Health-related Benefits Research Articles

Economic evaluation of the increased mental health value of increasing Queensland's protected areas to 17% land area

The authors explore the value that protected areas contribute to society and how an increase in protected areas would contribute to an increase in value. While protected areas contribute a wide range of benefits to a variety of stakeholders, focus within this report is placed on the mental health value and the affiliated benefits and costs accruing to the Queensland Government. The class of protected areas surveyed within this study is state-managed national parks. This is done in order to maintain consistency in the discussion of benefits and costs. Due to the robust studies evaluating them, this study focuses on the benefits that mental health values contribute to the Queensland Government. Other important potential contributors of value, including safeguarding against climate change, are not quantified in this study. This research calculates the economic benefits of expanding the protected area network in Queensland, Australia via mental health benefits. This research evaluates the potential benefits that would accrue to the state resulting from the expansion of national parks. This study endeavors to do this by using estimates of current benefits and costs derived from national parks, extrapolating those, and projecting them into the future in accordance with Queensland's protected area goals and strategic timeframe. This paper aims to present this information in a way that is useful for economists, conservation groups, policy makers, and the general public. • Protected areas cover 8.24% of Queensland's land area. • The Queensland Government aims to increase protected areas to 17% land area by 2030. • Protected areas contribute health-related benefits to users, known as mental health value. • The improved mental health of visitors to national parks contributes additional economic value. • There is a need for a comprehensive and robust plan for increasing the protected area estate in Queensland to 17% land cover.

Ethnic Composition of Couples and Mutual Health Benefit Receipt: Register-Based Evidence from Finland.

The literature on health dependencies among partners typically ignores diversity of partnership characteristics. One salient example is the ethnic composition. We extend prior work on partnerships and health by investigating how married and cohabiting partners mutually influence each other’s receipt of health-related benefits, focusing on how such correlations vary with the couple’s ethnic composition. We study partners’ mutual receipt of sickness allowance and disability pension in ethnically endogamous and exogamous couples in Finland. The population consists of native individuals in similar socioeconomic positions but belonging to two different ethnic groups—Finnish and Swedish speakers—who differ in health and family life. Using data from population registers, we estimate discrete-time hazard models for first-time benefit receipt, as related to partner’s benefit receipt, among midlife couples. We found evidence of mutual receipt of health benefits in both endogamous and exogamous couples, the correlation being strongest for disability pension. Partner correlation in disability pension receipt is slightly stronger in endogamous Swedish than in endogamous Finnish couples, while women in exogamous couples are slightly less sensitive to men’s receipt than vice versa. The results show that mutual health may be heterogeneous across couples that differ in ethnic composition.

Associations Between Device-Measured Physical Activity and Glycemic Control and Variability Indices Under Free-Living Conditions.

Background:Disturbances of glycemic control and large glycemic variability have been associated with increased risk of type 2 diabetes in the general population as well as complications in people with diabetes. Long-term health benefits of physical activity are well documented but less is known about the timing of potential short-term effects on glycemic control and variability in free-living conditions.Materials and Methods:We analyzed data from 85 participants without diabetes from the Food & You digital cohort. During a 2-week follow-up, device-based daily step count was studied in relationship to glycemic control and variability indices using generalized estimating equations. Glycemic indices, evaluated using flash glucose monitoring devices (FreeStyle Libre), included minimum, maximum, mean, standard deviation, and coefficient of variation of daily glucose values, the glucose management indicator, and the approximate area under the sensor glucose curve.Results:We observed that every 1000 steps/day increase in daily step count was associated with a 0.3588 mg/dL (95% confidence interval [CI]: −0.6931 to −0.0245), a 0.0917 mg/dL (95% CI: −0.1793 to −0.0042), and a 0.0022% (95% CI: −0.0043 to −0.0001) decrease in the maximum glucose values, mean glucose, and in the glucose management indicator of the following day, respectively. We did not find any association between daily step count and glycemic indices from the same day.Conclusions:Increasing physical activity level was linked to blunted glycemic excursions during the next day. Because health-related benefits of physical activity can be long to observe, such short-term physiological benefits could serve as personalized feedback to motivate individuals to engage in healthy behaviors.

Health impacts of a scale-up of supervised injection services in a Canadian setting: an interrupted time series analysis.

