Existing Health Conditions Research Articles

The Impact of Poor Air Quality on Hospitalisation of Multi-morbid Patients: A Systematic Review

Abstract Background Exposure to poor air quality worsen existing health conditions, particularly amongst vulnerable patients, leading to increased healthcare utilization. We conducted a systematic review to explore the impact of exposure to poor quality on healthcare requirements in multi-morbid patients. Methods We searched six major databases (Medline via Ovid, Embase via Ovid, Web of Science, CINAHL, Global Health, and Scopus) using search terms grouped into sets relating to ‘air pollution,’ ‘multimorbidity,’ “association” and ‘hospitalisation.’ We were interested in the impact of common air pollutants (PM2.5, PM10, SO2, NO2, O3, and CO) and articles were screened independently by two researchers. The review was registered with The International Prospective Register of Systematic Reviews (CRD42022369757) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results A total of nineteen studies were included. All six air pollutants increased hospitalisation amongst multi-morbid patients, especially those with diabetes and cardiovascular comorbidity. Females and the elderly (>65 years old) were the most vulnerable to the effects of air pollution, with an increase in hospitalisations of 9.23% and 6.35% when exposed to PM2.5 and PM10, respectively. Patients >65 years had a higher likelihood of hospitalisation for ischemic and haemorrhagic stroke when exposed to PM2.5 or PM10 at warm season. Patients (≥70 years) who had cardiovascular and pulmonary comorbidity were 3.9% more likely to be hospitalised for a cardiopulmonary event with a rise in NO2 levels. We found an intersectional effect (referred to as “the CADC effect” - Climatic changes, Air pollutant, Demographics, Chronic conditions) that influenced the likelihood of hospitalisation. Conclusions Future research is required to further understand this CADC effect in other high-risk population. Key messages • Females, elderly, those with cardiovascular, and pulmonary comorbidity are at the highest risk of hospitalisation with poor air quality. • The CADC effect explains the intersectional effect between hospitalisation in multimorbid patients, patients demographics and chronic conditions, and air pollution and temperature effects.

Climate change and vulnerable groups in Zimbabwe: Implications for social work practice

Social work is a practical profession that aims to improve problem-solving skills and social functioning, particularly for disadvantaged and marginalised vulnerable groups. The ongoing climate change is worsening the global social work burden since it increases the frequency of occurrence, magnitude, and duration of disaster events such as droughts, heat waves, diseases, tropical cyclones, and floods that negatively impact human beings. Specifically, children, people with disabilities, women, and the elderly are especially vulnerable, as they are often unable to move quickly and may have existing health conditions that make escaping from disasters difficult—meanwhile, the human rights perspective advocates for the inclusivity of all people in the disaster management process. The study used qualitative literature review analysis to explore social work-based strategies for managing the impacts of climate change in Zimbabwe while ensuring the participation of vulnerable groups in co-creating the strategy. The research involved a scoping literature review using African Journals Online, Google Scholar, and ProQuest Central search engines. The study followed specific steps, including formulating the research problem, developing and validating the reviewing protocol, searching for relevant literature using key search terms, screening for inclusion, assessing the relevance, extracting data, analysing and synthesising data, and reporting the findings. Conclusions and recommendations were based on the gaps and inconsistencies identified in the literature review.

Early- and life-long intake of dietary advanced glycation end-products (dAGEs) leads to transient tissue accumulation, increased gut sensitivity to inflammation, and slight changes in gut microbial diversity, without causing overt disease

