Tag: pubmed

Psychogeriatrics. 2023 Jul 20. doi: 10.1111/psyg.13008. Online ahead of print.

ABSTRACT

BACKGROUND: Effects of a multicomponent exercise programme have an impact on the physical, cognitive, and psychological domains in elderly community-dwellers. However, some individuals aged 65 years or more have not shown positive effects after the intervention as reported in similar research. The objective of this quasi-experimental study was to clarify the effectiveness of a multicomponent programme based on reality orientation therapy (ROT) on the physical performance, cognitive ability, and psychological state in the elderly.

METHOD: Participants were recruited from the general public in 20 areas of Akita Prefecture, Japan, and they took part in each exercise programme for 90 min a day, once every 2 weeks, for 3 months, according to the group classification using cluster randomization into 20 cohorts in Akita. Physical, cognitive, and geriatric depression assessments were performed at baseline and after the 6-month intervention in both the ROT-based intervention group and the control group.

RESULT: The final samples for analysis consisted of 31 participants in the control group and 30 participants in the intervention group. The results of the statistical analysis comparing the two groups showed that the 5-repetition sit-to-stand test was performed significantly faster (P < 0.05) and that the results of the word list memory (WM) test and the Symbol Digit Substitution Task also had significantly improved (P < 0.05) after the intervention in both groups. The WM score did not show an interactive effect between the group and time factors, but it had a significant main effect on time in both groups (P < 0.05).

CONCLUSION: The results of our quasi-experimental study indicated that the multicomponent programme based on the ROT would be as effective as the original multicomponent programme combined with aerobic exercise and cognitive tasks, as highlighted in the WM.

PMID:37474259 | DOI:10.1111/psyg.13008

BMJ Open. 2023 Jul 20;13(7):e061945. doi: 10.1136/bmjopen-2022-061945.

ABSTRACT

OBJECTIVE: The COVID-19 pandemic has had a significant impact on the burnout and mental health of medical staff. This meta-analysis aims to provide additional (and updated) evidence related to burnout and mental health problems among medical staff using a broader data pool.

DESIGN: Systematic review and meta-analysis.

DATA SOURCES: PubMed, Embase, Cochrane Library, CNKI, Wanfang data and three preprint databases (SSRN, bioRxiv and medRxiv) were searched from 1 January 2020 to 17 May 2021.

ELIGIBILITY CRITERIA: We included observational studies investigating the prevalence of burnout and mental health problems among medical staff during the COVID-19 pandemic, including cross-sectional study, cohort study and case-control study.

DATA EXTRACTION AND SYNTHESIS: Two independent reviewers used a self-designed form to extract the primary data. The Joanna Briggs Institute quality appraisal tool was used to assess the quality of selected studies. Heterogeneity among studies was assessed by I² statistic. A random-effects model was used to pool the prevalence. Subgroup analysis was performed to explore between-group differences.

RESULTS: 250 studies were included, with a sample of 292 230 participants from 46 countries. The pooled prevalence of burnout, anxiety, depression, insomnia, stress, post-traumatic stress disorder symptoms and somatic symptoms was 43.6% (95% CI 36.3% to 51.2%), 37.1% (95% CI 34.7% to 39.7%), 37.6% (95% CI 35.0% to 40.4%), 43.7% (95% CI 39.1% to 48.5%), 41.3% (95% CI 35.1% to 47.9%), 30.6% (95% CI 23.6% to 38.5%) and 25.0% (95% CI 16.7% to 35.6%), respectively. Subgroup analysis showed a higher prevalence of anxiety, depression and insomnia in frontline workers than in non-frontline workers, and a higher prevalence of anxiety in females than males. Mild cases accounted for the most significant proportion of the outcomes except for stress.

CONCLUSIONS: This study highlights that identifying the risks of burnout and mental health problems and adopting preventive interventions are priorities for policymakers and medical staff to avoid long-term occupational, health and social impacts.

PROSPERO REGISTRATION NUMBER: CRD42021254425.

PMID:37474193 | DOI:10.1136/bmjopen-2022-061945

BMJ Open. 2023 Jul 20;13(7):e073925. doi: 10.1136/bmjopen-2023-073925.

ABSTRACT

OBJECTIVES: This study aimed to identify the determinants of gastric cancer screening attendance among individuals aged 40 years in a region with high gastric cancer in China.

DESIGN: An anonymous, cross-sectional survey was conducted between October 2021 and March 2022.

SETTING: A self-administered online survey was conducted in Fujian Province in Southeastern China.

