Health Education Control Group Research Articles

Pilot Randomized Controlled Trial of a Yoga-Based Intervention Targeting Anger Management for People Who Are Incarcerated.

Introduction: Incarceration represents an opportune moment to improve self-management of anger and aggression. A hatha yoga-based intervention (YBI) could serve as a useful adjunctive intervention for anger within prisons. Methods: We enrolled 40 people with elevated levels of anger who were incarcerated (20 in a women's facility, and 20 in a men's facility) in a 10-week pilot randomized controlled trial of a YBI versus. a health education (HE) control group. Participants attended their respective groups once per week. We examined indices of feasibility and acceptability, including intervention credibility, expectancy the intervention would be helpful, intervention satisfaction, class attendance, engagement in personal practice, instructor fidelity, intervention safety, and study recruitment and retention rates. We also examined changes in clinical outcomes including anger, depression, anxiety, and behavioral infractions over time. Results: We met targets for several outcomes: credibility of the YBI and HE interventions, expectancy that they would be helpful, and satisfaction with the programs. Instructors demonstrated fidelity to both manuals. There were no serious adverse events related to study participation. Class attendance did not meet our target outcome in either facility and rates of personal practice met our target outcome in the men's but not the women's facility. For people enrolled in the YBI, anger, depression, and anxiety tended to decrease over time. Qualitative interviews with participants pointed to overall high satisfaction with the YBI and provided information on facility-related barriers to class attendance. Conclusion: Although we did not meet all our feasibility targets in this study, we note high participant enthusiasm. Thus, we believe this line of research is worth pursuing, with further attention to ways to decrease facility-related barriers to class attendance and personal practice. Clinical trials registration: NCT05336123.

Effects of acceptance and commitment therapy on fatigue interference in patients with advanced lung cancer and caregiving burden: protocol for a pilot randomised controlled trial

IntroductionCancer-related fatigue is common in patients with advanced lung cancer. It not only interferes with patients’ health-related quality of life, but also increases the caregiving burden of their caregivers. Acceptance...

Pengaruh Media Booklet dan Audio Visual terhadap Pengetahuan Akseptor KB tentang Kontrasepsi Jangka Panjang di Wilayah Bogor Utara Tahun 2023

Long-acting contraception is one effective method of family planning. However, sufficient knowledge about long-acting contraception is still low among birth control acceptors in the North Bogor Region. Therefore, this study aims to investigate the effect of the use of booklet and audio-visual media on the knowledge of birth control acceptors regarding long-term contraception in the region. The purpose of this study was to evaluate whether the use of booklet and audio-visual media can increase the knowledge of family planning acceptors about long-term contraception in the North Bogor Region. This study used a pseudo-experimental design with a control group pretest-posttest design. The study sample consisted of 100 KB acceptors selected by purposive sampling and divided into two groups, namely the experimental group that received intervention using booklet and audio-visual media, and the control group that did not receive the intervention. The study data were collected through knowledge questionnaires before and after the intervention. Data analysis was performed using independent t-test and t-paired test. The results showed that there was a significant increase in knowledge of birth control acceptors after receiving interventions using booklet and audio-visual media. The experimental group showed a higher increase in knowledge compared to the control group, in the treatment group with audiovisual media the increase in knowledge was better when compared to the health education control group with Booklet media The average level of knowledge of the control group before being given treatment was 12.5 After being given treatment the average score of the control group rose to 13.4. While the average Audio visual group average score was 13.25. After being treated, the average score increased by 14.6. The t-test result shows a p value (0.000<0.05). The use of booklet and audio-visual media is effective in increasing the knowledge of birth control acceptors about long-acting contraception.

Protocol for evaluating the effects of the Reducing Cardiometabolic Diseases Risk dietary pattern in the Chinese population with dyslipidaemia: a single-centre, open-label, dietary intervention study

IntroductionCardiometabolic disease (CMD) is the leading cause of mortality in China. A healthy diet plays an essential role in the occurrence and development of CMD. Although the Chinese heart-healthy diet...

Effects of mindfulness training and exercise on cognitive function in healthy older adults without dementia: the MEDEX clinical trial

AbstractBackgroundA 2×2 factorial multi‐site randomized clinical trial was conducted to determine whether Mindfulness Based Stress Reduction (MBSR), exercise, or their combination improve cognitive function in older adults..Method585 older adults (aged 65‐84; mean age 71.5, 72.5% women) with subjective cognitive concerns but no dementia were randomized to MBSR, exercise with aerobic, strength and functional components, combined MBSR and exercise, or a health education control group. Interventions lasted 18 months and consisted of group‐based classes and home practice.ResultNeither MBSR, exercise, nor their combination significantly improved either primary outcome of memory or cognitive control (composites of neuropsychological tests), or secondary outcomes of hippocampal volume, DLPFC thickness and surface area, functional cognitive capacity or self‐reported cognitive concerns.ConclusionAmong older adults with subjective cognitive concerns but without dementia, mindfulness training, exercise, or both did not significantly improve cognitive or brain structural outcomes.