In response to a dramatic rise in overdose deaths due to injection drug use, there was a rapid scale-up of low-threshold supervised injection services (SIS), termed 'overdose prevention sites' (OPS), in Vancouver, Canada in December 2016. We measured the potential impact of this intervention on SIS use and related health outcomes among people who inject drugs (PWID). Segmented regression analyses of interrupted time series data from two community-recruited prospective cohorts of PWID from January 2015 to November 2018 were used to measure the impact of the OPS scale-up on changes in SIS use, public injection, syringe sharing and addiction treatment participation, controlling for pre-existing secular trends. Vancouver, Canada. Of 745 PWID, 292 (39.7%) were women, 441 (59.6%) self-reported white ancestry and the median age was 47 years (interquartile range = 38, 53) at baseline. Immediate (i.e. step level) and gradual (i.e. slope) changes in the monthly proportion of participants who self-reported past 6-month SIS use, public injection, syringe sharing and participation in any form of addiction treatment. Post OPS expansion, the monthly prevalence of SIS use immediately increased by an estimated 6.4% [95% confidence interval (CI) = 1.7, 11.2] and subsequently further increased by an estimated 0.7% (95% CI = 0.3, 1.1) per month. The monthly prevalence of addiction treatment participation immediately increased by an estimated 4.5% (95% CI = 0.5, 8.5) following the OPS expansion, while public injection and syringe sharing were estimated to immediately decrease by 5.5% (95% CI = 0.9, 10.0) and 2.5% (95% CI = 0.5, 4.6), respectively. Findings were inconclusive as to whether or not an association was present between the intervention and subsequent gradual changes in public injection, syringe sharing and addiction treatment participation. Scaling-up overdose prevention sites in Vancouver, Canada in December 2016 was associated with immediate and continued gradual increases in supervised injection service engagement and immediate increases in related health benefits.

Rates, Risks, and Time to Fracture in Patients Undergoing Laparoscopic Vertical Sleeve Gastrectomy versus Roux-en-Y Gastric Bypass.

To assess the rates, risks, and time to fracture in patients undergoing laparoscopic vertical sleeve gastrectomy (VSG) versus those undergoing Roux-en-Y gastric bypass (RYGB). Metabolic and bariatric surgery has been implicated in significant bone loss and may increase fracture risk. Preoperative patient characteristics that might impact fracture risk and the time to fractures have not been established. Furthermore, the patient characteristics that might impact fracture risk and the time to fractures by surgical approach are unknown. This population-based retrospective cohort analysis used Humana claims data from January 1, 2007 to March 31, 2017, and included 4073 patients undergoing laparoscopic RYGB and VSG as a first surgical intervention for weight loss. The primary outcomes were the incidence of fractures (Humeral, Radial or Ulnar, Pelvic, Hip, and Vertebral) within 48 months after laparoscopic VSG versus RYGB and days to these fractures. An analysis of total fractures (odds ratio [OR] 0.53; 95% confidence interval [CI], 0.38-0.73), vertebral fractures (OR 0.61; 95% CI, 0.38-0.99), hip fractures (OR 0.36; 95% CI, 0.15-0.84), and humeral fractures (OR 0.44; 95% CI, 0.22-0.90) demonstrated a reduction in fracture risk in patients undergoing VSG versus RYGB. Furthermore, postmenopausal status was independently associated with increased odds of total fractures and hip fractures (OR 2.18; 95% CI, 1.06-4.50; OR 5.83; 95% CI, 1.16-29.27; respectively). Likewise, osteoporosis at the time of surgery was associated with increased odds of total fractures (OR 1.61; 95% CI, 1.09-2.37), vertebral fractures (OR 2.01; 95% CI, 1.19-3.39), and hip fractures (OR 2.38; 95% CI, 1.19-4.77). Except for a significantly decreased odds of vertebral fractures in osteoporotic patients undergoing VSG versus RYGB (OR 0.41; 95% CI, 0.18-0.95), osteoporotic or postmenopausal status at the time of surgery was not found to increase odds of fracture depending on surgical intervention. However, time to fracture (total) and for all site-specific fractures, except for pelvic fractures, was significantly reduced in postmenopausal women undergoing RYGB versus VSG. Time to fracture (total) and for all site-specific fractures except pelvic and radial or ulnar fractures was significantly reduced in osteoporotic patients undergoing RYGB versus VSG. Though bariatric surgery is associated with several health-related benefits, increased fracture risk is an important factor to discuss with patients undergoing bariatric surgery. Bariatric surgery strategy, RYGB versus VSG, carries a differential risk of fracture, with RYGB carrying a higher risk of fracture and decreased time to fracture. Furthermore, patients who are postmenopausal or osteoporotic at the time of surgery carry an increased risk of total fractures, independent of bariatric surgery strategy. Being mindful of patient-specific fracture risk after bariatric surgery may help anticipate, identify, and prevent fractures.