Dietary advanced glycation end-products (dAGEs) accumulate in organs and are thought to initiate chronic low-grade inflammation (CLGI), induce glycoxidative stress, drive immunosenescence, and influence gut microbiota. Part of the toxicological interest in glycation products such as dietary carboxymethyl-lysine (dCML) relies on their interaction with receptor for advanced glycation end-products (RAGE). It remains uncertain whether early or lifelong exposure to dAGEs contributes physiological changes and whether such effects are reversible or permanent. Our objective was to examine the physiological changes in Wild-Type (WT) and RAGE KO mice that were fed either a standard diet (STD − 20.8 ± 5.1 µg dCML/g) or a diet enriched with dCML (255.2 ± 44.5 µg dCML/g) from the perinatal period for up to 70 weeks. Additionally, an early age (6 weeks) diet switch (dCML→STD) was explored to determine whether potential harmful effects of dCML could be reversed. Previous dCML accumulation patterns described by our group were confirmed here, with significant RAGE-independent accumulation of dCML in kidneys, ileum and colon over the 70-week dietary intervention (respectively 3-fold, 17-fold and 20-fold increases compared with controls). Diet switching returned tissue dCML concentrations to their baseline levels. The dCML-enriched diet had no significative effect on endogenous glycation, inflammation, oxidative stress or senescence parameters. The relative expression of TNFα, VCAM1, IL6, and P16 genes were all upregulated (∼2-fold) in an age-dependent manner, most notably in the kidneys of WT animals. RAGE knockout seemed protective in this regard, diminishing age-related renal expression of TNFα. Significant increases in TNFα expression were detectable in the intestinal tract of the Switch group (∼2-fold), suggesting a higher sensitivity to inflammation perhaps related to the timing of the diet change. Minor fluctuations were observed at family level within the caecal microbiota, including Eggerthellaceae, Anaerovoracaceae and Marinifilaceae communities, indicating slight changes in composition. Despite chronic dCML consumption resulting in higher free CML levels in tissues, there were no substantial increases in parameters related to inflammageing. Age was a more important factor in inflammation status, notably in the kidneys, while the early-life dietary switch may have influenced intestinal susceptibility to inflammation. This study affirms the therapeutic potential of RAGE modulation and corroborates evidence for the disruptive effect of dietary changes occurring too early in life. Future research should prioritize the potential influence of dAGEs on disease aetiology and development, notably any exacerbating effects they may have upon existing health conditions.

Enhancing Treatment Outcomes in Atrial Fibrillation: A Contemporary Literature Review of the Impact of Optimizing Patient Well-Being in Treatment Management.

Atrial fibrillation (AF) is the most common heart rhythm disorder, defined by an irregular and rapid heartbeat. It is the most prevalent cardiac arrhythmia in the United States, characterized by irregular heartbeats due to asynchrony between atrial and ventricular contractions. AF can be categorized as paroxysmal or persistent and, as such, poses significant health risks, including heart failure and stroke. Factors like age, sex, lifestyle, and existing health conditions elevate AF risk. There have been a lot of debates around AF risk management and its impact on prognosis. This literature review aims to explore the influence of addressing modifiable risk factors in AF patients on its morbidity and mortality, exploring various treatment options and their effectiveness. Current guidelines suggest rate control and anticoagulation for persistent AF with medications like beta blockers and non-vitamin K oral anticoagulants. Catheter ablation for rhythm control is contentious. Studies on supplemental treatments, lifestyle changes, and managing comorbidities show mixed results, necessitating further research for comprehensive treatment effectiveness in AF patients, which this literature review will discuss.

Diagnostic Value of Saliva RT-PCR Test within Suspected SARS-CoV-2 Cases in Indonesia

Introduction: The ongoing SARS-CoV-2 pandemic has profoundly emphasized the pressing need for accurate and reliable diagnostic procedures. Given the potential health risks associated with nasopharyngeal swabs, there has been growing interest in seeking alternative diagnostic mediums. In this context, our study delved into evaluating saliva as a potential diagnostic tool, simultaneously assessing its efficiency in relation to patient demographics and their exhibited clinical symptoms. Methods: Spanning from May to December 2020, we conducted a comprehensive cross-sectional analysis. We meticulously examined medical records to gather insights on patient characteristics, existing health conditions, onset of symptoms, clinical manifestations, and compared the results obtained from both salivary and nasopharyngeal RT-PCR tests for SARS-CoV-2. Results: Among the individuals suspected of SARS-CoV-2 infection, the mean age stood at 52.4 years, with males representing 60.3% of this group. Interestingly, a significant 76.9% reported underlying health conditions, predominantly hypertension and diabetes. The most commonly reported symptoms encompassed respiratory challenges, notably coughing and shortness of breath, succeeded by symptoms like nausea, fever, and a general sense of fatigue. The performance of saliva tests, in terms of accuracy, appeared to be significantly influenced by the timing of symptom emergence. Conclusion: The RT-PCR tests utilizing saliva samples demonstrated considerable promise, especially during the early stages of symptom manifestation, providing a reliable alternative to traditional nasopharyngeal swabs. The findings suggest a superior diagnostic sensitivity when utilizing saliva during the initial phases of a SARS-CoV-2 infection.

