Active Intervention Research Articles

A look into the cancer continuum for the development of a physical activity intervention: qualitative investigation of the physical activity experiences and preferences of female cancer survivors.

Clinical guidelines recommend cancer survivors (i.e., people with a cancer diagnosis) engage in regular physical activity (PA) during and post treatment, yet most do not. Additionally, PA promotion for cancer survivors has primarily focused on post treatment, calling for an understanding of PA promotion during treatment. This study explores the PA experiences and preferences of both in-treatment and post-treatment breast and gynecologic cancer survivors (BGCS) to inform the design of a PA intervention. Semi-structured interviews were conducted with postmenopausal women aged ≥ 50years, diagnosed with breast or gynecological cancer (stages 1-3), who were undergoing, or recently completed (12 to 24months) chemotherapy and/or primary treatment. Interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to explore themes. Participants (N = 26; Mage: 63.9years) had a breast (92.3%) and gynecologic (7.7%) cancer diagnosis and 46.2% (n = 12) were in treatment whereas 53.8% (n = 14) were post treatment. BGCS experienced several side effects of cancer treatment and both groups felt PA was an important goal. In-treatment BGCS focused on managing side effects (e.g., fatigue) and recognized energy fluctuated around treatments, making those periods less ideal for PA. In-treatment BGCS strongly endorsed a flexible, at-home intervention. Post-treatment BGCS emphasized recovery and relapse prevention, also favoring at-home, flexible interventions but showing greater interest towards support groups to aid with their recovery journey. Preferred activities included walking, dancing, and muscle-strengthening. Findings highlight the unique challenges postmenopausal BGCS face in participating in PA, especially in-treatment, emphasizing the importance of a tailored PA intervention.

Fit club: Outcomes from 35-minute daily exercise program for autistic adolescents

BackgroundAutistic children and adolescents have academic performance challenges and are often reluctant to participate in physical activities. Executive function (EF) abilities generally remain stable or worsen as autistic children get older and obesity and lack of physical fitness are frequent concerns experienced by these individuals. Finding ways to address these concerns has the potential to improve outcomes in autistic youth. MethodWe conducted a 12-month, repeated-measures study to examine the effectiveness of a mandatory 35-minute daily school physical activity intervention involving low to moderate exertion for autistic adolescents (n = 29). Changes in fitness, EF, social responsiveness, and restrictive and repetitive behaviors were examined. ResultsSignificant improvements were seen in fitness, EF areas (specifically cognitive flexibility and planning/organizing), restrictive and repetitive behaviors and social responsiveness. ConclusionFindings suggest that participation in a mandatory daily 35-minute physical activity program with low to moderate exertion is feasible and may contribute to improved EF, fitness, restricted and repetitive behavior, and social responsiveness in autistic adolescents.

Impact of Interventions by Certified Pharmacists for Outpatients with Cancer Pain on Hospital Admission after the Introduction of Opioid Analgesics.

The treatment of patients with cancer in an outpatient setting is important for maintaining patients' QOL and reducing the social burden of therapy, thus requiring extensive intervention by pharmacists in the outpatient setting. Japan has a system to certify pharmacists with specialized knowledge and skills in palliative care. However, few studies have investigated the impact of certified pharmacists' activities and of pharmacists' interventions on hospitalization and outpatient visits. Therefore, in this study, we retrospectively investigated the effects of interventions by certified pharmacists during the period from the introduction of opioid analgesics to hospitalization for pain management and the duration of outpatient visits at a single acute care hospital. Analysis using the Cox proportional hazards model showed that interventions by certified pharmacists significantly reduced hospitalizations for pain management (p = 0.014). Further, the results of the log-rank test showed that interventions by certified pharmacists significantly prolonged the period from the introduction of opioid analgesics to hospitalization compared with the absence of such interventions (p = 0.013). Additionally, interventions by certified pharmacists significantly increased the duration of outpatient visits compared with the absence of such interventions (p < 0.001). These results suggest that active and careful interventions by pharmacists, including certified pharmacists, contribute to the maintenance of the patients' QOL and healthcare economics by extending the period from the introduction of opioid analgesics to hospitalization for pain management and the duration of outpatient visits.