Physiotherapy using a free-standing robotic exoskeleton for patients with spinal cord injury: a feasibility study

BackgroundEvidence is emerging for the use of overground lower limb robotic exoskeletons in the rehabilitation of people with spinal cord injury (SCI), with suggested benefits for gait speed, bladder and bowel function, pain management and spasticity. To date, research has focused on devices that require the user to support themselves with a walking aid. This often precludes use by those with severe trunk, postural or upper limb deficits and places the user in a suboptimal, flexed standing position. Free-standing exoskeletons enable people with higher level injuries to exercise in an upright position. This study aimed to evaluate the feasibility of therapy with a free-standing exoskeleton for those with SCI, and to determine the potential health-related benefits of this intervention.MethodsThis 12-week intervention study with 12-week waitlist control and 12-week follow up, provided people with SCI scoring < 5 on the mobility section of the spinal cord independence measure (SCIM-III) twice weekly therapy in the REX (Rex Bionics, Auckland, NZ), a free-standing lower limb robotic exoskeleton. The primary outcome measure of interest was function, as measured on the SCIM-III. A battery of secondary outcomes was included. Participants also completed a survey on their perceptions of this treatment modality, to determine acceptability.ResultsForty-one potential participants were screened for eligibility. Two females (one ASIA A, one ASIA C) and one male (ASIA B) completed all 24 intervention sessions, and the follow up assessment. One participant showed positive trends in function, fatigue, quality of life and mood during the intervention phase. Grip and quadriceps strength, and lower limb motor function improved in another. Two improved their percentage of lean body mass during the intervention phase. Remaining results were varied across patients, time points and outcomes. The intervention was highly acceptable to all participants.ConclusionWith three of 41 potential participants being eligible and completing this study, our results show that there are potential benefits of exercise in a free-standing exoskeleton for people with severe mobility impairment due to SCI, for a small subset of patients. Further research is warranted to determine those most likely to benefit, and the type of benefit depending on the patient characteristics.Trial registration The trial was registered prospectively on 20 April 2018 at www.anzctr.org.au/ (ACTRN12618000626268)

Claims on Ready-to-Eat Cereals: Are Those With Claims Healthier?

Background: The use of advertising content strategies that suggest consuming a product will confer nutrient- and health-related benefits influences household food purchasing decisions, which increases consumption of energy-dense, nutrient-poor products. We examined the presence of marketing claims regarding nutrient content, health and nature in ready-to-eat (RTE) cereal packages in relation to the products' nutritional quality.Methods: A cross-sectional content analysis was conducted on 178 RTE cereal packages available in the six largest supermarket chains in four Colombian cities from August to November 2018. The nutritional quality of products was assessed through the nutrient profile model established by the Chilean Law of Food Labeling and Advertising law.Results: All products sampled exceeded the regulation threshold for at least one nutrient of concern (e.g., high-in calories and/or sugar). The majority (66.3%) of packages had claims related to nature, 57.3% had nutrient-content claims, and 15.7% had health benefit or risk avoidance claims. Most products with nature, nutrient-content, and health claims were high in energy (99.2, 98.0, and 92.9%, respectively) and sugar (88.1, 87.3, and 92.9%, respectively).Conclusion: RTE cereal products offered in major Colombian supermarket chains are heavily marketed using nutrition- and nature-related claims. Nearly all products with claims are high in energy and sugar, despite the messages conveyed by the claims to consumers. Results support the implementation of mandatory regulations restricting claims on food and beverage products high in nutrients of concern.

Lupine (Lupinus spp.) proteins: characteristics, safety and food applications

Lupines (Lupinus spp.) have emerged as a cheap functional food with the advantages of being non-genetically modified crop, able to adapt to harsh conditions and low-input farming. Lupines are rich in protein and poor in starch, similar to soy. The factor limiting the use of lupine is the presence of quinolizidine alkaloids especially in bitter species. Nevertheless, modern breeding programs ensured the selection of sweet lupine species with reduced alkaloid content (≤ 0.2 g/kg DM). Numerous techniques have been employed to produce lupine protein isolates, concentrates and hydrolysates. These proteins are rich in bioactive peptides associated with health-related benefits and have been reported with interesting techno-functional properties. Lupine Protein isolates and concentrates are used mostly for developing healthy foods, while hydrolysates are more applied in nutraceutical and cosmetic industries. Further research is needed to ensure better safety and wider spectrum of application through adequate strategies for allergenicity mitigation and improving techno-functionality.