Health and demographic indicators of selected districts of India: An impact of Swasthya Rakshan Programme (SRP).

Swasthya Rakshan Programme (SRP) provides health care services through Ayurveda, an initiative of the Government of India that aims to survey and create alertness of essential health appliances to ameliorate society from its grassroots level. The present study aimed to survey the prevailing health standards of residents in certain districts of India and to record the prevalence of diseases among them according to their living conditions, food habits, lifestyle, education, occupation and other socio-economic status. Data was collected through a community-based cross-sectional survey conducted from April 2018 to March 2019 in 22 Districts of 19 states in India. A stratified multi-stage sampling design was adopted for the survey. Documentation of demographic profile, food habits, lifestyle, hygiene status, and existing health conditions was assessed. A pre-designed semi-structured questionnaire was used for the collection of the data. Before initiating the programme, written consent was obtained. In this study, from 162 selected villages/colonies/areas, a total of 562,913 population and 81,651 households were surveyed. Sixty-nine thousand three hundred nineteen patients were cared for various ailments through health camps. The study found that the most prevalent disease in the concerned population was 'Sandhivata' (Osteo-arthritis), that is, 43.0%, followed by 'Dourbalya' (Debility), that is, 11.7%. The study includes insightful analyses of comprehensive demographic and health indicators classified by various socio-economic categories. The collected data regarding the prevalence of diseases with their sociodemographic correlations may provide a better understanding of the locality and thus may help in all future health endeavours.

Environmental and health impacts of air pollution: A mini-review

Air pollution is one of the leading risk factors for death but also a significant contributor to the global disease burden, affecting quality of life. According to a World Health Organisation (WHO) report, seven million people die from air pollution every year, and 9 out of 10 people worldwide breathe polluted air. Any person can be affected by exposure to polluted air, especially the elderly, children, pregnant women, and people with comorbidities. Some studies indicate that the diseases most affected by air pollution are respiratory infections, chronic obstructive pulmonary disease (COPD), lung cancer, and cardiovascular diseases. The degree of effect on the body depends on the pollutant composition, source and dose, level and duration of exposure to polluted air. Particulate matter (PM10 and PM2.5), carbon monoxide (CO), ozone (O3), nitrogen dioxide (NO2), and sulphur dioxide (SO2) could lead to air pollution. Long-term exposure to air pollution can affect every organ in the body and worsen existing health conditions. Short-term exposure to contaminants can include unpleasant sensations such as coughing, wheezing, shortness of breath, eye, nose, and throat irritation, headache, dizziness, and fatigue. Community and individual solutions such as using clean fuel, wearing personal masks, filtering indoor air, and ventilating need to be taken to reduce the impact of air pollution.

Disparities in Unmet Health Care Needs Among US Children During the COVID-19 Pandemic.

The COVID-19 pandemic disrupted pediatric health care in the United States, and this disruption layered on existing barriers to health care. We sought to characterize disparities in unmet pediatric health care needs during this period. We analyzed data from Wave 1 (October through November 2020) and Wave 2 (March through May 2021) of the COVID Experiences Survey, a national longitudinal survey delivered online or via telephone to parents of children aged 5 through 12 years using a probability-based sample representative of the US household population. We examined 3 indicators of unmet pediatric health care needs as outcomes: forgone care and forgone well-child visits during fall 2020 through spring 2021, and no well-child visit in the past year as of spring 2021. Multivariate models examined relationships of child-, parent-, household-, and county-level characteristics with these indicators, adjusting for child's age, sex, and race/ethnicity. On the basis of parent report, 16.3% of children aged 5 through 12 years had forgone care, 10.9% had forgone well-child visits, and 30.1% had no well-child visit in the past year. Adjusted analyses identified disparities in indicators of pediatric health care access by characteristics at the level of the child (eg, race/ethnicity, existing health conditions, mode of school instruction), parent (eg, childcare challenges), household (eg, income), and county (eg, urban-rural classification, availability of primary care physicians). Both child and parent experiences of racism were also associated with specific indicators of unmet health care needs. Our findings highlight the need for continued research examining unmet health care needs and for continued efforts to optimize the clinical experience to be culturally inclusive.

Risk of winter hospitalisation and death from acute respiratory infections in Scotland: national retrospective cohort study.