The Impact of Visual Distraction Interventions on Patients' Pain and Anxiety During Colonoscopy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Patients undergoing colonoscopy may experience psychological distress related to the procedure, which may deter adherence and acceptance of future colonoscopies. Visual/audiovisual distraction interventions to alleviate colonoscopy-related pain and anxiety have been developed. This study aims to investigate the impact of these interventions on colonoscopy-related outcomes. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) testing the efficacy of visual/audiovisual distraction. Eligible studies were systematically retrieved by searching PubMed, EMBASE, WOS, SCOPUS, and Cochrane through June 2024 and extracted by 2 investigators. Continuous and dichotomous outcome variables were pooled using Cohen's d and risk ratio (RR) with confidence interval (CI) using Stata MP version 17. We assessed heterogeneity using the χ2 test and I2 statistic (PROSPERO ID: CRD42024555902). We included 13 RCTs with 1439 patients randomized to an active intervention (n=804) or usual care (n=635). Only 3 RCTs were endoscopists-blinded studies, whereas the rest were open-label. The interventions included playing nature scene videos, real-time videos of the colonoscopy, or movies preferred by the patients. The active intervention arm was associated with a significant reduction in the pain experienced during colonoscopy (Cohen's d: -0.57, 95% CI [-0.79, -0.35], P<0.0001), reduced anxiety related to colonoscopy (Cohen's d: -0.66, 95% CI [-1.15, -0.18], P=0.01), and increased patients' satisfaction (Cohen's d: 0.65, 95% CI [0.49, 0.80], P<0.0001) compared with patients who received the usual care during colonoscopy. There were no significant differences between both groups in the willingness to re-undergo the procedure (RR: 1.11, 95% CI [0.98, 1.25], P=0.09), analgesia use (Cohen's d: -0.21, 95% CI [-0.42, 0.0], P=0.05), or total procedure duration (Cohen's d: -0.12, 95% CI [-0.24, 0.0], P=0.06). Visual/audiovisual distraction interventions decrease colonoscopy-associated pain and anxiety and increase patients' satisfaction. These are promising interventions to improve patient compliance and quality of care during colonoscopy.

Influence of the functional intervention on the development of essential social skills in children with life-limiting conditions

Life-limiting conditions often cause children to be overlooked as participants in everyday activities. For parents child development should lead to independence in daily living activity. For parents of children who are disabled, independence is a step to a better quality of a child’s life. The aim of the study was to examine the effectiveness of functional intervention of self-service activities in children with life-limiting conditions at the age of 3–6 years of life. 32 children aged 3–6 years (N = 32, girls and boys) were followed for two years. The Progress Assessment Chart of Personal and Social Development (PPAC) H.C Gunzburg according to Witkowski inventory was used to assess. After two years of functional intervention, statistically significant improvement in everyday activities was observed in examining group. The control group showed less progress than the study group, even though the children in the control group were older. Functional intervention allows for effective work with a patient with life-limited conditions. Better progress was observed in the younger group, subjected to therapy for the existence of developmental potential occurring in children with limitations in intellectual development.

A Tailored Postpartum eHealth Physical Activity Intervention for Individuals at High Risk of Postpartum Depression-the POstpartum Wellness Study (POW): Protocol and Data Overview for a Randomized Controlled Trial.