Home-based exercise program for adolescents with juvenile dermatomyositis quarantined during COVID-19 pandemic: a mixed methods study

BackgroundExercise has been suggested to prevent deterioration of health-related quality of life (HRQL) and overall health in pediatric rheumatologic diseases during the COVID-19 pandemic. Herein we describe the effects of a 12-week, home-based, exercise program on overall health and quality of life among quarantined patients with juvenile dermatomyositis (JDM).MethodThis prospective, quasi-experimental, mixed methods (qualitative and quantitative) study was conducted between July and December 2020, during the most restricted period of COVID-19 pandemic in Brazil. The home-based exercise program consisted of a 12-week, three-times-a-week, aerobic and strengthening (bodyweight) training program. Qualitative data were systematically evaluated. Strengths and Difficulties Questionnaire (SDQ), Pediatric Quality of Life Inventory (PedsQOL) and Pittsburgh Sleep Quality Index (PSQI) evaluate symptoms of mental health disorder, HRQL, and quality of sleep.Findings11 patients (out of 27) met the inclusion criteria (91% female; mean ± SD age: 13.5 ± 3.2 years). Adherence to the intervention was 72.6%. Barriers to exercise involved poor internet connectivity, excessive weekly sessions, and other commitments. Even though not statistically significant, Self-report SDQ subscales Total Difficulties Score, Emotional Problems Score, and PedsQOL School Functioning Score improved after intervention (− 2.4; 95%confidence interval [CI] -5.1; 0.2, p = 0.06; − 1.0; 95%CI -2.2; 0.2, p = 0.09 and; 11.7; 95%CI -2.5; 25.8, p = 0.09, respectively). Remaining SDQ subscales were not altered. Six themes emerged from patients’ and parents’ comments (qualitative results). Patients engaged in exercise reported other health-related benefits including increased motivation, concentration and strength.InterpretationA home-based exercise program was associated with qualitative perceptions of improvements in overall health and HRQL by quarantined adolescents with JDM during COVID-19 pandemic. Lessons from this trial may help developing interventions focused on tackling physical inactivity in JDM.

Barriers and Facilitators for the Romanian Older Adults in Enjoying Physical Activity Health-Related Benefits

Older adults are considered a vulnerable category within the population, which is exposed to an accelerated risk of functional degeneration. The purpose of this study was to explore different facilitating factors and possible existing barriers to being physically active in older age in urban areas of Romania. A cross-sectional survey was conducted among 172 participants who were asked to assess their health, on a scale from 1 to 3, and to fill out two questionnaires: 1. Physical Activity Scale for the Elderly; 2. Depression, Anxiety, and Stress Scale. Participants were also asked to specify to what extent they performed different leisure activities during the last week. SPSS was used for data analysis. The chi-squared test, t-test, ANOVA, and MANOVA emphasised the differences between participants, at p &lt; 0.05. Regarding health condition, 27.3% of participants responded that their health was good, 53.5%—satisfactory, and 19.2%—not so good. The results showed significant differences between older adults participating in Elderly Clubs and non-participants, only in terms of PASE leisure. There were significant multivariate effects of the variables Gender and Stable life partner regarding PASE leisure. Weak negative correlations were identified between leisure physical activities and emotional state. Among the proposed leisure activities, watching TV and listening to music represented the most frequent preferences of the participants. The older adults participating in this study preferred to become involved with different physical activities, in conjunction with their habits, health, age, sex, stable life partner, and Elderly Club participation.

Influence of Temperature Conditions during Growth on Bioactive Compounds and Antioxidant Potential of Wheat and Barley Grasses.