Sleep Technology Intervention to Target Cardiometabolic Health (STITCH): a randomized controlled study of a behavioral sleep extension intervention compared to an education control to improve sleep duration, blood pressure, and cardiometabolic health among adults with elevated blood pressure/hypertension

BackgroundShort sleep duration, defined as < 7 h sleep on weeknights, affects 40% of the US adult population, contributing to the increased risk for cardiometabolic diseases, decreased safety, and poorer mental health. Despite the prevalence of short sleep duration, few studies have tested interventions to extend sleep duration. The objective of this study is to test the effects of a behavioral sleep extension intervention on sleep duration, blood pressure, and other measures of cardiometabolic health among adults with elevated blood pressure or hypertension.MethodsThis is a single-blind, randomized controlled trial to determine the impact of a behavioral sleep extension intervention on sleep duration and cardiometabolic health among individuals with short sleep duration (< 7 h per night) and elevated blood pressure or hypertension (SBP 120–150 mmHg or DBP 80–90 mmHg). After completing the screening, participants will be randomly assigned to either a sleep coaching (intervention) or health education (control) group. The participants will have weekly contact for either coaching or education for 8 weeks (intervention period) followed by monthly coaching or education for the next 2 months (maintenance period). Participants will complete assessment visits, actigraphy, and 24-h ambulatory blood pressure recording at baseline/screening, 8 weeks, and 6 and 12 months. The primary outcome is sleep duration at 8 weeks, and the secondary outcome is blood pressure at 8 weeks.DiscussionThe results of this study will determine the effects of behavioral sleep extension on sleep and cardiometabolic health among adults with short sleep duration and elevated BP/hypertension. The results will inform the feasibility and efficacy of behavioral sleep extension and provide information needed for future multi-site effectiveness studies.Trial registrationClinicalTrials.gov NCT04766424. Registered on 21 February 2021.

Effects of computerized cognitive training on structure‒function coupling and topology of multiple brain networks in people with mild cognitive impairment: a randomized controlled trial

BackgroundPeople with mild cognitive impairment (MCI) experience a loss of cognitive functions, whose mechanism is characterized by aberrant structure‒function (SC-FC) coupling and topological attributes of multiple networks. This study aimed to reveal the network-level SC-FC coupling and internal topological changes triggered by computerized cognitive training (CCT) to explain the therapeutic effects of this training in individuals with MCI.MethodsIn this randomized block experiment, we recruited 60 MCI individuals and randomly divided them into an 8-week multidomain CCT group and a health education control group. The neuropsychological outcome measures were the Montreal Cognitive Assessment (MoCA), Chinese Auditory Verbal Learning Test (CAVLT), Chinese Stroop Color–Word Test (SCWT), and Rey–Osterrieth Complex Figure Test (Rey CFT). The brain imaging outcome measures were SC-FC coupling and topological attributes using functional MRI and diffusion tensor imaging methods. We applied linear model analysis to assess the differences in the outcome measures and identify the correspondence between the changes in the brain networks and cognitive functions before and after the CCT.ResultsFifty participants were included in the analyses after the exclusion of three dropouts and seven participants with low-quality MRI scans. Significant group × time effects were found on the changes in the MoCA, CAVLT, and Rey CFT recall scores. The changes in the SC-FC coupling values of the default mode network (DMN) and somatomotor network (SOM) were higher in the CCT group than in the control group (P(unc.) = 0.033, P(unc.) = 0.019), but opposite effects were found on the coupling values of the visual network (VIS) (P(unc.) = 0.039). Increasing clustering coefficients in the functional DMN and SOM and subtle changes in the nodal degree centrality and nodal efficiency of the right dorsal medial prefrontal cortex, posterior cingulate cortex, left parietal lobe, somatomotor area, and visual cortex were observed in the CCT group (P < 0.05, Bonferroni correction). Significant correspondences were found between global cognitive function and DMN coupling values (P(unc.) = 0.007), between immediate memory and SOM as well as FPC coupling values (P(unc.) = 0.037, P(unc.) = 0.030), between delayed memory and SOM coupling values (P(unc.) = 0.030), and between visual memory and VIS coupling values (P(unc.) = 0.007).ConclusionsEight weeks of CCT effectively improved global cognitive and memory functions; these changes were correlated with increases in SC-FC coupling and changes in the topography of the DMN and SOM in individuals with MCI. The CCT regimen also modulated the clustering coefficient and the capacity for information transformation in functional networks; these effects appeared to underlie the cognitive improvement associated with CCT.Trial registrationChinese Clinical Trial Registry, ChiCTR2000034012. Registered on 21 June 2020.