Postpartum depression (PPD) is associated with significant health consequences for the parent and child. Current recommendations for PPD prevention require intense health care system resources. Evidence-based interventions for PPD prevention that do not further burden the health care system are needed. Evidence suggests that physical activity (PA) can generally reduce depressive symptoms. Technology-based interventions may help decrease common barriers to PA. This study aims to report the protocol and provide a data overview of the POstpartum Wellness study (POW)-an effectiveness trial evaluating whether an eHealth PA intervention tailored for postpartum individuals increased PA and decreased depressive symptoms among individuals at high PPD risk. This remote parallel-group randomized controlled trial included postpartum individuals with a history of depression or at least moderate current depressive symptoms not meeting the PPD diagnostic threshold and with low PA levels from an integrated health care delivery system. Participants were randomized to an eHealth PA intervention or usual care. The intervention group received access to a library of web-based workout videos designed for postpartum individuals, which included interaction with their infants. At baseline and follow-up (3 and 6 months), PA was measured using questionnaires and a wrist-worn accelerometer. Depressive symptoms were measured using the Patient Health Questionnaire-8 (PHQ-8). Data were collected to assess exploratory outcomes of sleep, perceived stress, anxiety, parent-infant bonding, and infant development. The study was funded in January 2020. Participants were enrolled via REDCap (Research Electronic Data Capture) or telephonically between November 2020 and September 2022; data collection ended in April 2023. Randomized participants (N=99) were 4 months post partum at baseline with moderately severe depressive symptoms (mean PHQ-8 score 12.6, SD 2.2). Intervention (n=50) and usual care (n=49) groups had similar sociodemographic characteristics, months post partum, baseline depressive symptoms, number of children at home, and prepregnancy PA levels. Retention in assessments was ≥66% for questionnaires and ≥48% for accelerometry, with modest differences by group. At 3-month follow-up, 73 of 99 (74%) participants (intervention: 35/50, 70%; usual care: 38/49, 78%) completed questionnaires; 53 of 99 (54%) wore the accelerometer for 7 days (27 of 50 (54%) intervention, 26 of 49 (53%) usual care). At 6-month follow-up, 66 of 99 (67%) participants (30 of 50 (60%) intervention, 36 of 49 (73%) usual care) completed questionnaires and 43 of 99 (43%) wore the accelerometer for 7 days (21 of 50 (42%) intervention, 22 of 49 (45%) usual care). Data analysis is completed, and a manuscript with these findings is currently under review for publication. The POW trial evaluates the effectiveness of an eHealth PA intervention for improving depressive symptoms and increasing PA among postpartum individuals at high PPD risk. Results have implications for the design and delivery of behavioral interventions among vulnerable patients. ClinicalTrials.gov NCT04414696; https://clinicaltrials.gov/ct2/show/NCT04414696. DERR1-10.2196/56882.

A Comparative Analysis of Active Control vs. Folding Wing Tip Technologies for Gust Load Alleviation

As part of the Ultra High Aspect Ratio Wing Advanced Research and Designs (U-HARWARD) project, funded by CS2JU, various gust load alleviation (GLA) technologies have been developed and studied. GLA plays a crucial role in the development of new generation ultra-high aspect ratio wings (UHARWs), as it reduces gust loads, thereby decreasing the structural weight of the wing and, consequently, the entire aircraft. This weight reduction enhances overall aircraft efficiency, enabling a higher aspect ratio. GLA technologies are categorized into passive systems, which require no active intervention, and active systems, where control surfaces redistribute the aerodynamic loads. In this study, passive GLA was implemented using a folding wing tip (FWT) developed by the University of Bristol, while active GLA employed a Static Output Feedback controller developed by Politecnico di Milano. Both approaches were compared against a baseline aircraft configuration. A flutter assessment confirmed that FWT does not introduce aeroelastic instabilities, ensuring the aircraft remains flutter-free across its flight envelope. A thorough comparison of load envelopes, based on nearly 2000 load cases across different flight points and mass configurations, was conducted in compliance with CS25 regulations, examining both positive and negative gust conditions. The results show a possible 15% reduction in the dynamic load envelope for both passive and active solutions. Using NeOPT, a hybrid finite element (FE) model was developed, with a detailed global FEM (GFEM) for the wingbox and stick elements for other components. Linear gust analyses in Nastran, with the hinge locked and released, provided high-fidelity results, comparing wing failure indexes and demonstrating the effectiveness of the FWT solution.

Non-health-targeted promotions and step counts of smartphone-based mall walking program users

Abstract Background The COVID-19 pandemic changed lifestyles and raised concerns regarding physical inactivity among adults. Mobile health interventions for physical activity may be a potential solution. However, the effects may diminish over time. This study investigated whether incorporating non-health-targeted promotions into an existing mobile health-walking program could stimulate users to walk. Methods We used nationwide cohort data of smartphone users participating in a shopping mall walking program in Japan. We focused on existing users registered in the program until October 31, 2022. A Japanese anime tie-in promotion was conducted by the shopping mall company from December 3 to 25, 2022, offering additional rewards alongside the regular program. We collected step count records of existing users 1 month before and after (November 1 to December 2, 2022, and December 26, 2022 to January 31, 2023, respectively), and during the promotion period. Propensity score matching was applied to ensure balance in the baseline characteristics of existing users in terms of gender, age, and pre-promotion program participation frequency. Next, we analyzed the association between participation in the promotion program and the average daily step counts during and after the promotional period using mixed effects models for repeated measures, while adjusting for the same covariates. Results Among the 18,156 users included in the study, 13,386 (73.7%) were women, with a mean (SD) age of 45.2 (12.7) years, and a mean (SD) pre-promotion program participation frequency of 9.7 (9.6) per month. During the promotion period, the participants walked 87 (95% CI: 50-125) more steps per day than non-participants, after adjusting for covariates. No clear association was observed 1 month post-promotion. Conclusions These findings indicate that non-health-targeted promotions may be short-term motivators for existing app users to walk. Ongoing monitoring is necessary to assess the long-term impact. Key messages • Mobile health intervention effects may diminish over time. • A non-health-related promotion could stimulate existing mall walking program app users to increase their daily step count temporarily.

