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Journal of Primary Care & Community... 2024Lifestyle interventions can prevent type 2 diabetes (T2D) by successfully inducing behavioral changes (eg, avoiding physical inactivity and sedentariness, increasing...
Hybrid Evaluation of a Lifestyle Change Program to Prevent the Development of Type 2 Diabetes Among Individuals With Prediabetes: Intended and Observed Changes in Intervening Mechanisms.
BACKGROUND
Lifestyle interventions can prevent type 2 diabetes (T2D) by successfully inducing behavioral changes (eg, avoiding physical inactivity and sedentariness, increasing physical activity and/or healthy eating) that reduce body weight and normalize metabolic levels (eg, HbA1c). For interventions to be successful, it is important to influence "behavioral mechanisms" such as self-efficacy, which motivate behavioral changes. Theory-based expectations of how self-efficacy, chronic stress, and mood changed over time were investigated through a group-based behavior change intervention (PREMIT). At 8 intervention sites, PREMIT was offered by trained primary care providers in 18 group-sessions over a period of 36 months, divided into 4 intervention phases. Adherence to the intervention protocol was assessed.
METHOD
Participants (n = 962) with overweight and prediabetes who had achieved ≥8% weight loss during a diet reduction period and completed the intervention were categorized into 3 groups: infrequent, frequent, or very frequent group sessions attendance. The interactions between participation in the group sessions and changes in self-efficacy, stress, and mood were multivariate tested. Intervention sites were regularly asked where and how they deviated from the intervention protocol.
RESULTS
There was no increase in the participants' self-efficacy in any group. However, the level of self-efficacy was maintained among those who attended the group sessions frequently, while it decreased in the other groups. For all participants, chronic stress and the frequency of attending group sessions were inversely related. Significant differences in mood were found for all groups. All intervention centers reported specific activities, additional to intervention protocol, to promote participation in the group sessions.
CONCLUSIONS
The results suggest that the behavioral changes sought by trained primary care providers are related to attendance frequency and follow complex trajectories. The findings also suggest that group-based interventions in naturalistic primary care settings aimed at preventing T2D require formats and strategies that encourage participants to attend group sessions regularly.
Topics: Humans; Diabetes Mellitus, Type 2; Prediabetic State; Male; Female; Middle Aged; Self Efficacy; Life Style; Aged; Adult; Stress, Psychological; Exercise; Program Evaluation; Affect; Risk Reduction Behavior; Primary Health Care; Overweight
PubMed: 38916158
DOI: 10.1177/21501319241248223 -
Scandinavian Journal of Pain Jan 2024
Topics: Humans; Reproducibility of Results; Exercise; Pain Measurement; Pain Threshold; Male; Female; Adult
PubMed: 38916102
DOI: 10.1515/sjpain-2024-0044 -
Drug Design, Development and Therapy 2024Nerve injury is a serious complication of percutaneous endoscopic transforaminal lumbar discectomy due to nerve root contact. The maximum tolerable concentration (MTC)...
Determining the Maximum Tolerable Concentration of Ropivacaine to Maintain Sensation of the Nerve Root in Percutaneous Endoscopic Transforaminal Lumbar Discectomy: Can Epidural Anaesthesia Achieve Pain-Tactile Separation Block to Avoid Nerve Injury?
INTRODUCTION
Nerve injury is a serious complication of percutaneous endoscopic transforaminal lumbar discectomy due to nerve root contact. The maximum tolerable concentration (MTC) of ropivacaine concentration for epidural anaesthesia, is defined as the concentration that minimises pain while preserving the sensation of the nerve roots. This distinct advantage allows the patient to provide feedback to the surgeon when the nerve roots are contacted.
