walk at baseline and 8 weeks. Participants were randomized to: 1) active control (BAT; = 19); 2) CCT ( = 17); or 3) CCT preceded by exercise (Ex-CCT; = 17). Change in cortical volume and thickness were assessed and compared across all groups using Freesurfer.
RESULTS
BAT versus CCT increased left rostral middle frontal gyrus volume ( = 0.027) and superior temporal gyrus thickness ( = 0.039). Ex-CCT versus CCT increased left cuneus thickness ( < 0.001) and right post central gyrus thickness ( = 0.005), and volume ( < 0.001). Ex-CCT versus BAT increased left ( = 0.001) and right ( = 0.020) superior parietal gyri thickness. There were no significant between-group differences in gait speed ( > 0.175). Increased left superior parietal volume ( = 0.036, = 0.340) and thickness ( = 0.002, = 0.348), right post central volume ( = .017, = 0.341) and thickness ( = 0.001, = 0.348), left banks of superior temporal sulcus thickness ( = 0.002, = 0.356), and left precuneus thickness ( < 0.001, = 0.346) were associated with increased gait speed.
CONCLUSIONS
CCT with physical exercise, but not CCT alone, improves cortical volume and thickness in older adults. These changes may contribute to the maintenance of gait speed in aging.
PubMed: 38910947
DOI: 10.3233/ADR-230206 -
Journal of Alzheimer's Disease Reports 2024The evidence supporting the effectiveness of combined interventions in Alzheimer's disease (AD) patients remains inconclusive.
BACKGROUND
The evidence supporting the effectiveness of combined interventions in Alzheimer's disease (AD) patients remains inconclusive.
OBJECTIVE
The aim of this study was to evaluate the mid- and long-term effectiveness of physical training, alone or combined with cognitive games, on cognitive performance in patients with moderate AD.
METHODS
Seventy-nine AD patients (≈73% females, age of ≈70±1 years) were randomly divided into three groups: aerobic-based training (AT-group, = 27), aerobic-based training plus cognitive games (ACT-group, = 25), and a control group engaged in reading (CG, = 26), two sessions per week. Cognitive performance was evaluated at the start, 4th week (W4), end of the 8th week (W8), and after a 4-week detraining period (W12), using problem-solving (Tower-of-Hanoi), selective attention (Stroop-test), and working memory (Digit-Span-test) assessments. Stress levels and quality of life were also evaluated. Aerobic and combined training induced a positive effect on all cognitive functions tested at W4 (except problem-solving) and W8 (all < 0.001) with greater improvements in working-memory and problem-solving in ACT-group ( < 0.05). Depression levels also decreased significantly, and quality of life improved at W8 ( < 0.001) in both groups. After 4 weeks of detraining, the beneficial effect of AT and ACT was still observed. The CG did not show any significant improvements at all time points. Physical and cognitive interventions appear effective for improving cognitive-functions, quality-of-life, and reducing depression in AD patients. Combined training emerges as a more effective strategy to mitigate AD progression. Further research is necessary to validate these results and explore their potential for preventing early cognitive decline.
PubMed: 38910946
DOI: 10.3233/ADR-249003 -
Cureus May 2024Objective and background This study aimed to develop a deep convolutional neural network (DCNN) model capable of generating synthetic 4D magnetic resonance angiography...
Objective and background This study aimed to develop a deep convolutional neural network (DCNN) model capable of generating synthetic 4D magnetic resonance angiography (MRA) from 3D time-of-flight (TOF) images, allowing estimation of temporal changes in arterial flow. TOF MRA provides static information about arterial structures through maximum intensity projection (MIP) processing, but it does not capture the dynamic information of contrast agent circulation, which is lost during MIP processing. Considering the principles of TOF, it is hypothesized that dynamic information about arterial blood flow is latent within TOF signals. Although arterial spin labeling (ASL) can extract dynamic arterial information, ASL MRA has drawbacks, such as longer imaging times and lower spatial resolution than TOF MRA. This study's primary aim is to extend the utility of TOF MRA by training a machine-learning model on paired TOF and ASL data to extract latent dynamic information from TOF signals. Methods A DCNN combining a modified U-Net and a long-short-term memory (LSTM) network was trained on a dataset of 13 subjects (11 men and two women, aged 42-77 years) using paired 3D TOF MRA and 4D ASL MRA images. Subjects had no history of cerebral vessel occlusion or significant stenosis. The dataset was acquired using a 3T MRI system with a 32-channel head coil. Preprocessing involved resampling and intensity normalization of TOF and ASL images, followed by data augmentation and arterial mask generation. The model learned to extract flow information from TOF images and generate 8-phase 4D MRA images. The precision of flow estimation was evaluated using the coefficient of determination (R²) and Bland-Altman analysis. A board-certified neuroradiologist validated the quality of the images and the absence of significant stenosis in the major cerebral arteries. Results The generated 4D MRA images closely resembled the ground-truth ASL MRA data, with R² values of 0.92, 0.85, and 0.84 for the internal carotid artery (ICA), proximal middle cerebral artery (MCA), and distal MCA, respectively. Bland-Altman analysis revealed a systematic error of -0.06, with 95% agreement limits ranging from -0.18 to 0.12. Additionally, the model successfully identified flow abnormalities in a subject with left MCA stenosis, displaying a delayed peak and subsequent flattening distal to the stenosis, indicative of reduced blood flow. Visualization of the predicted arterial flow overlaid on the original TOF MRA images highlighted the spatial progression and dynamics of the flow. Conclusions The DCNN model effectively generated synthetic 4D MRA images from TOF images, demonstrating its potential to estimate temporal changes in arterial flow accurately. This non-invasive technique offers a promising alternative to conventional methods for visualizing and evaluating healthy and pathological flow dynamics. It has significant potential to improve the diagnosis and treatment of cerebrovascular diseases by providing detailed temporal flow information without the need for contrast agents or invasive procedures. The practical implementation of this model could enable the extraction of dynamic cerebral blood flow information from routine brain MRI examinations, contributing to the early diagnosis and management of cerebrovascular disorders.
PubMed: 38910733
DOI: 10.7759/cureus.60803 -
Biological Psychiatry. Cognitive... Jun 2024Working memory is a fundamental cognitive process that is critically involved in planning, comprehension, reasoning, or problem-solving. Acute stress has been shown to...
BACKGROUND
Working memory is a fundamental cognitive process that is critically involved in planning, comprehension, reasoning, or problem-solving. Acute stress has been shown to impair working memory. This stress-induced working memory deficit has profound implications for our cognitive functioning in everyday life as well as for stress-related mental disorders. Here, we tested whether a cognitive training intervention can make working memory more resistant to disruptive effects of acute stress.
METHODS
In a pre-registered, fully-crossed between-subjects design with the factors stress (vs. control) and cognitive training (vs. sham), one hundred twenty-three healthy men and women (aged 18-35 years) completed a daily cognitive training program targeting working memory-related processes or a sham training over a period of six weeks. After this six-week training intervention, participants underwent a standardized stress or control manipulation shortly before their working memory performance was tested.
RESULTS
As expected, the exposure to acute stress led to a significant working memory impairment in the sham training group. Critically, although the subjective, autonomic, and endocrine stress responses were comparable in the two training groups, this stress-induced working memory impairment was abolished in the intervention training group.
CONCLUSIONS
These results are the first to show that a cognitive training intervention directed at prefrontal and hippocampal functioning can prevent the detrimental effects of stressful events on working memory performance.
PubMed: 38909897
DOI: 10.1016/j.bpsc.2024.06.006