Having paid work 1 year after disability claim in different types of mental and behavioural disorders

Abstract Background The majority of claimants diagnosed with a mental and/or behavioral disorder have residual work capacity, however, the chance of actual (return to) work after a disability claim assessment may differ within this diagnosis group depending on the specific type of disease. The aim of this study is to examine the associations of different mental and behavioural diseases with having paid employment one year after the claim assessment. Methods This longitudinal register based cohort study included all work disability applicants with mental and behavioural disorders assessed with residual work capacity in the Netherlands in 2016. Data were derived from the Dutch Social Security Institute (UWV) and were linked to register data on paid employment. ICD codes were used to categorize 11 disease groups (mental retardation, autism spectrum disorders, ADHD, somatoform disorders, adjustment disorders, PTSS, anxiety, personality disorders, mood affective disorders, addictions and delusional disorders. Multivariable logistic regression analyses were conducted separately for applicants who work and not work at time of the claim assessment. Results A total of 8544 claimants (mean age 45, 56% female; n = 1915 work at baseline) were included. In the working group being diagnosed with ADHD (OR 3.05, CI 1.08-8.61) or PTSS (OR 1.45, CI 1.04-2.02) was associated with paid work, and adjustment disorder was negatively associated (OR 0.74, CI 0.56-0.97). In the not-working group, autism spectrum disorder (OR 1.51, CI 1.02-2.22), personality disorder (OR 1.36, CI 1.02-1.81) and addiction (OR 1.94, CI 1.32-2.86) was associated with return to work, and somatoform (OR 0.51, CI 0.31-0.84) disorders and mood affective disorders (OR 0.83, CI 0.70-0.99) were negatively associated. Conclusions The findings of this study show different associations between type of mental and behavioural disease groups and paid employment one year after the claim assessment. Key messages • The association of either remaining at work or return to work is different among mental and behavioural diagnosis groups, therefore a different approach is indicated. • Active interventions to facilitate return to or remain at work might be indicated in specific diagnosis groups.

Effects of a Six-Month Physical Activity Program on Health Risk Factors and Body Composition Among Overweight and Obese Middle-Aged Adults.

Introduction. Physical activity is vital for preventing and managing lifestyle-related diseases, which pose significant health and socio-economic challenges. This study aimed to evaluate the effects of a six-month supervised physical activity program on health risk factors and body composition in middle-aged individuals with overweight or obesity. Methods. The study involved 166 men and women aged 30 to 65 years, with a body mass index (BMI) ranging from 26 to 35 and moderate to severe health risks. Participants of the study were engaged in a six-month physical activity training program designed in accordance with World Health Organization guidelines. Comprehensive assessments were performed at baseline and after the intervention, including measurements of various anthropometric and body composition parameters, as well as evaluations of functional performance. Fitness tests were also conducted to assess participants' physical capacity and to monitor improvements throughout the training period. Results. Baseline measures of body mass composition and age demonstrated a strong positive correlation with visceral fat rating (VFR) in both men (r = 0.364, p < 0.001) and women (r = 0.420, p = 0.002). Following the six-month training program, participants exhibited an average improvement of 30% (p < 0.001) in their Cooper endurance test results. The physical activity intervention positively impacted body mass index (BMI) and various body composition metrics, including fat mass, VFR, and muscle mass, across all participants and most subgroups (gender, BMI, and age). In males, training at higher maximum heart rate (HRmax) zones significantly contributed to a reduction in the percentage of fat mass (80-89% HRmax) and an increase in the percentage of muscle mass (70-79% and 80-89% HRmax). Conclusions. The study indicates that a six-month supervised physical activity program significantly improves health risk factors and body composition (visceral fat reduction and improvement in percent of fat and muscle mass) among middle-aged individuals with overweight or obesity. Therefore, we advocate for the integration of structured physical activity interventions into healthcare practices to effectively enhance health outcomes in this population.