METHODS
We used a biased-coin design to determine the MTC, which was estimated by the 10% effective concentration (EC), ie, the concentration at which 10% of patients lost sensation in the nerve roots. The determinant for positive response was lack of sensory feedback upon contact with the nerve root, and the feedback from occurrence of sensations in the innervation area upon contact with the nerve root was defined as a negative response. Primary outcome was the response from contact nerve root. Secondary outcomes were the type and number of statements of negative response and each patient's pain score during surgery.
RESULTS
Fifty-four patients were included in this study. The EC was 0.434% (95% CI: 0.410%, 0.440%) using isotonic regression in comparison with 0.431% (95% CI: 0.399%, 0.444%) using probit regression. Three type statements of negative response were reported including "tactile sensation", radiculalgia, and numbness.
CONCLUSION
The MTC of ropivacaine used for epidural anaesthesia was 0.434% to avoid nerve injury in percutaneous endoscopic transforaminal lumbar discectomy.
Topics: Ropivacaine; Humans; Male; Middle Aged; Female; Lumbar Vertebrae; Adult; Anesthetics, Local; Anesthesia, Epidural; Diskectomy, Percutaneous; Endoscopy; Spinal Nerve Roots; Dose-Response Relationship, Drug; Sensation; Aged
PubMed: 38915867
DOI: 10.2147/DDDT.S451980 -
PeerJ 2024Low energy availability (LEA) causes pathophysiology of the female athlete's body affecting the bone and reproductive health and was observed to have a high prevalence...
BACKGROUND
Low energy availability (LEA) causes pathophysiology of the female athlete's body affecting the bone and reproductive health and was observed to have a high prevalence in recreational female athletes previously. The aim of this study was to analyse the relationship between low energy availability in females questionnaire (LEAF-Q), bone mineral density (BMD), and postural stability in recreational athletes.
METHODS
Recreational female athletes ( = 24, age: 23.71 ± 2.94, Tier I) completed LEAF-Q, postural stability measurement during quiet stance (Zebris platform FDM; GmbH) and their BMD was measured using DXA (Hologic QDR Horizon A). Non-parametric statistical tests were used to analyse the relationships between LEAF-Q, BMD, and postural stability and to compare differences between participants divided by the LEAF-Q score and its subscales.
RESULTS
Risk of LEA was observed in 50% of recreational athletes participating in this study. Up to 46% of participants perceived menstrual bleeding changes related to training and 37.50% experienced menstrual dysfunction. Body composition and body weight fluctuations were observed to affect postural stability and BMD. With the risk score for LEA, the BMD and postural stability were not negatively affected in recreational athletes. However, the high number of recreational athletes in the risk score for LEA and menstrual dysfunctions highlights the need for public health programs aimed to increase awareness of LEA and its health consequences and for open communication about the menstrual cycle. Future longitudinal studies observing LEA, BMD, menstrual function, postural stability, and their interrelationship in female athletes are needed to increase the knowledge of this topic.
Topics: Humans; Female; Bone Density; Athletes; Young Adult; Adult; Postural Balance; Surveys and Questionnaires; Athletic Injuries; Relative Energy Deficiency in Sport; Body Composition; Absorptiometry, Photon
PubMed: 38915384
DOI: 10.7717/peerj.17533 -
Journal of Rehabilitation Medicine Jun 2024To explore and characterize somatosensory dysfunction in patients with post-polio syndrome and chronic pain, by conducting examinations with Quantitative Sensory Testing.
OBJECTIVE
To explore and characterize somatosensory dysfunction in patients with post-polio syndrome and chronic pain, by conducting examinations with Quantitative Sensory Testing.
DESIGN
A cross-sectional, descriptive, pilot study conducted during 1 month.
SUBJECTS/PATIENTS
Six patients with previously established post-polio syndrome and related chronic pain.
METHODS
All subjects underwent a neurological examination including neuromuscular function, bedside sensory testing, a thorough pain anamnesis, and pain drawing. Screening for neuropathic pain was done with 2 questionnaires. A comprehensive Quantitative Sensory Testing battery was conducted with z-score transformation of obtained data, enabling comparison with published reference values and the creation of sensory profiles, as well as comparison between the study site (more polio affected extremity) and internal control site (less affected extremity) for each patient.