Wheat and barley grasses are freshly sprouted leaves of wheat and barley seeds, and are rich sources of phytochemicals. This study was conducted to investigate the effects of day and night temperatures on the growth, bioactive compounds, and antioxidant potential of wheat and barley grasses. Briefly, each grass was cropped in an organic growing medium at 10/5 °C, 20/15 °C, and 30/25 °C (day/night temperature) in a growth chamber by maintaining specific light (12/12 h light/dark; light intensity 150 µmol photons m−2 s−1) and humidity (60%) conditions for 8 days. The highest growth parameters (height, weight, and yield) were observed at the 20/15 °C growth conditions in both types of grass. Conversely, the lowest growth parameters were observed at 10/5 °C. However, the low growth temperature of 10/5 °C resulted in increased levels of bioactive compounds (total phenol, total flavonoid, and total vitamin C), antioxidant activities (2,2′-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid and 2,2-Diphenyl-1-picrylhydrazyl radical-scavenging activity)), and antioxidant enzymes (guaiacol peroxidase activity, catalase activity, and glutathione reductase) in both types of grass. Therefore, proper temperature growth conditions of wheat and barley grasses may be a convenient and efficient method to increase bioactive compounds and antioxidant potential in our diet to exploit the related health benefits.

Management Approach Combining Prognostic Screening and Targeted Treatment for Patients with Low Back Pain Compared with Standard Physiotherapy: A Systematic Review &amp; Meta-analysis

Introduction: Research evidence suggests that a stratified care management approach is better at improving clinical and economic outcomes for low back pain (LBP) patients compared with usual care in the short term. However, it is unclear if these health and economic benefits are sustainable in the longer term. The aim of this study was, therefore, to determine the effectiveness of stratified care compared with standard physiotherapy for LBP treatment.&#x0D; Methodology: A comprehensive search was undertaken of seven electronic databases (CINAHL, MEDLINE, Pedro, EMBASE, PsycINFO, Cochrane Register for Controlled Trials, and Web of Science with full text). Although no time limits were applied, studies were limited to English language publications and those involving human participants only. Study selection, data extraction, and appraisal of study were independently undertaken by both reviewers (CO and LE).&#x0D; Result: In total, 6842 patients (aged 18 years and above) were included in the eight trials reviewed; four were randomized controlled trials (RCTs) and four were non-RCTs. The pooled analysis of three studies (n = 2460) demonstrated a strong evidence in favor of stratified care over standard care at improving overall pain (Weighted Mean Difference (WMD) [random] 0.46 [95% CI 0.21, 0.71]; P &lt; 0.0003), with overall effect (Z = 3.6) and (Roland-Morris disability questionnaire (RMDQ) scores (WMD [random] 0.71 [95% CI 0.05, 1.37]; P &lt; 0.03), with overall effect (Z = 2.11) at three-, four-, and six-months’ follow-up periods.&#x0D; Conclusion: This current review demonstrated that a stratified care approach provides substantial clinical, economic, and health-related cost benefits in the medium- and high-risk subgroups compared with usual care. Further research is needed for longer-term benefits.

Labor Market Attachment in Patients with Myeloproliferative Neoplasms: A Nationwide Matched Cohort Study