Systematic review and meta-analysis on the effects of physical activity-based interventions on frailty status and clinical outcomes in adults with long-term cardiac conditions

Abstract Introduction Frailty is common in patients with long-term cardiac conditions and is associated with poor clinical outcomes, but limited treatment options are available. Previous studies investigating interventions for frailty have shown positive results with physical activity interventions, however, these studies were largely based on general elderly populations. Aim To assess the impact of physical activity-based interventions on frailty and clinical outcomes in frail patients with long-term cardiac conditions. Methods A systematic review and meta-analysis was conducted based on the PRISMA guideline, using Medline, Embase, CENTRAL, PEDro, CINAHL electronic databases for articles published between 2000 and 2023. Studies which recruited adults &amp;gt;18 years with long-term cardiac conditions (including angina, acute coronary syndrome (ACS), valve disease, heart failure (HF), atrial fibrillation, cardiac surgery and congenital heart disease) who underwent physical activity-based interventions were included. The primary outcome was change in frailty (measured using a validated tool) post intervention. We also assessed the effect of interventions on mortality and hospitalisation. Results We screened 2697 records and reviewed 91 full-text articles; 12 studies (14 articles) were included, involving 1394 patients. Median age of participants ranged from 64 to 82 years. Five studies recruited participants with HF, 3 evaluated participants post transaortic valve implantation, 3 recruited cardiac surgical patients and 1 study evaluated participants post ACS. Physical activity-based interventions were multi-domain, including a mixture of aerobic, strength, balance, endurance and respiratory muscle training; the majority (N=10) had individualised exercise prescription. Meta-analysis of 8 randomised controlled trials (RCTs) showed statistically significant improvement in frailty associated with physical activity-based interventions compared to controls [pooled standardised mean difference (95% CI) = -0.34 (-0.59 to -0.08), p = 0.01, I2 = 48%]. Seven RCTs evaluated change in frailty by short physical performance battery (SPPB). Meta-analysis of these studies showed a statistically significant improvement in SPPB associated with physical activity-based interventions compared to controls [pooled mean difference (95% CI) = 0.83 (0.31-1.34), p = 0.002, I2 = 49%]. (Figure) The magnitude of improvement in SPPB exceeded the minimally clinically significant improvement of 0.5. Three studies evaluated the effect of physical activity-based intervention on clinical outcomes, all of which showed neutral effect on mortality and hospitalisation. Conclusion Physical activity-based interventions in patients with frailty and long-term cardiac conditions were associated with significant improvement in frailty status, with neutral effect on mortality and hospitalisation. Figure: Meta-analysis of 7 RCTs assessing effect of physical activity-based interventions on SPPB

Evaluating the feasibility of an Adapted Physical Activity intervention among breast cancer patients

Abstract Adapted physical activity (PA) programs have shown promising results to reduce physical, psychological and social side effects associated with breast cancer (BC), but the extent to which they can be effectively adopted, implemented and maintained is unclear. The aim of this study is to use the RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) framework to evaluate RIPOSTE (Reconstruction, Image de soi, Posture, Oncologie, Santé, Thérapie, Escrime), an innovative intervention focused on improving the quality of life (QoL) of BC surgery patients through fencing. A convergent mixed-methods pilot study was conducted to evaluate the RE-AIM dimensions of RIPOSTE. 24 participants who have just undergone surgery for invasive BC were randomly allocated either in the “RIPOSTE” group (starting immediately after their inclusion), or the “Delayed RIPOSTE” group (starting at 3 months following their inclusion). They answered to questionnaires at inclusion and at the end of the program on QoL, shoulder functional capacity, fatigue, anxiety-depression and PA. Interviews were conducted with 10 participants, 3 sports physicians and 1 fencing master. RIPOSTE program was able to reach mainly young and dynamic participants, attracted by the originality of fencing and keen to improve their physical condition. Regarding effectiveness, our results suggest a trend to the improvement of health indicators, even without any significant differences between the two groups. The cooperation, exchanges and cohesion within the group greatly facilitated the adoption of the program, whereas interruptions during vacations were the main barriers. Maintenance analyses showed that most participants continued to practice PA after the program. RIPOSTE is an acceptable and effective program for involving BC survivors in PA, that needs to be tested at larger scale to investigate its effectiveness, but has the potential to be transferred and scaled up worldwide. Key messages • These results would help to enrich the literature on how to best intervene to enhance treatment and recovery among patients and facilitate transfer from a research program to a field daily practice. • By highlighting complexities of RIPOSTE effectiveness and implementation, this study could lead to a more complete program that addresses issues related to improving external and internal validity.