Examining the Malleability of Negative Views of Aging, Self-Efficacy Beliefs, and Behavioral Intentions in Middle-Aged and Older Adults.

This study examined the malleability of a tripartite cluster of purported mechanistic variables targeted in a 4-week intervention program designed to improve adults' engagement in physical activity. The targeted cluster of purported mechanisms consisted of negative views of aging (NVOA), self-efficacy beliefs, and behavioral intentions. A randomized single-blind control group design was used to implement the AgingPLUS program in a sample of middle-aged and older adults (N = 335; Mage = 60.1 years; SDage = 8.3 years; age range 45-75 years). Using an intention-to-treat approach and analyses of covariance adjusting for participants' baseline scores, findings showed significant improvements in the purported mechanistic variables both at the immediate (Week 4) and delayed posttest (Week 8) in the treatment group but not in the control group. These improvements were for the most part maintained until 8-month postrandomization, although to a smaller extent. Specifically, participants in the AgingPLUS group showed significant improvements in NVOA, self-efficacy beliefs, and behavioral intentions compared to the Health Education control group. Standardized effect sizes for statistically significant effects were variable and ranged from small (d = -0.23) to large (d = 0.80). Effect sizes showed some decay of the intervention at the 8-month posttest. Taken together, the findings supported the efficacy of the AgingPLUS program and showed that variables representing the purported mechanisms of the intervention were significantly moved in a positive direction. In doing so, the AgingPLUS program met a major requirement of the experimental medicine approach to behavior change interventions. NCT0329948.

Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA (ACHIEVE): a multicentre, randomised controlled trial

Hearing loss is associated with increased cognitive decline and incident dementia in older adults. We aimed to investigate whether a hearing intervention could reduce cognitive decline in cognitively healthy older adults with hearing loss. The ACHIEVE study is a multicentre, parallel-group, unmasked, randomised controlled trial of adults aged 70-84 years with untreated hearing loss and without substantial cognitive impairment that took place at four community study sites across the USA. Participants were recruited from two study populations at each site: (1) older adults participating in a long-standing observational study of cardiovascular health (Atherosclerosis Risk in Communities [ARIC] study), and (2) healthy de novo community volunteers. Participants were randomly assigned (1:1) to a hearing intervention (audiological counselling and provision of hearing aids) or a control intervention of health education (individual sessions with a health educator covering topics on chronic disease prevention) and followed up every 6 months. The primary endpoint was 3-year change in a global cognition standardised factor score from a comprehensive neurocognitive battery. Analysis was by intention to treat. This trial was registered at ClinicalTrials.gov, NCT03243422. From Nov 9, 2017, to Oct 25, 2019, we screened 3004 participants for eligibility and randomly assigned 977 (32·5%; 238 [24%] from ARIC and 739 [76%] de novo). We randomly assigned 490 (50%) to the hearing intervention and 487 (50%) to the health education control. The cohort had a mean age of 76·8 years (SD 4·0), 523 (54%) were female, 454 (46%) were male, and most were White (n=858 [88%]). Participants from ARIC were older, had more risk factors for cognitive decline, and had lower baseline cognitive scores than those in the de novo cohort. In the primary analysis combining the ARIC and de novo cohorts, 3-year cognitive change (in SD units) was not significantly different between the hearing intervention and health education control groups (-0·200 [95% CI -0·256 to -0·144] in the hearing intervention group and -0·202 [-0·258 to -0·145] in the control group; difference 0·002 [-0·077 to 0·081]; p=0·96). However, a prespecified sensitivity analysis showed a significant difference in the effect of the hearing intervention on 3-year cognitive change between the ARIC and de novo cohorts (pinteraction=0·010). Other prespecified sensitivity analyses that varied analytical parameters used in the total cohort did not change the observed results. No significant adverse events attributed to the study were reported with either the hearing intervention or health education control. The hearing intervention did not reduce 3-year cognitive decline in the primary analysis of the total cohort. However, a prespecified sensitivity analysis showed that the effect differed between the two study populations that comprised the cohort. These findings suggest that a hearing intervention might reduce cognitive change over 3 years in populations of older adults at increased risk for cognitive decline but not in populations at decreased risk for cognitive decline. US National Institutes of Health.