RESULTS
Derived sensory profiles showed signs of increased prevalence of sensory aberrations compared with reference values, especially Mechanical Pain Thresholds, with significant deviation from reference data in 5 out of 6 patients. No obvious differences in sensory functions were seen between study sites and internal control sites.
CONCLUSION
Post-polio syndrome may be correlated with a mechanical hyperalgesia/allodynia and might be correlated to a somatosensory dysfunction. With lack of evident side-to-side differences, the possibility of a generalized dysfunction in the somatosensory system might be considered.
Topics: Humans; Postpoliomyelitis Syndrome; Pilot Projects; Cross-Sectional Studies; Female; Male; Middle Aged; Aged; Pain Measurement; Pain Threshold; Chronic Pain; Somatosensory Disorders; Adult; Neurologic Examination; Hyperalgesia; Neuralgia
PubMed: 38915293
DOI: 10.2340/jrm.v56.26192 -
BMC Psychology Jun 2024Video games have become a prevalent source of entertainment, especially among children. Furthermore, the amount of time spent playing video games has grown dramatically....
BACKGROUND
Video games have become a prevalent source of entertainment, especially among children. Furthermore, the amount of time spent playing video games has grown dramatically. The purpose of this research was to examine the mediation effects of attention and child memory on the relationship between video games addiction and cognitive and learning abilities in Egyptian children.
METHODS
A cross-sectional research design was used in the current study in two schools affiliated with Dakahlia District, Egypt. The study included 169 children aged 9 to 13 who met the inclusion criteria, and their mothers provided the questionnaire responses. The data collection methods were performed over approximately four months from February to May. Data were collected using different tools: Socio-demographic Interview, Game Addiction Scale for Children (GASC), Children's Memory Questionnaire (CMQ), Clinical Attention Problems Scale, Learning, Executive, and Attention Functioning (LEAF) Scale.
RESULTS
There was a significant indirect effect of video game addiction on cognitive and learning skills through attention, but not child memory. Video game addiction has a significant impact on children's attention and memory. Both attention and memory have a significant impact on a child's cognitive and learning skills.
CONCLUSIONS
These results revealed the significant effect of video game addiction on cognitive and learning abilities in the presence of mediators. It also suggested that attention-focused therapies might play an important role in minimizing the harmful effects of video game addiction on cognitive and learning abilities.
Topics: Humans; Child; Female; Male; Attention; Video Games; Adolescent; Cross-Sectional Studies; Memory; Learning; Cognition; Behavior, Addictive; Egypt; Internet Addiction Disorder; Executive Function
PubMed: 38915089
DOI: 10.1186/s40359-024-01849-9 -
Journal of Neuroengineering and... Jun 2024Impaired ankle proprioception strongly predicts balance dysfunction in chronic stroke. However, only sparse data on ankle position sense and no systematic data on ankle...
BACKGROUND
Impaired ankle proprioception strongly predicts balance dysfunction in chronic stroke. However, only sparse data on ankle position sense and no systematic data on ankle motion sense dysfunction in stroke are available. Moreover, the lesion sites underlying impaired ankle proprioception have not been comprehensively delineated. Using robotic technology, this study quantified ankle proprioceptive deficits post-stroke and determined the associated brain lesions.
METHODS
Twelve adults with chronic stroke and 13 neurotypical adults participated. A robot passively plantarflexed a participant's ankle to two distinct positions or at two distinct velocities. Participants subsequently indicated which of the two movements was further/faster. Based on the stimulus-response data, psychometric just-noticeable-difference (JND) thresholds and intervals of uncertainty (IU) were derived as measures on proprioceptive bias and precision. To determine group differences, Welch's t-test and the Wilcoxon-Mann-Whitney test were performed for the JND threshold and IU, respectively. Voxel-based lesion subtraction analysis identified the brain lesions associated with observed proprioceptive deficits in adults with stroke.