We undertook a national analysis to characterise and identify risk factors for acute respiratory infections (ARIs) resulting in hospitalisation during the winter period in Scotland. A population-based retrospective cohort analysis. Scotland. The study involved 5.4 million residents in Scotland. Cox proportional hazard models were used to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for the association between risk factors and ARI hospitalisation. Between 1 September 2022 and 31 January 2023, there were 22,284 (10.9% of 203,549 with any emergency hospitalisation) ARI hospitalisations (1759 in children and 20,525 in adults) in Scotland. Compared with the reference group of children aged 6-17 years, the risk of ARI hospitalisation was higher in children aged 3-5 years (aHR = 4.55; 95% CI: 4.11-5.04). Compared with those aged 25-29 years, the risk of ARI hospitalisation was highest among the oldest adults aged ≥80 years (aHR = 7.86; 95% CI: 7.06-8.76). Adults from more deprived areas (most deprived vs. least deprived, aHR = 1.64; 95% CI: 1.57-1.72), with existing health conditions (≥5 vs. 0 health conditions, aHR = 4.84; 95% CI: 4.53-5.18) or with history of all-cause emergency admissions (≥6 vs. 0 previous emergency admissions, aHR = 7.53; 95% CI: 5.48-10.35) were at a higher risk of ARI hospitalisations. The risk increased by the number of existing health conditions and previous emergency admission. Similar associations were seen in children. Younger children, older adults, those from more deprived backgrounds and individuals with greater numbers of pre-existing conditions and previous emergency admission were at increased risk for winter hospitalisations for ARI.

Psychiatric evaluation and support for the elderly undergoing elective surgery

Providing evaluation and support for individuals who choose to undergo surgery is an essential aspect of comprehensive healthcare. With the global population aging, it's becoming more common for elderly individuals to opt for surgeries. This requires understanding how health impacts surgical outcomes in this vulnerable group. This study delves into the presentation and management of factors throughout the entire surgical process, including before, during, and after surgery. The clinical presentation covers existing health conditions, cognitive issues, emotional responses, and ethical considerations related to decision-making abilities. Recognizing these factors is crucial in order to provide tailored interventions that promote the well-being of patients and improve overall outcomes. Clinical management involves measures before surgery, collaborative care models during the period and strategies to prevent or address psychiatric complications after surgery. Ethical considerations are consistently important throughout this process, especially concerning decision-making abilities. This comprehensive approach involves psychiatrists, geriatricians, anesthetists and other healthcare professionals who work together to enhance the well-being of surgical patients. As our population continues to age, further research and attention on aspects of care within this demographic are vital for providing comprehensive and patient-centered healthcare.

Automated Menu Planning Algorithm for Children: Food Recommendation by Dietary Management System using SVM, RF, DT for Indian Food Database

In recent years, childhood obesity and related health issues have become a major concern worldwide. Proper nutrition is crucial for children's growth and development, making it essential to ensure they have a balanced and nutritious diet. This study presents an innovative approach to address this issue through an Automated Menu Planning Algorithm for Children (AMPAC). AMPAC utilizes a Dietary Management System powered by the SVM, RF, DT (Iterative Dichotomiser 3) decision tree algorithm, specifically designed for the Indian food context. The proposed system leverages a comprehensive Indian Food Database, encompassing diverse and culturally relevant food items. By integrating the SVM, RF, DT algorithm, AMPAC can analyze the nutritional content of various foods and recommend suitable meal plans based on specific dietary requirements. The system considers essential factors such as age, gender, body mass index (BMI), and any existing health conditions to create personalized and balanced menus. To validate the effectiveness of AMPAC, extensive testing and evaluation have been conducted using a diverse group of participants, including children, parents, and nutrition experts. The results demonstrate the system's accuracy, efficiency, and user satisfaction, highlighting its potential to revolutionize menu planning for children and promote healthier eating habits. This research contributes to the fields of nutrition, computer science, and public health by offering an innovative solution to address the critical issue of childhood nutrition. AMPAC's user-friendly interface and intelligent algorithm empower users to make informed food choices, ultimately fostering a healthier and happier future generation. Key Words : Automated Menu Planning, Food Recommendation, SVM, RF, DT Algorithm, Indian Food Database, Childhood Nutrition, Nutritional Requirements, Personalized Diet.