Effect of mindfulness-based stress reduction in patients with acute myocardial infarction after successful primary percutaneous coronary intervention: a retrospective study

ObjectiveThis study aimed to examine the effects of mindfulness-based stress reduction (MBSR) in patients with acute myocardial infarction (AMI) after primary percutaneous coronary intervention (PPCI).MethodsA retrospective study was conducted with data collected from AMI patients who underwent successful PPCI. The study included 61 cases that received 8-week MBSR intervention (MBSR group) and 61 cases that received weekly health education (control group) over the same period. Outcome measures, including hemodynamic parameters, psychosocial characteristics [Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS), Perceived Social Support Scale (PSSS)], health-related quality of life [HRQoL, 7-item Seattle Angina Questionnaire (SAQ-7)], and major adverse cardiovascular events (MACE), were assessed at baseline (T1), post-intervention (T2), 1 month after the post-intervention (T3) and 3 months after the post-intervention (T4).ResultsCompared to the control group, the MBSR group showed improvements in blood pressure, specifically in systolic blood pressure (SBP) at T4, and diastolic blood pressure (DBP) at T3 and T4, and mean arterial blood pressure (MABP) at T3 and T4. Additionally, the MBSR group had lower scores of anxiety and perceived stress (HADS, PSS) and higher scores of perceived social support (PSSS) after the intervention. Furthermore, the MBSR group had higher scores on the SAQ-7 at all measurement points. The control group had a significantly higher total MACE rate compared to the MBSR group (26.23% vs. 9.84%).ConclusionsThis study provides support for the potential benefits of MBSR as an adjunctive treatment for AMI patients undergoing PPCI.

739-P: Metabolome Alterations Associated with 12-Week Sitting Time Reduction among Sedentary, Postmenopausal Latinas

Background: Prolonged sitting is associated with health risk. The metabolic impact of replacing sitting time with standing is unknown. We explored metabolome changes after a 12-week standing intervention. Methods: Sedentary postmenopausal Latinas with overweight (N=254; 55+ years of age; BMI ≥25 kg/m2) were randomized to an increased standing intervention or a health education control group. Clinical, behavioral and fasting plasma measurements were collected at baseline and 12-weeks. Sitting, standing and stepping time was assessed objectively by a thigh-worn inclinometer (activPAL). Aqueous metabolites and carnitines were measured using LC-MS/MS. Results: Top tertile of intervention group Best Responders (N=43) was selected by criteria of change in mean sitting bout duration and total sitting time. Variable-Matched Controls (N=43) were selected from the control group using a random forest model trained to predict the Best-Responders. Best Responders changed sitting and standing time by -110.0 (11.0) and 104.6 (10.1) min, respectively, compared to the Matched Controls change of 7.1 (9.8) and -7.8 (9.0) min, respectively. A covariate-controlled GLM revealed significant group differences in change scores of 24 metabolites (FDR q = 0.048-2.1E-4) from baseline to 12-week follow-up. Enzyme enrichment predicted significant functional changes in enzymes involved in glutamate and histidine catabolism. Pathway analysis showed significant effects in 14 metabolites of aminoacyl tRNA biosynthesis, as well as 4 metabolites involved in phenylalanine, tyrosine, tryptophan, ubiquinone/terpenoid-quinone biosynthesis and beta-alanine metabolism (all p &amp;lt; 0.05). Metabolite change scores mapped to central carbon metabolism with significant elevation of 14 amino acids involved in pyruvate, acetoacetyl- and acetyl-CoA metabolism, and TCA cycle intermediate biosynthesis. Conclusion: Standing intervention results in broad amino acid metabolism alterations. Disclosure J.Patterson: None. P.Jasbi: None. H.Gu: None. M.Allison: None. C.Reuter: None. B.Rana: None. L.Natarajan: None. D.D.Sears: None. Funding American Heart Association (16SFRN28420000)

Effects of instability resistance training on static postural control of cognitively impaired older adults