RESULTS
83% of adults with stroke exhibited abnormalities in either position or motion sense, or both. JND and IU measures were significantly elevated compared to the control group (Position sense: + 77% in JND, + 148% in IU; Motion sense: +153% in JND, + 78% in IU). Adults with stroke with both impaired ankle position and motion sense had lesions in the parietal, frontal, and temporoparietal regions.
CONCLUSIONS
This is the first study to document the magnitude and frequency of ankle position and motion sense impairment in adults with chronic stroke. Proprioceptive dysfunction was characterized by elevated JND thresholds and increased uncertainty in perceiving ankle position/motion. Furthermore, the associated cortical lesions for impairment in both proprioceptive senses were largely overlapping.
Topics: Humans; Male; Robotics; Proprioception; Female; Middle Aged; Stroke; Ankle; Aged; Adult; Chronic Disease; Brain; Stroke Rehabilitation
PubMed: 38915064
DOI: 10.1186/s12984-024-01396-9 -
BMC Medicine Jun 2024To assess the largely undetermined separate and joint effects of sleep and liver function biomarkers on liver cancer.
BACKGROUND
To assess the largely undetermined separate and joint effects of sleep and liver function biomarkers on liver cancer.
METHODS
Data of 356,894 participants without cancer at baseline in the UK Biobank were analyzed. Sleep score was evaluated using five sleep traits (sleep duration, chronotype, insomnia, snoring, and excessive daytime sleepiness) and dichotomized into healthy or unhealthy sleep. Circulating liver function biomarkers were measured. Cox proportional hazard model was performed to investigate the independent and joint associations of sleep and liver function biomarkers with liver cancer incidence.
RESULTS
After a median follow-up time of 13.1 years, 394 cases of incident liver cancer were documented. The multivariable-adjusted hazard ratio (HR) for liver cancer was 1.46 (95% confidence interval: 1.15-1.85) associated with unhealthy sleep (vs. healthy sleep), and was 1.17 (1.15-1.20), 1.20 (1.18-1.22), 1.69 (1.47-1.93), 1.06 (1.06-1.07), 1.08 (1.07-1.09), 1.81 (1.37-2.39), or 0.29 (0.18-0.46) associated with each 10-unit increase in alanine transaminase (ALT), aspartate transaminase (AST), total bilirubin (TBIL), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), total protein (TP), or albumin (ALB), respectively. Individuals with unhealthy sleep and high (≥ median) ALT, AST, TBIL, GGT, ALP, or TP or low (< median) ALB level had the highest HR of 3.65 (2.43-5.48), 4.03 (2.69-6.03), 1.97 (1.40-2.77), 4.69 (2.98-7.37), 2.51 (1.75-3.59), 2.09 (1.51-2.89), or 2.22 (1.55-3.17) for liver cancer, respectively. Significant additive interaction of unhealthy sleep with high TP level on liver cancer was observed with relative excess risk due to an interaction of 0.80 (0.19-1.41).
CONCLUSIONS
Unhealthy sleep was associated with an increased risk of liver cancer, especially in participants with lower ALB levels or higher levels of ALT, AST, TBIL, GGT, ALP, or particularly TP.
Topics: Humans; Male; Female; Middle Aged; Liver Neoplasms; Prospective Studies; Sleep; Biomarkers; Aged; United Kingdom; Adult; Incidence; Liver Function Tests; Risk Factors; Liver
PubMed: 38915009
DOI: 10.1186/s12916-024-03440-w -
BMC Public Health Jun 2024This survey study investigated the types of sources other than medical professionals (e.g., social media) that the caregivers of children with...