Physical Activity-Related Health Services in Germany: Relevance and Necessary Framework Conditions - a Position Paper of the DNVF Working Group Physical Activity-Related Health Services Research

Based on the relevance of an established and broad foundation of physical activity in healthcare, this position paper of the DNVF working group Physical Activity-Related Health Services research presents current conceptual approaches to physical activity-related health services in Germany and highlights the need for interprofessional and interdisciplinary approaches. Three central positions are outlined and elaborated in order to integrate the evidence on health benefits of physical activity and exercise more strongly into healthcare and to show that, against the background of the challenges in the German healthcare system, physical activity-related health services can make a cost-effective and high-quality contribution to improve healthcare. These three positions include 1) the integration of all professional groups involved in healthcare into physical activity-related health services, 2) the greater integration of physical activity professions and physical activity interventions into all healthcare contexts and 3) the systematic consideration of physical activity- and exercise-related expertise in clinical guidelines.

Affecting factors and seasonal effects on the continuous positive airway pressure adherence of patients with obstructive sleep apnea

Continuous positive airway pressure (CPAP) is the preferred treatment for obstructive sleep apnea (OSA), but adherence remains challenging. This study identifies factors influencing CPAP adherence, including the impact of Korea's four distinct seasons. A retrospective study of 650 patients with OSA and prescribed with CPAP was conducted at a single institution from January 2018 to December 2020, and the patients' answers on various sleep questionnaires, demographic and polysomnographic data, and when and whether they returned the CPAP devices were collected and analyzed. The sample population was divided into when and whether the CPAP device was returned to the institution and the average daily use of the CPAP device. Results show that treatment failure is high in the first 12 weeks. Moreover, patients with more severe sleep apnea tended to have severe OSA-related clinical symptoms and are more likely to adhere to the treatment. In this study show that the seasons did not affect CPAP adherence because of indoor environmental factors. However, results show that other patient factors, such as BMI, AHI, RDI, daytime drowsiness, mood changes, and other OSA-related symptoms, have greater effects on CPAP adherence than seasonal change. Initial positive experience is important to adapt to the CPAP, and for this reason, more active intervention by sleep physicians during the initial CPAP adaptation is necessary.

Meningkatkan Kapasitas Kelompok Tani Sejati Melalui Manejemen Branding dan Strategi Pemasaran Digital Produk Pupuk Organik

The conventional marketing system for agricultural products has not been able to increase sales of products produced by farmer groups. This community service activity intervention aims to empower the Sejati Farmers Group through the socialization of branding management and digital marketing strategies for organic fertilizer products. This activity was carried out in July 2024 at the Sejati Farmers Group, Lendang Nangka Utara Village, Masbagik District, East Lombok Regency, with 18 participants. The service method used participatory and personal communication. This training resulted in a 25% increase in knowledge and a 15% increase in organic fertilizer sales in the three months after the training. In addition, this activity provides alternative solutions to environmental and social problems, as well as improving the welfare of the local community.