BACKGROUND: Mounting evidence has demonstrated functional and cognitive-related benefits after Instability Resistance Training (IRT) in individuals, healthy as wellas patients presenting with neurological disorders. However, whether IRT may play a significant role in the postural control of older adults has not been established. OBJECTIVE: To evaluate the effects of 12- weeks of IRT on static postural control of older adults with subjective cognitive impairment. METHODS: In this randomized controlled trial, a total of 67 participants (aged 65 years and older) were randomly assigned to either 12 weeks of IRT (n= 22), traditional resistance training (RT) (n= 23), or a health education control group (CON) (n= 22). Static postural control was assessed using a force platform that recorded the displacement amplitude of the center of pressure (CoP) in the anteroposterior (AP) and mediolateral (ML) directions in bipedal support (30 seconds) with eyes open and closed. RESULTS: All groups increased AP displacement in the conditions of eyes open and closed. During the eyes-closed condition, only the IRT group increased the ML displacement. No between-group differences were detected in any postural control (p&gt; 0.05). CONCLUSIONS: 12 weeks of IRT does not improve the static postural control in older adults with cognitive impairment.

THE COMPARISON OF DUAL TASK TIME AMONG APOE CARRIERS AGAINST NON-APOE CARRIERS IN AGING ADULTS

Abstract No single variable has been identified as the sole factor for predicting an individuals’ declining health status. In order to predict mental or physical decline in older adults, researchers have designed tasks that include both a physical and mental or cognitive demand known as dual task (DT). The purpose of implementing dual task is to assess the possible changes in accuracy when a second task gets compounded with a given single task. Our study consists of males and females aged from 45 to 75 years who have risk factors for dementia. Each subject was randomly assigned to either a health coaching (HC), or health education (HE) control group. The HC group received coaching to address the lifestyle areas known to be linked to AD risk, such as diet, exercise, sleep, stress, cognitive training, and social interaction. Blood markers of each individual have been assessed to determine carrier status of Apolipoprotein E 4 (APOE4) due to the correlation between the allele and increased risk of Alzheimer’s. To be included in the study, the participants must have at least 2 positive risk factors for AD as determined by the Australian National University-Alzheimer Disease Risk Index (ANU-ADRI). Among non-APOE carriers, a 2x3 (group x time) mixed ANOVA revealed a significant interaction effect wherein the HC group improved DTC score more than the HE group from time 1 to time 3, F (2, 362) =1.253, P=0.017. No significant interaction was noted for APOE carriers.

Effects of Mindfulness Training and Exercise on Cognitive Function in Older Adults

Episodic memory and executive function are essential aspects of cognitive functioning that decline with aging. This decline may be ameliorable with lifestyle interventions. To determine whether mindfulness-based stress reduction (MBSR), exercise, or a combination of both improve cognitive function in older adults. This 2 × 2 factorial randomized clinical trial was conducted at 2 US sites (Washington University in St Louis and University of California, San Diego). A total of 585 older adults (aged 65-84 y) with subjective cognitive concerns, but not dementia, were randomized (enrollment from November 19, 2015, to January 23, 2019; final follow-up on March 16, 2020). Participants were randomized to undergo the following interventions: MBSR with a target of 60 minutes daily of meditation (n = 150); exercise with aerobic, strength, and functional components with a target of at least 300 minutes weekly (n = 138); combined MBSR and exercise (n = 144); or a health education control group (n = 153). Interventions lasted 18 months and consisted of group-based classes and home practice. The 2 primary outcomes were composites of episodic memory and executive function (standardized to a mean [SD] of 0 [1]; higher composite scores indicate better cognitive performance) from neuropsychological testing; the primary end point was 6 months and the secondary end point was 18 months. There were 5 reported secondary outcomes: hippocampal volume and dorsolateral prefrontal cortex thickness and surface area from structural magnetic resonance imaging and functional cognitive capacity and self-reported cognitive concerns. Among 585 randomized participants (mean age, 71.5 years; 424 [72.5%] women), 568 (97.1%) completed 6 months in the trial and 475 (81.2%) completed 18 months. At 6 months, there was no significant effect of mindfulness training or exercise on episodic memory (MBSR vs no MBSR: 0.44 vs 0.48; mean difference, -0.04 points [95% CI, -0.15 to 0.07]; P = .50; exercise vs no exercise: 0.49 vs 0.42; difference, 0.07 [95% CI, -0.04 to 0.17]; P = .23) or executive function (MBSR vs no MBSR: 0.39 vs 0.31; mean difference, 0.08 points [95% CI, -0.02 to 0.19]; P = .12; exercise vs no exercise: 0.39 vs 0.32; difference, 0.07 [95% CI, -0.03 to 0.18]; P = .17) and there were no intervention effects at the secondary end point of 18 months. There was no significant interaction between mindfulness training and exercise (P = .93 for memory and P = .29 for executive function) at 6 months. Of the 5 prespecified secondary outcomes, none showed a significant improvement with either intervention compared with those not receiving the intervention. Among older adults with subjective cognitive concerns, mindfulness training, exercise, or both did not result in significant differences in improvement in episodic memory or executive function at 6 months. The findings do not support the use of these interventions for improving cognition in older adults with subjective cognitive concerns. ClinicalTrials.gov Identifier: NCT02665481.