BACKGROUND
This survey study investigated the types of sources other than medical professionals (e.g., social media) that the caregivers of children with attention-deficit/hyperactivity disorder (ADHD) use to acquire knowledge about ADHD and investigated the association between the use of such information sources and caregiver parenting stress and anxiety in Taiwan.
METHODS
A total of 213 caregivers of children with ADHD participated in this study. The sources that the caregivers used to acquire knowledge about ADHD other than medical professionals were investigated. Caregiver parenting stress was assessed using the Parenting Stress Index, and caregiver anxiety was assessed using the Beck Anxiety Inventory. The associations of the types of sources used and total number of source use with caregiver parenting stress and anxiety were investigated using multivariate linear regression analysis.
RESULTS
The most common source of knowledge other than medical professionals was teachers (55.4%), followed by social media (52.6%), traditional media (50.7%), friends (33.8%), caregivers of other children (21.1%), and family members (18.3%). The caregivers' mean total number of using sources of knowledge about ADHD other than medical professionals was 2.32. Acquiring knowledge about ADHD from social media was significantly associated with caregiver parenting stress. Additionally, acquiring knowledge about ADHD from caregivers of other children was significantly associated with caregiver parenting stress and anxiety, as was the frequency of using sources of knowledge about ADHD other than medical professionals.
CONCLUSION
The caregivers of children with ADHD acquired knowledge about ADHD from multiple sources. Acquiring knowledge about ADHD from social media was significantly associated with caregiver parenting stress. The number of sources of knowledge about ADHD was significantly associated with caregiver parenting stress and anxiety.
Topics: Humans; Attention Deficit Disorder with Hyperactivity; Taiwan; Female; Male; Caregivers; Adult; Parenting; Stress, Psychological; Anxiety; Child; Middle Aged; Surveys and Questionnaires; Information Seeking Behavior; Health Knowledge, Attitudes, Practice; Social Media
PubMed: 38914984
DOI: 10.1186/s12889-024-18761-x -
BMC Public Health Jun 2024Psychosocial hazards in the workplace were identified as a considerable risk to employee mental health as well as their general well-being. Few studies were found to...
BACKGROUND
Psychosocial hazards in the workplace were identified as a considerable risk to employee mental health as well as their general well-being. Few studies were found to examine its relationship with work engagement and mental health. Thus, this study examines the relationships between psychosocial factors, work engagement, and mental health within the faculty in Saudi Arabia using structural equation modeling.
METHODS
The cross-sectional study was conducted with a sample size of 375 faculty. Data collection was done using a self-administered online survey that included instruments such as the Copenhagen Psychosocial Questionnaire (COPSOQ), Utrecht Work Engagement Scale (UWES), and General Health Questionnaire (GHQ-12). SmartPLS 3 software facilitated data analysis and included the assessment of factors. Structural equation modelling was used to examine the interplay between psychosocial factors, work engagement, and mental health.
RESULTS
The robust measurement model was characterized by high loadings (0.719 to 0.970), Cronbach's alpha (0.595 to 0.933), and composite reliability (0.807 to 0.968). Convergent and discriminant validity were confirmed using AVE and various criteria. The fit of the saturated model was superior. Burnout explained significant variance (0.585) with predictive relevance for all constructs. Notably, the impact of burnout on family conflict and the influence of stress on burnout were found to have significant effect sizes.
CONCLUSION
The study uses structural equation modeling to examine the relationships between psychosocial factors, work engagement, and mental health among faculty in Saudi Arabia. The robust measurement model demonstrated high reliability and validity, while the saturated model demonstrated excellent fit. These findings contribute to our understanding of psychosocial dynamics, work engagement, and overall health among faculty in Saudi Arabia.
Topics: Humans; Saudi Arabia; Cross-Sectional Studies; Male; Female; Adult; Mental Health; Work Engagement; Latent Class Analysis; Faculty; Surveys and Questionnaires; Middle Aged; Burnout, Professional
PubMed: 38914969
DOI: 10.1186/s12889-024-19114-4