Growth factor dysregulation and placental dysfunction

The article is devoted to the study of angiogenic and antiangiogenic vascular growth factors in placental dysfunction, which is of great importance in obstetrics and perinatology. The study of growth factors as predictors of the development of placental dysfunction makes it possible to determine in advance the development of many obstetric pathologies, including preeclampsia and fetal growth retardation, which is of great practical importance. The authors conducted an immunological study of pregnant women with placental dysfunction and pregnant women with a physiological pregnancy. Purpose of the study: to study serum growth factors in women with placental dysfunction. We examined 47 pregnant women with a gestation period of 26-40 weeks, with a diagnosis of placental dysfunction, who were under observation in the obstetric department of the city maternity complex No. 3 of the city of Tashkent. The control group consisted of 35 women with a physiological pregnancy. All women underwent an immunological blood test: cellular and humoral immunity, as well as cytokines (VEGF-A, PlGF, sFlt-1, sFlt-1/PlGF) were studied. Based on the results obtained, the authors suggest that an increased level of soluble sFlt-1 and a simultaneous decrease in the levels of VEGF-A and PlGF in pregnant women at 26-40 weeks of gestation may portend the development of pregnancy complications, including preeclampsia and fetal growth restriction, and increase the risk of premature birth. Ddelivery due to impaired placental blood flow and oxygen deficiency for the fetus, lead to deterioration of microcirculation, and insufficient levels of VEGF-A and PlGF can contribute to vascular endothelial dysfunction, which can also contribute to the development of preeclampsia. The studied angiogenic and antiangiogenic vascular growth factors are important indicators and can serve as markers for predicting pregnancy complications for active medical intervention in maintaining the health of both mother and child.

Investigating the Feasibility and Acceptability of a Facebook Delivered, Parent Mediated, Physical Activity Intervention for Children with Developmental Coordination Disorder

ABSTRACT Objective Children with Developmental Coordination Disorder (DCD) experience difficulties performing fundamental movement skills, resulting in reduced physical activity (PA). Given low PA can impact mental and physical health, improving PA in DCD appears imperative. This study investigates the feasibility of a Facebook delivered, parent mediated, PA intervention for children with DCD. Methods Parents of children with DCD (n=31; 5-11 years), were invited to private Facebook groups where physical activity resources and questionnaires were provided over 12 weeks. Parents and their children wore activity trackers during the intervention period. Feasibility and acceptability of the intervention was considered with reference to (1) Facebook engagement, (2) adherence intervention components, and (3) parent perspectives. Results Facebook engagement was high, with 78.03% (SD=23.06) of all intervention posts being viewed by parents on average. Activity trackers were worn correctly for 92.45% of intervention days and 95.61% of intervention weeks. Weekly questionnaires were completed, on average, 84.37% of the time. Parent perspectives were positive, with 80.77% somewhat or strongly agreeing that the intervention was useful for themselves and their child. Conclusions Given the results described, Facebook appears to be a feasible platform through which parent mediated physical activity interventions can be provided to children with DCD.

The effect of climate crisis on bipolar disorder: A qualitative study about experiences of individuals diagnosed with bipolar disorder.

It can be said that the bipolar disorder is influenced by weather events. It is stated that climate change can have direct and indirect effects on bipolar disorder. Determining the impact of the climate crisis on individuals with bipolar disorder may assist in the development of preventive, protective and active treatment interventions for this group. The aim of this study was to determine the views and experiences of people with bipolar disorder about the impact of the climate crisis on their illness. The study was conducted using the phenomenological method, one of the qualitative study methods. Purposive sampling was used to select the sample for the study. In-depth individual interviews were conducted with the selected sample group. Data saturation was reached with 11 participants and data collection was finalized. The study data was collected using a personal information form and an open-ended structured interview form in which participants were asked about their views and experiences of the climate crisis. Voice recordings were transcribed, and categories, sub-themes and themes were formed. Based on the statements of people with a bipolar diagnosis, the study formed the themes of emotional impact, negative physical impact, impact on daily life, impact on symptoms, negative impact on recovery and ways of coping. People with a bipolar diagnosis are negatively affected by the impact of the climate crisis in many areas. There is a need to develop intervention programmes to arm people with a bipolar diagnosis against the negative effects of the climate crisis.

Comparison of active release technique and post-isometric relaxation in treatment of plantar fasciitis among traffic police wardens: a quasi-experimental study