A Multi‐domain Lifestyle Intervention does not Improve Health and Cognitive Outcomes Among APOE e4 Carriers after 4‐months

AbstractBackgroundAlzheimer’s Disease (AD) currently affects 24 million individuals worldwide, this rate is expected to triple by 2050. The greatest genetic risk for AD is apolipoprotein E (ApoE; e4 allele carriers), e4 carriers typically exhibit abnormal regulation of lipoprotein metabolism. It is important to understand whether multi‐domain lifestyle interventions can mitigate cognitive decline and improve overall health in ApoEe4 carriers. Thus far, the data are mixed due to sample sizes and methodological limitations. Therefore, the purpose of this present investigation is to determine if a digital multi‐domain intervention (MDI) can improve health and cognitive outcomes in cognitively at‐risk e4 carriers over 4 months.MethodAdults 45‐75 years old participated in this present investigation, each participant was randomly assigned to a health coaching intervention group (HC; n=61 non‐carriers; n=24 e4 carriers) or health education control group (HE; n=62 non‐carriers; n=20 e4 carriers). Participants completed weight, height, venous blood draw, a digital memory and associative learning test during baseline and 4‐month follow‐up visits. A 2 (time) x 2 (group) x 2 (APOE) factorial‐ANOVA was utilized to examine differences in the dependent variables (body mass index (BMI), cholesterol, triglycerides, memory, learning). Age, sex, and education were accounted for.ResultTriglycerides significantly increased among HC e4carriers compared to HC non‐carriers (p=.009). BMI significantly increased among carriers regardless of intervention group compared to non‐carriers (p&lt; .001). Cholesterol values showed a decreasing trend among HC non‐carriers, HE carriers, and non‐carriers compared to no change among HC carriers (p=.118). At both time points, e4 carriers in HE and HC exhibited significantly lower scores on memory tasks compared to non‐carriers (p=.020). HC non‐carriers saw a significant increase in associative learning scores, HC e4carriers and HE group (e4 carriers and non‐carriers) showed decreases in an associative learning task (p=.016).ConclusionHC e4 carriers are unresponsive to a MDI lifestyle intervention compared to non‐carriers after 4‐months. These findings could be due to ApoE essential role in circulation lipoprotein metabolism and key role in regulation of cholesterol impacting synaptic function maintenance; e4 allele carriers usually demonstrate higher dysfunction. Follow‐up analyses are required to substantiate current preliminary findings.

Effectiveness of mind-body exercise via Baduanjin on physical and psychological outcomes in patients with pulmonary ground-glass nodules: A non-randomized controlled pilot study

BackgroundWith the increasing incidence and mortality of lung cancer, ground-glass nodules (GGNs) have become an ongoing public health concern. In clinical practice, the physical and psychological distress of GGN patients is easy to overlook during the follow-up after diagnosis. Such patients typically have limited medical options and few of these options involve mind-body exercises. ObjectiveThe purpose of this pilot study was to explore the effectiveness of the mind-body exercise Baduanjin on physical and psychological outcomes among GGN patients. DesignWe conducted a prospective, non-randomized, controlled, assessor-blinded trial (ClinicalTrials.gov: NCT03420885). SettingThis trial was conducted at three medical sites, both located in Shanghai, China, between April 2017 and January 2020. ParticipantsPatients with GGN. InterventionSixty GGN participants were divided into a health education control group only receiving health education (n = 30) and a Baduanjin intervention group receiving health education plus a Baduanjin training program (n = 30). Both groups were treated for 16 weeks. Outcome measurementsOutcomes were assessed at baseline and week 16. The primary outcomes included pulmonary function (FVC, FVC%, FEV1, FEV1/FVC, PEF) and psychological condition (SAS score, SDS score). The secondary outcome was quality of life (SF-36). ResultsCompared with the health education control group, the Baduanjin intervention group had significant improvements in pulmonary function (FVC, FVC%, FEV1), psychological outcomes (SAS score, SDS score), and quality of life (SF-36). The significant differences in pre-intervention and post-intervention between groups were as follows: FVC (MD = 0.21, 95%CI: 0.10 to 0.33, P = 0), FVC% (MD = 6.90, 95%CI: 3.10 to 10.70, P = 0.001), FEV1 (MD = 0.18, 95%CI: 0.07 to 0.29, P = 0.001); SAS score (MD = −4.90, 95%CI: −8.28 to −1.52, P = 0.005), SDS score (MD = −5.83, 95%CI: −9.46 to −2.21, P = 0.002); physical component summary (PCS) of SF-36 (MD = 5.03, 95%CI: 2.54 to 7.51, P = 0), mental component summary (MCS) of SF-36 (MD = 5.78, 95%CI: 2.64 to 8.92, P = 0.001). Linear regression analysis was performed to study the influence of confounder variables on the improvements of primary outcomes, and no significant change was found. Moreover, Pearson correlation coefficient analysis demonstrated that ameliorations in lung function (FVC, FVC%, FEV1, FEV1/FVC, and PEF) were significantly associated with a decrease in anxious symptoms and depressive symptoms. ConclusionGGN patients in the Baduanjin intervention group showed greater benefits in pulmonary function and psychological outcomes than those in the health education control group, and the effectiveness was stable. The findings support Baduanjin as an effective, safe, enjoyable, and promising complementary intervention for management of GGN in patients with physical and psychological distress.