PARTICIPANTS: People aged 40 years living in five selected cities in Fujian Province with no history of cancer.

MAIN OUTCOME MEASURES: Gastric cancer screening attendance was measured with the question ‘Have you ever been screened for gastric cancer in the past’.

RESULTS: In total, 2547 complete responses were obtained. The mean age of respondents was 47.72±7.20 years, and 59.8% were men. A total of 42.6% of participants reported that they had undergone gastric cancer screening. The result of multivariable logistic regression analysis showed that participants with a first-degree relative affected with gastric cancer (OR=2.02, 95% CI: 1.58 to 2.59) and high perceived susceptibility of gastric cancer (OR=2.03, 95% CI: 1.58 to 2.59) were the strongest facilitators for screening attendance. Other factors positively associated with screening attendance were age 51-60 years (OR=1.69, 95% CI: 1.31 to 2.18), living in urban regions (OR=1.27, 95% CI: 1.05 to 1.55), friends/neighbours/colleagues with gastric cancer (OR=1.30, 95% CI: 1.07 to 1.58), history of chronic gastric disease (OR=1.90, 95% CI: 1.57 to 2.30), perceived high cost (OR=1.28, 95% CI: 1.01 to 1.61) and physician recommendation (OR=1.71, 95% CI: 1.36 to 2.16). On the other hand, factors negatively associated with screening attendance included perceived barriers, namely screening is only necessary when symptoms present (OR=0.71, 95% CI: 0.58 to 0.87) and perceived appointment for gastroscopy screening is difficult and time-consuming (OR=0.75, 95% CI: 0.60 to 0.94). No significant association was found between knowledge level and participation in screening.

CONCLUSION: This study highlights important individual-level factors and barriers to gastric cancer screening. Strategies targeting under-screened populations and eliminating patient-perceived barriers to gastric cancer screening are essential.

PMID:37474189 | DOI:10.1136/bmjopen-2023-073925

BMJ Open. 2023 Jul 20;13(7):e072535. doi: 10.1136/bmjopen-2023-072535.

ABSTRACT

OBJECTIVES: Adolescent childbirth is associated with older adult adverse health outcomes that negatively affect mobility function, but these associations have not been studied globally in large samples of reproductive-age women. This study examines the association between age at first childbirth and mobility disability in national surveys from low-income and middle-income countries, and hypotheses that adolescent childbirth is associated with mobility disability.

DESIGN: Cross-sectional analysis.

SETTING: Population health surveys from 2013 to 2018 containing mobility disability measures among ever-pregnant women ages 15-49. These included 13 Demographic Health Surveys from Haiti, Pakistan, Uganda, Cambodia, Colombia, South Africa, Timor-Leste, Albania, Gambia, Maldives, Peru, Senegal and Yemen and 1 Maternal Health Survey from Ghana.

PARTICIPANTS: The sample included 157 988 women ages 15-49 years.

PRIMARY OUTCOME MEASURE: Adolescent childbirth was defined as 10-19 years of age. Poisson regression models were used to estimate prevalence ratios (PRs) of mobility disability among women who first gave birth during adolescence and in adult life (ages 20-45 years) in each country and across the whole sample. Countries were also analysed according to the use of standard and non-standard mobility disability measures. Covariates included current age, urban/rural residence, education and household wealth.

RESULTS: Prevalence of adolescent childbirth (17.5%-66.2%) and mobility disability (0.32%-21.45%) varied widely across countries. Adolescent childbirth was significantly (p<0.05) associated with greater mobility disability in six of eight countries using standard disability measures. Among the six countries that did not use standard disability measures, none showed a statistically significant association between adolescent childbirth and mobility disability. Considering the whole sample and adjusting for all covariates, women who gave birth during adolescence had greater prevalence of mobility disability (pooled PR 1.19, 95% CI 1.06-1.31).

CONCLUSIONS: This analysis suggests a moderate and consistent association of adolescent childbearing with subsequent mobility disability.

PMID:37474178 | DOI:10.1136/bmjopen-2023-072535

BMJ Open. 2023 Jul 20;13(7):e071407. doi: 10.1136/bmjopen-2022-071407.

ABSTRACT

OBJECTIVE: This study aims to comprehensively evaluate the resources for prevention and control of chronic and non-communicable diseases (NCDs) in China to provide a reference basis for optimising the resource allocation for prevention and control of NCDs.