BackgroundPlantar fasciitis (PF) is a common cause of chronic foot pain that leads to functional limitations in individuals. There has been recent research on plantar fasciitis, but no studies have compared the effects of the active release technique and post-isometric relaxation in patients to determine which manual therapy technique improves foot pain and function.ObjectiveThis study aimed to compare the effectiveness of the active release technique and post-isometric relaxation on proximal foot pain and functional status and to assess muscular tightness among patients with traffic police wards and plantar fasciitis.MethodsA quasi-experimental study (pre-test, post-test) was conducted in the Physiotherapy Department of Police Hospital, Gujranwala, Pakistan, between October 2022 and April 2023. We included 30 consecutively aged 25- to 60-year-old symptomatic police wardens diagnosed with planter fasciitis, who complained of pain on walking and standing for more than 3 months and met the inclusion criteria. They were equally assorted into two groups (n = 15 in each group) using convenient sampling. Group A received an active release exercise technique, group B received a post-isometric relaxation technique, and the participants in both groups received a similar baseline treatment protocol that consisted of calf stretching and stretching of the plantar fascia (5 repetitions and holding for 15 s). In the outcome measures, we included the Foot Function Index to assess the function of the foot and the Visual Analog Scale to examine the pain intensity measured during rest. The participants in both groups performed the selective protocol 3 days per week for 3 weeks, and we calculated the results at baseline and on the third day of the third week. We analyzed the data using SPSS software version 24 (IBM Corp., Armonk, NY). We compared within-group differences in the VAS score and FFI using paired t tests and analyzed between-group differences in the VAS score and FFI before and after performing the ART and PIR using independent t tests.ResultsThe 8-week intervention therapy revealed a demographic age mean and standard deviation of 36.60 ± 6.11 for group A and 35.60 ± 4.85 for group B. Within-group analysis demonstrated a significant decrease in VAS (pain) score following ART intervention (1.80 ± 0.862, p < 0.01) compared to PIR (6.07 ± 0.884). Between-group analysis indicated a significant reduction in FFI (disability) scores for group A (30.33 ± 3.200, p < 0.03) compared to group B (56.93 ± 4.773). Moreover, ART intervention exhibited significant improvement in VAS scores (p < 0.05), with 95% CI [1.49, 2.11]. The mean difference in FFI scores was substantially greater in the ART group (86.00 to 30.33) compared to the PIR group (p > 0.05), suggesting non-significant differences.ConclusionThe active release exercise intervention is more effective than post-isometric relaxation in improving pain and foot function disability in patients with plantar fasciitis. The present study aimed to help physical therapists choose the most efficient manual therapy exercise intervention to improve functional limitations.

Adapting a Telehealth Physical Activity and Diet Intervention to a Co-Designed Website for Self-Management After Stroke: Tutorial.

People who experience a stroke are at a higher risk of recurrent stroke when compared with people who have not had a stroke. Addressing modifiable risk factors like physical inactivity and poor diet has been shown to improve blood pressure, a leading contributor to stroke. However, survivors of stroke often experience challenges with accessing risk reduction services including long wait lists, difficulty with transportation, fatigue, impaired function, and diminished exercise capacity. Providing health interventions via a website can extend the reach when compared with programs that are only offered face to face or via real-time telehealth. Given global challenges of accessing secondary prevention programs, it is important to consider alternative ways that this information can be made available to survivors of stroke worldwide. Using the "design thinking" framework and drawing on principles of the integrated knowledge translation approach, we adapted 2 co-designed telehealth programs called i-REBOUND - Let's get moving (physical activity intervention) and i-REBOUND - Eat for health (diet Intervention) to create the i-REBOUND after stroke website. The aim of this paper is to describe the systematic process undertaken to adapt resources from the telehealth delivered i-REBOUND - Let's get moving and i-REBOUND - Eat for health programs to a website prototype with a focus on navigation requirements and accessibility for survivors of stroke. We engaged a variety of key stakeholders with diverse skills and expertise in areas of stroke recovery, research, and digital health. We established a governance structure, formed a consumer advisory group, appointed a diverse project team, and agreed on scope of the project. Our process of adaptation had the following 3 phases: (1) understand, (2) explore, (3) materialize. Our approach considered the survivor of stroke at the center of all decisions, which helped establish guiding principles related to our prototype design. Careful and iterative engagement with survivors of stroke together with the application of design thinking principles allowed us to establish the functional requirements for our website prototype. Through user testing, we were able to confirm the technical requirements needed to build an accessible and easy-to-navigate website catering to the unique needs of survivors of stroke. We describe the process of adapting existing content and co-creating new digital content in partnership with, and featuring, people who have lived experience of stroke. In this paper, we provide a road map for the steps taken to adapt resources from 2 telehealth-delivered programs to a website format that meets specific navigation and accessibility needs of survivors of stroke.