Latin Dance and Working Memory: The Mediating Effects of Physical Activity Among Middle-Aged and Older Latinos.

BackgroundPhysical activity (PA) is a promising method to improve cognition among middle-aged and older adults. Latinos are at high risk for cognitive decline and engaging in low levels of PA. Culturally relevant PA interventions for middle-aged and older Latinos are critically needed to reduce risk of cognitive decline. We examined changes in cognitive performance among middle-aged and older Latinos participating in the BAILAMOS™ dance program or a health education group and compared the mediating effects of PA between group assignment and change in cognitive domains.MethodsOur 8-month randomized controlled trial tested BAILAMOS™, a 4-month Latin dance program followed by a 4-month maintenance phase. A total of 333 older Latinos aged 55+ were randomized to either BAILAMOS™, or to a health education control group. Neuropsychological tests were administered, scores were converted to z-scores, and specific domains (i.e., executive function, episodic memory, and working memory) were derived. Self-reported PA was assessed, and we reported categories of total PA, total leisure PA, and moderate-to-vigorous PA as minutes/week. A series of ANCOVAs tested changes in cognitive domains at 4 and 8 months. A mediation analysis tested the mediating effects of each PA category between group assignment and a significant change in cognition score.ResultsThe ANCOVAs found significant improvement in working memory scores among participants in the dance group at month 8 [F(1,328) = 5.79, p = 0.017, d = 0.20], but not in executive functioning [F(2,328) = 0.229, p = 0.80, Cohen’s d = 0.07] or episodic memory [F(2,328) = 0.241, p = 0.78, Cohen’s d = 0.05]. Follow-up mediation models found that total PA mediated the relationship between group assignment and working memory, in favor of the dance group (β = 0.027, 95% CI [0.0000, 0.0705]). Similarly, total leisure PA was found to mediate this relationship [β = 0.035, 95% CI (0.0041, 0.0807)].ConclusionA 4-month Latin dance program followed by a 4-month maintenance phase improved working memory among middle-aged and older Latinos. Improvements in working memory were mediated by participation in leisure PA. Our results support the current literature that leisure time PA influences cognition and highlight the importance of culturally relevant PA modalities for Latinos.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [NCT01988233].

Health Education-Based Effectiveness of Health Belief Model on Vulva Hygiene Behavior in Prevention of Vaginal Discharge for Pregnant Woman