METHODS: China Chronic Disease and Risk Factor Surveillance sites and National Demonstration Areas for Integrated Chronic and Non-communicable Disease Prevention and Control (NCDDA) were selected as investigation objects. In December 2021, the district (or county) resource allocation for NCD prevention and control was investigated through the NCDDA management information system. According to the index system of NCD prevention and control, 31 indicators of 6 dimensions were collected, and the weighted technique for order preference by similarity to an ideal solution, weighted rank-sum ratio and fuzzy comprehensive evaluation methods were used for comprehensive evaluation of resources for prevention and control of NCDs.

RESULTS: The 653 districts (or counties) in this study cover 22.96% of China’s districts (or counties). The top three weights were full-time staff for NCD prevention and control (0.1066), the amount of funds for NCD prevention and control (0.0967), and the coverage rate of districts (or counties) establishing chronic obstructive pulmonary disease surveillance information system (0.0886). The comprehensive evaluation results for the resources for prevention and control of NCDs by the three methods were basically the same. The results of fuzzy comprehensive evaluation showed that the resource allocation in urban areas (0.9268) was better than that in rural areas (0.3257), the one in eastern region (0.9016) was better than that in central (0.3844) and western regions (0.3868), and the one in NCDDA (0.9625) was better than that in non-NCDDA (0.2901).

CONCLUSION: The resources in China for NCD prevention and control differ among different regions, which should be taken into account in future policymaking and resource allocation.

PMID:37474175 | DOI:10.1136/bmjopen-2022-071407

BMJ Open. 2023 Jul 19;13(7):e065622. doi: 10.1136/bmjopen-2022-065622.

ABSTRACT

OBJECTIVE: To model the referral, diagnostic and treatment pathway for cardiovascular disease (CVD) in the English National Health Service (NHS) to provide commissioners and managers with a methodology to optimise patient flow and reduce waiting lists.

STUDY DESIGN: A systems dynamics approach modelling the CVD healthcare system in England. The model is designed to capture current and predict future states of waiting lists.

SETTING: Routinely collected, publicly available data streams of primary and secondary care, sourced from NHS Digital, NHS England, the Office of National Statistics and StatsWales.

DATA COLLECTION AND EXTRACTION METHODS: The data used to train and validate the model were routinely collected and publicly available data. It was extracted and implemented in the model using the PySD package in python.

RESULTS: NHS cardiovascular waiting lists in England have increased by over 40% compared with pre- COVID-19 levels. The rise in waiting lists was primarily due to restrictions in referrals from primary care, creating a bottleneck postpandemic. Predictive models show increasing point capacities within the system may paradoxically worsen downstream flow. While there is no simple rate-limiting step, the intervention that would most improve patient flow would be to increase consultant outpatient appointments.

CONCLUSIONS: The increase in NHS CVD waiting lists in England can be captured using a systems dynamics approach, as can the future state of waiting lists in the presence of further shocks/interventions. It is important for those planning services to use such a systems-oriented approach because the feed-forward and feedback nature of patient flow through referral, diagnostics and treatment leads to counterintuitive effects of interventions designed to reduce waiting lists.

PMID:37474168 | DOI:10.1136/bmjopen-2022-065622

BMJ Open. 2023 Jul 20;13(7):e074615. doi: 10.1136/bmjopen-2023-074615.

ABSTRACT

INTRODUCTION: Several systematic reviews (SRs) have been conducted to determine the effectiveness of early mobilisation in critically ill adults with heterogeneous methodology and results. Redundancy in conducting SRs, unclear justification when leading new SRs or updating, and discordant results of SRs on the same research question may generate research waste that makes it difficult for clinicians to keep up to date with the best available evidence. This meta-research aims to assess the redundancy, methodological and reporting quality, and potential reasons for discordance in the results reported by SRs conducted to determine the effectiveness of early mobilisation in critically ill adult patients.

METHODS AND ANALYSIS: A meta-research of early mobilisation SRs in critically ill adult patients will be conducted. A search of MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), Cochrane Library, Epistemonikos and other search resources will be conducted. Two independent reviewers will perform study selection, data extraction and quality appraisal. Discrepancies will be resolved by consensus or a third reviewer. The redundancy of SRs will be assessed by the degree of overlap of primary studies. In addition, the justification for conducting new SRs will be evaluated with the ‘Evidence-Based Research’ framework. The methodological quality of the SRs will be assessed with the A MeaSurement Tool to Assess systematic Reviews 2 tool, and the quality of the reports through compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. To assess the potential reasons for discordance in the results of the SRs considering divergence in results and their interpretation.