Prevalence of Sleep Disorders Among the General Population of the Jazan Region of Southwest Saudi Arabia.

Sleep disorders impose a substantial burden on the global population, leading to an array of health complications. Understanding their prevalence and associated risk factors is crucial to formulating effective interventions. This study aimed to determine the prevalence and associated risk factors of sleep disorders among residents of the Jazan region of Saudi Arabia. This cross-sectional study conducted an online survey from December 2022 to March 2023. The sample comprised 670 respondents aged 18 years and older residing in Jazan. Demographic data, lifestyle habits, sleep patterns, and sleep disorder symptoms were assessed. The participants were predominantly women (62.2%), with an average age of 30.99 years and a normal body mass index. The analyses revealed that 28.8% of the respondents reported experiencing sleep disorders, and 13.4% particularly had obstructive sleep apnea. Nearly half of the participants reported having primary insomnia, excessive daytime sleepiness, and restless leg syndrome. Significant associations were found between sleep disorders and older age (p = 0.012), obesity (p = 0.043), short or thin neck (p = 0.034), smoking (p = 0.003), caffeine use (p = 0.001), existing health conditions (p = 0.001), medication use (p = 0.013), lack of daytime naps (p = 0.043), and frequent nighttime awakenings to urinate (p = 0.001). The most common self-reported reasons for nightly awakenings were urination, anxiety or stress, discomfort or noise, and health conditions. The findings suggest a high prevalence of sleep disorders among adults in Jazan, Saudi Arabia. Various demographic, lifestyle, and health-related factors are linked to these disorders. Therefore, targeted sleep health education and interventions could be instrumental in tackling this significant public health issue.

The health of people attending residential treatment for alcohol and other drug use: Prevalence of and risks for major lifestyle diseases.

Cardiovascular disease and cancers are the leading cause of mortality amongst people accessing treatment for alcohol and other drug use. The current study aimed to examine risk factors for chronic disease amongst people attending residential alcohol and other drug treatment services. Participants (N = 325) were attending residential alcohol and other drug treatment services across Australia. Diabetes and cardiovascular disease risk scores were calculated using established risk estimation algorithms. Differences in existing health conditions, risk factors for chronic diseases and risk algorithms were calculated for males and females. In addition to alcohol and other drug use (including tobacco use), 95% of the sample had at least one other risk factor for chronic disease. Of participants not already diagnosed, 36% were at a high risk of developing type 2 diabetes and 11% had a high risk of developing cardiovascular disease. The heart age of participants was 11 years older than actual age (Mage = 40.63, Mheart age = 52.41). Males had a higher cardiovascular disease risk than females. A large proportion of people accessing residential alcohol and other drug treatment were at risk of chronic disease. Future research is needed that uses objective indicators of physical health. Such research will help to develop our understanding of prevention and intervention initiatives that could be adopted by treatment providers to improve the physical health of their consumers.

SECONDARY STUDENTS’ PROFILE AND SCHOLASTIC PERFORMANCE DURING COVID-19: THE CASE OF A LABORATORY SCHOOL IN THE PHILIPPINES

Students' performance in the classroom can be viewed as vital since an aptitude for learning and intelligence can pave the way for their future success in both the workplace and the economy. This study examined the secondary students' profile and scholastic performance during the COVID-19 pandemic at a laboratory school in Eastern Visayas, Philippines. It utilized the quantitative approach to ascertain the variation among the specified study variables involving 620 secondary students from different grade levels. Secondary data on students' profile variables and scholastic performance were obtained from the school's Learner Information System (LIS). The T-test for two independent samples was likewise utilized to examine the significant difference in the performance of male and female students according to grade levels. Based on the results, majority of the students used mobile data and broadband as means to access the internet. Moreover, the online and blended learning were the student's preferred learning modalities. However, the inadequacy of gadgets available, insufficient load, intermittent mobile or internet access, existing health conditions, difficulty in self-regulated learning, conflict with other activities, and high electrical consumption and distractions were among the challenges students faced during the pandemic. Meanwhile, the students displayed very satisfactory to outstanding scholastic performance amidst COVID-19. Likewise, the study found no significant performance difference between male and female students in grades 8 and 12, in contrast to other grade levels. Therefore, creating flexible and responsive teaching practices in the current and post-pandemic educational environment and the enhancement of internet connectivity is recommended.