Introduction: Leucorrhoea can endanger pregnancy and result premature labor. Health education is needed for good vulva hygiene behavior. This study aims to explain the effectiveness of Health Education (HE) based on the Health Belief Model (HBM) on Vulva Hygiene Behavior in the Prevention of Leucorrhoea in Pregnant Women. Method: The first stage of research was literature study, expert discussion, and development of an intervention module. The participants were pregnant women in the second trimester. The instrument is the researcher. An interview guide with a questionnaire. Qualitative data analysis. The second stage of research used the quasi-experimental design (pre and post-testdesign). The independent variable is Health Education based on the Health Belief Model (HBM). The dependent variable is the behavior of Vulva Hygiene in the prevention of vaginal discharge for pregnant women. An instrument with a questionnaire. Data collection through pre-test, intervention, post-test. The number of participants in each group was 30 participants. Research at the Kedungdoro Public Health Center in Surabaya from December 2019-October 2020. Result: The first stage of research, showed that several trimester II pregnant women performed vulva hygiene correctly and some did not know how to do vulva hygiene, some did not do vulva hygiene. The module consists of 4 themes. The Health Education (HE) experimental group based on the Health Belief Model (HBM) was effective on Vulva Hygiene behavior in preventing vaginal discharge in pregnant women with a value (P) = 0.000. The Health Education (He) control group based on the Health Belief Model (HBM) was not effective on vulva hygiene behavior in preventing vaginal discharge in pregnant women with a value (P) = 0.083. The results of the pre-test of vulva hygiene behavior in the prevention of vaginal discharge in the non-intervention group and the intervention group were not different with a value (P) of 0.488&gt; 0.05. In the post-test of vulva hygiene behavior in the intervention group and the non-intervention group, there was a difference with a value (P) of 0.000 &lt;0.05. Analysis: Through Health Education based on the Health Belief Model, it can increase the confidence of each individual to behave healthily, in the form of prevention and use of health facilities. The Health Belief Model (HBM) is the main framework for healthy behavior. This gives HBM a function as a preventive or preventive model. Discuss: The behavior of vulva hygiene in preventing vaginal discharge in pregnant women between the experimental group and the control group was a significant difference.

Does Direct-to-Consumer Personal Genetic Testing Improve Gynecological Cancer Screening Uptake among Never-Screened Attendees? A Randomized Controlled Study

The clinical impact of direct-to-consumer genetic testing (DTC-GT) on health behavior change has remained controversial. The aim of this study is to clarify the short-term effects of DTC-GT on gynecological cancer screening uptake among middle-aged never-screened Japanese women in a randomized controlled trial (RCT). A total of 144 women aged 45–50 who had never undergone gynecological cancer screening were randomly selected to receive health education (control group), or health education and DTC-GT (intervention group), at a 1:1 ratio. We compared the gynecological screening uptake during the follow-up period. Furthermore, to estimate the impact of learning of an elevated genetic cancer risk in the intervention group, we conducted an analysis dichotomized by genetic risk category. A total of 139 women completed the one-year follow-up survey (69 in the control group and 70 in the intervention group). The follow-up period did not differ between control and intervention groups (the median follow-up period was 276 days and 279 days, respectively, p = 0.746). There were 7 (9.7%) women in the control group and 10 (13.9%) in the intervention group who attended breast cancer screening (p = 0.606), and 9 (12.5%) women from both groups attended cervical cancer screening (p = 1.000). Likewise, there were no significant differences in cancer screening uptake in the analysis stratified by risk category within the intervention group. In conclusion, there was no significant effect of DTC-GT on gynecological cancer screening uptake in this RCT setting. Increasing cancer screening attendance may require a combination of well-established intervention strategies and DTC-GT. Clinical Trial Registration: UMIN-CTR Identifier, UMIN000031709.

The effects of low-impact moderate-intensity stepping exercise on fatigue and other functional outcomes in older adults with multimorbidity: A randomized controlled trial

ObjectivesFatigue is highly prevalent among older adults with multimorbidity. As the World Health Organization advocates for strategies that improve the functional status of this aged cohort, this study examined the effects of a low-impact moderate-intensity exercise program on their fatigue levels and related functional health outcomes. Methods and MaterialsA multi-site clinical trial randomized 124 community-dwelling older adults with multimorbidity [mean age: 78.1 years (SD: 7.0); female: 83.8%] to a low-impact exercise program (intervention) group or a health education (control) group. The exercise program was designed to address fatigue-associated low energy levels, and consisted of thrice-weekly low-impact stepping exercises that were progressively increased from low intensity to moderate intensity over a 12-week period, using group-based practice to encourage engagement. The Multidimensional Fatigue Inventory, FRAIL Scale, International Physical Activity Questionnaire, the two-minute walking test, and Profile of Mood States (short-from) were administered at baseline, post-intervention, and 12 weeks thereafter. ResultsGeneralized estimating equation showed that the intervention group reported greater decreases in fatigue and frailty, and greater improvements in physical activity level, exercise tolerance, and mood status than the control group. The positive effects of the intervention on most of these outcomes were sustained over the two post-test endpoints. Discussion and implicationsThe low-impact stepping-based moderate-intensity exercise program is effective to improve fatigue and functional outcomes in older adults with multimorbidity. As it can be challenging to engage the fatigued older adults in exercise training, this study adds insights to inform community-based care approach for multimorbidity management.