ETHICS AND DISSEMINATION: As meta-research, this study does not involve the participation of people whose rights may be violated. However, this overview will be developed rigorously and systematically to achieve valid and reliable results. The findings of this meta-research study will be presented at conferences and published in a peer-reviewed journal related to rehabilitation, critical care or research methodology.

TRIAL REGISTRATION NUMBER: osf.io/kxwq9.

PMID:37474166 | DOI:10.1136/bmjopen-2023-074615

Am J Clin Nutr. 2023 Jul 18:S0002-9165(23)66055-1. doi: 10.1016/j.ajcnut.2023.07.011. Online ahead of print.

ABSTRACT

BACKGROUND: Adherence to the American Cancer Society (ACS) guidelines of avoiding obesity, maintaining physical activity, and consuming a diet rich in fruits, vegetables, and whole grains is associated with longer survival in colorectal cancer (CRC) survivors. Dietary components of the ACS guidelines may act in part by changing the microbiome, which is implicated in CRC outcomes.

OBJECTIVES: We conducted a pilot cross-sectional study to explore associations between ACS guidelines and the gut microbiome.

DESIGN: Stool samples and questionnaires were collected from 28 CRC survivors at the University of California, San Francisco (UCSF) from 2019-2020. ACS scores were calculated based on validated questionnaires. Gut microbial community structure from 16S amplicons and gene/pathway abundances from metagenomics were tested for associations with the ACS score and its components using analysis of variance (ANOVA) and general linear models.

RESULTS: The overall ACS score was not significantly associated with variations in the fecal microbiota. However, fruit and vegetable intake and alcohol intake accounted for 19% (p=0.005) and 13% (p=0.01) of variations in the microbiota, respectively. Fruit/vegetable consumption was associated with increased microbial diversity, increased Firmicutes, decreased Bacteroidota, and changes to multiple genes and metabolic pathways, including enriched pathways for amino acid and short-chain fatty acid biosynthesis and plant-associated sugar degradation. In contrast, alcohol consumption was positively associated with overall microbial diversity, negatively associated with Bacteroidota abundance, and associated with changes to multiple genes and metabolic pathways. The other components of the ACS score were not statistically significantly associated with the fecal microbiota in our sample.

CONCLUSION: These results guide future studies examining the impact of changes in intake of fruits, vegetables, and alcoholic drinks on the gut microbiome for CRC survivors.

PMID:37474105 | DOI:10.1016/j.ajcnut.2023.07.011

Prog Cardiovasc Dis. 2023 Jul 18:S0033-0620(23)00071-3. doi: 10.1016/j.pcad.2023.07.005. Online ahead of print.

NO ABSTRACT

PMID:37474084 | DOI:10.1016/j.pcad.2023.07.005

Sci Total Environ. 2023 Jul 18:165650. doi: 10.1016/j.scitotenv.2023.165650. Online ahead of print.

ABSTRACT

Earth observation satellites have facilitated the quantification of how vegetation phenology responds to climate warming on large scales. However, satellite image pixels may contain a mixture of multiple vegetation types or species with diverse phenological responses to climate variability. It is unclear how these mixed pixels affect the statistical relationships between satellite-derived vegetation phenology and climate factors. Here, we aim to investigate the impacts of percent tree cover (PTC), a measure of mixed pixel, on the statistical relationships between satellite-derived vegetation greenup date (GUD) and spring air temperature across Eurasian boreal forests at a 0.05° spatial resolution. We estimated GUD using Moderate Resolution Imaging Spectroradiometer (MODIS) time series data. The responses of GUD to interannual variation in spring temperature (April to May) during 2001-2020 were characterized by correlation coefficient (RT_AM) and sensitivity (ST_AM). We then evaluated the local impacts of PTC on spatial variations in RT_AM and ST_AM using partial correlation analysis through spatial moving windows. Our results indicate that, for most areas, forests with higher PTC were associated with stronger RT_AM and ST_AM. Moreover, PTC had stronger local impacts on RT_AM and ST_AM than mean annual temperature and temperature seasonality for 37.3 % and 27.4 % of the moving windows, respectively. These impacts were spatially varying and different among forest types. Specifically, deciduous broadleaf forests and deciduous needleleaf forests tend to have a higher proportion of these impacts compared to other forest types. Our findings demonstrate the nonnegligible effects of PTC on the statistical responses of GUD to temperature variability at coarse spatial resolution (0.05°) across Eurasian boreal forests.

PMID:37474076 | DOI:10.1016/j.scitotenv.2023.165650