Organization of complex treatment of the rhinocerebral form of mucormicosis in the post-covid period

Aim: To develop an optimal variant of complex treatment of the rhinocerebral form of mucormycosis in the postCOVID period.Materials and Methods: Treatment data from 48 patients diagnosed with the rhinocerebral form of mucormycosis, sourced from various regions of the Republic of Tajikistan, was scrutinized for this analysis.Results and Discussion: The analysis revealed that patients who had contracted COVID-19 (n=12; 0.9%) and had existing health conditions, experienced the onset of neurovascular insufficiency in the early stages of the post-COVID period, roughly 1-3 months subsequent to the infection. This condition was ostensibly triggered by the direct viral disruption of the blood-brain barrier, hypercoagulation, and ensuing neurovascular complications. It was also noted that these patients had been administered fifth-generation antibiotics and glucocorticosteroids during their treatment.Conclusion: The study findings suggest that the emergence of the rhinocerebral form of mucormycosis in the postCOVID period, especially in patients with concurrent health conditions, could be linked to weakened immunity and immunodeficiency. These are often induced by the prolonged, unregulated use of antibiotics and glucocorticosteroids, consequently leading to an increase in pathogenic and opportunistic fungi. In light of these findings, it is recommended that such patients be admitted to specialized medical institutions for appropriate treatment.

An IoT-Based Framework for Personalized Health Assessment and Recommendations Using Machine Learning

To promote a healthy lifestyle, it is essential for individuals to maintain a well-balanced diet and engage in customized workouts tailored to their specific body conditions and health concerns. In this study, we present a framework that assesses an individual’s existing health conditions, enabling people to evaluate their well-being conveniently without the need for a doctor’s consultation. The framework includes a kit that measures various health indicators, such as body temperature, pulse rate, blood oxygen level, and body mass index (BMI), requiring minimal effort from nurses. To analyze the health parameters, we collected data from a diverse group of individuals aged 17–24, including both men and women. The dataset consists of pulse rate (BPM), blood oxygen level (SpO2), BMI, and body temperature, obtained through an integrated Internet of Things (IoT) unit. Prior to analysis, the data was augmented and balanced using machine learning algorithms. Our framework employs a two-stage classifier system to recommend a balanced diet and exercise based on the analyzed data. In this work, machine learning models are utilized to analyze specifically designed datasets for adult healthcare frameworks. Various techniques, including Random Forest, CatBoost classifier, Logistic Regression, and MLP classifier, are employed for this analysis. The algorithm demonstrates its highest accuracy when the training and testing datasets are divided in a 70:30 ratio, resulting in an average accuracy rate of approximately 99% for the mentioned algorithms. Through experimental analysis, we discovered that the CatBoost algorithm outperforms other approaches in terms of achieving maximum prediction accuracy. Additionally, we have developed an interactive web platform that facilitates easy interaction with the implemented framework, enhancing the user experience and accessibility.

Invisible illness: The consequences of limited health insurance in Africa.

Limited health insurance coverage in Africa poses a significant challenge, impeding access to quality healthcare for millions of individuals. This paper synthesizes information from existing literature and research on the topic of limited health insurance coverage in Africa. The identified consequences and root causes are presented in a structured format. The consequences of limited health insurance coverage in Africa include increased financial burden on households, decreased access to health services, and inadequate coverage for essential health services. These consequences contribute to reduced utilization of healthcare services and negative health outcomes, including the deterioration of existing health conditions and the development of new health problems. The financial burden is particularly significant due to high poverty rates in Africa, forcing households to pay for healthcare services out of pocket and leading to considerable financial strain and even financial ruin. Additionally, limited health insurance coverage restricts access to necessary health services, resulting in delayed treatment, missed diagnoses, and poor health outcomes. The root causes of limited health insurance coverage in Africa are multifaceted and include factors such as poverty, lack of government support, and limited private-sector involvement. These systemic issues contribute to the persistence of inadequate health insurance coverage and hinder efforts to improve access to quality healthcare for African populations.

“It’s not time for us to sit down yet”: how group exercise programs can motivate physical activity and overcome barriers in inactive older adults

ABSTRACT Purpose Physical activity and exercise are critical for older adults’ physical and mental health. The purpose of this qualitative study was to richly capture the motivators of and barriers to engaging in physical activity in previously inactive older adults who participated in a three-arm randomized controlled trial (RCT) of eight-week group exercise interventions. Methods We conducted a qualitative content analysis of individual interviews with fifteen participants—five from each study arm: strength training, walking, and inactive control. Participants included nine females and six males ranging from 60 to 86 years of age. Results Key motivators of physical activity included perceived improvements in physical and mental health, positive social influences, observed health deterioration in others, and the desire to spend time with and take care of family members. Barriers to physical activity included existing health conditions, fear of getting hurt, negative social influences, perceived lack of time and motivation, inconvenient times and locations, and monetary cost. Conclusions Our findings add to the body of literature identifying factors that motivate and stand in the way of older adults’ engagement in physical activity. These factors influence older adults’ self-efficacy and should be incorporated into the design of new and existing programs to encourage initiation and maintenance of physical activity.

COVID-19 pandemic experiences among people with epilepsy: Effect on symptoms of co-occurring health conditions and fear of seizure

ObjectiveThe Coronavirus disease 2019 (COVID-19) pandemic profoundly affected people worldwide, but little is known about how it impacted people with epilepsy (PWE). We examined the associations between COVID-19 stressors and health outcomes including increases in other health symptoms and fear of seizure among PWE. MethodsThis cross-sectional study used data from an online survey that asked about demographic characteristics, health conditions, and potential life stressors during COVID-19. Data were collected from October 30 to December 8, 2020. COVID-19 stressors were anger, anxiety, stress, healthcare access, fear of seeking healthcare, social isolation, sense of control over their lives, and alcohol consumption. A binary variable was created for each of these measures to indicate whether PWEs experienced a negative change versus a neutral or positive change. We used multivariable logistic regression to assess the associations of COVID-19 stressors with primary outcomes: exacerbated co-occurring health conditions and increasing fear of seizure during the pandemic. ResultsOf the 260 PWE included in the study, 165 (63.5%) were women; the average age was 38.7 years. During the survey administration period, 79 (30.3%) of the respondents reported exacerbated co-occurring health conditions, and 94 (36.2%) reported an increased fear of seizures. Regression results indicated that the fear of seeking healthcare during COVID-19 was associated with both exacerbated co-occurring health conditions (aOR 1.12; 95%CI 1.01–1.26) and increasing fear of seizure (aOR 2.31; 95%CI 1.14–4.68). Social isolation was associated with exacerbated co-occurring health conditions during COVID-19 (aOR 1.14; 95%CI 1.01–1.29). Reduced access to physical healthcare was associated with increasing fear of seizure (aOR 2.58; 95%CI 1.15–5.78). ConclusionA considerable number of PWE experienced more symptoms of existing health conditions and fear of seizure during the initial year of the pandemic (2020). Fear of seeking healthcare services was associated with both negative outcomes. Assuring access to health care and reducing social isolation could potentially reduce negative outcomes for PWE. It is necessary to provide adequate support for PWE to reduce risks as COVID-19 continues to be a health concern.

Evaluation of Eating Attitudes, Nutritional Status, and Anthropometric Measurements of Women Who Exercise: The Case of Karabük

Unhealthy nutrition attitudes and behaviors are quite common among women. The development of such behaviors involves a high risk for existing health conditions of slightly obese and obese individuals. The way to a better quality of life is through doing regular physical activity, having a healthy diet, and changing eating attitudes. In this context, this study was conducted to examine the nutritional status and eating attitudes of women who applied to a private clinic and exercised. A total of 111 women between the ages of 18-45 who applied to a private nutrition and diet clinic in Karabük province in Türkiye and engaged in regular physical activity (at least 150 minutes per week or more) were included in the study. The data were collected using a questionnaire including the participants’ demographic data, anthropometric measurements, 3-day food consumption records, physical activity habits and Eating Attitude Test (EAT-40) scale. The measurements were performed with the Inbody 120 device, which performs detailed body analysis. SPSS 23.0 (IBM SPSS Statistics) was used in the analysis of the data. The “Independent Sample-t” test (t-table value) was used to compare the measurement values of two independent groups. Eating attitudes of women differ according to age, educational status and BMI groups. Of the women with normal eating behavior, 50.6% are married, 46.1% are between the ages of 30-34, 49.4% are university graduates, and 61.8% are within the normal BMI range (P