▪BACKGROUNDMyeloproliferative neoplasms (MPNs) are characterized by a substantial symptom burden, risk of debilitating complications (e.g., thrombosis), and increased comorbidity. Recently, three comprehensive questionnaire studies (Mesa 2016, Harrison 2017, Jingbo 2018) have reported a high impact of MPNs on patients' ability to work. However, no registry-based studies have assessed labor market attachment (LMA) of MPN patients and matched nonMPN comparisons.AIMTo assess the pre- and post-diagnostic LMA of MPN patients and matched nonMPN comparisons.METHODSWe conducted a descriptive, registry-based nationwide cohort study, using data from the Danish National Chronic Myeloid Neoplasia Registry including all Danish MPN patients diagnosed between January 2010 and December 2016. Population-based cohorts of nonMPN comparisons were constructed by 1:10 matching on age, sex, level of education, and region of residence. Data on LMA were retrieved from the Danish Register for Evaluation of Marginalization, which holds information on all public transfer payments in Denmark. Data were linked using the unique civil registration number, which identifies all Danish citizens. The LMA endpoints were defined for each individual as working (not receiving any type of transfer payment), unemployed, receiving transfer payment for either sick leave, disability pension, age pension, or other health-related benefits (e.g., wage-subsidized employment). We assessed LMA weekly for each individual from two years before diagnosis until death, emigration, or two years after the diagnosis. For each cohort, we presented LMA as proportions with 95% confidence intervals (CIs), as well as the proportion of individuals who died during follow-up.RESULTSThe study included 3,342 MPN patients (1,140 essential thrombocythemia [ET]; 1,109 polycythemia vera [PV]; 533 myelofibrosis [MF]; and 560 unspecified MPN [MPN-U]) and 32,737 nonMPN comparisons (11,181 nonET; 10,873 nonPV; 5,217 nonPMF; and 5,466 nonMPN-U). The median age at time of diagnosis was: ET 67 years (interquartile range [IQR], 55-76); PV, 69 years (IQR, 61-77); PMF, 73 years (IQR, 66-79); and MPN-U, 72 years (IQR, 63-80).At time of MPN diagnosis, the majority of MPN patients and nonMPN comparisons received age pension (range: ET, 52.1% [95% CI, 49.2-55.0] to nonMF, 70.3% [95% CI, 69.1-71.6]). The proportions working were: ET, 35.1% (95% CI, 32.3-37.9) vs. nonET, 37.3% (95% CI, 36.5-38.2); PV, 22.6% (95% CI, 20.2-25.1) vs. nonPV, 30.8% (95% CI, 29.9-31.7); MF, 23.8% (95% CI, 20.2-27.4) vs. nonMF, 23.6% (95% CI, 22.5-24.8); and MPN-U, 22.1% (95% CI,18.7- 25.6) vs. nonMPN-U, 27.8% (95% CI, 26.6-29.0). Across MPN subtypes, a larger proportion of patients than comparisons were on sick leave: ET, 3.5% (95% CI, 2.4-4.6) vs. nonET, 1.3% (95% CI, 1.1-1.5); PV, 5.5% (95% CI, 4.2-6.8) vs. nonPV, 0.9% (95% CI, 0.7-1.1); MF (not applicable due to small numbers) vs. nonMF, 0.6% (95% CI, 0.4-0.8); and MPN-U, 3.0% (95% CI, 1.6- 4.5) vs. nonMPN-U, 1.0% (95% CI, 0.7-1.3). Regarding disability pension, the proportions ranged from 4.1% (95% CI, 2.4-5.8) to 5.0% (95% CI, 3.7-6.3) among patients and from 3.1% (95% CI, 2.6-3.6) to 4.7% (95% CI, 4.3-5.1) among comparisons. For both MPN patients and nonMPN comparisons, few were unemployed (≤3.3%) or received other health-related benefits (≤1.6%).Two years preceding diagnosis, the proportion of PV and MPN-U patients working was slightly lower than the matched comparisons: PV, 31.0% (95% CI, 28.4-33.8) vs. nonPV, 34.3% (95% CI, 33.5-35.2) and MPN-U, 28.2% (95% CI, 24.6-32.1) vs. nonMPN-U, 32.0% (95% CI, 30.7-33.2), while this difference was not observed between ET and MF patients and their respective comparisons.From two years before to two years after diagnosis, we observed slightly larger reductions in the proportion working among MPN patients than among comparisons. Among MPN patients, the proportion on sick leave including other health-related benefits, increased during the study period, while it remained unchanged among comparisons. The proportion of patients and comparisons on disability pension remained stable.CONCLUSIONOverall, our findings showed that Danish patients with ET, PV, MF, and MPN-U had slightly impaired LMA already two years before diagnosis and up to two years after diagnosis. Thus, fewer patients were working and more patients transferred to sick leave compared with matched individuals without MPN. [Display omitted] DisclosuresStenling: Novartis: Current Employment. Paulsson: Novartis: Current Employment. Frederiksen: Novartis: Research Funding; Alexion: Research Funding; Gilead: Research Funding; Abbvie: Research Funding; Janssen Pharmaceuticals: Research Funding. Hasselbalch: Novartis, AOP Orphan: Consultancy, Other: Advisory Board.

Positive effects of community attachment on internalised stigma and wellbeing among people who inject drugs.

Internalised stigma experienced by people who inject drugs (PWID) is known to have negative health consequences. Research has explored factors that may protect or buffer individuals from the negative consequences of internalised stigma. Community attachment, or perceived connection to a community of like people, can have numerous health-related benefits. However, this relationship may be complex for PWID; being part of a social network of PWID may provide opportunity for more frequent drug use and equipment sharing. This study investigated the relationships between community attachment, internalised stigma, and wellbeing among PWID, while also addressing potential health risks associated with PWID community attachment. PWID (n=603) were recruited through nine peer-based drug user organisations across Australia with assistance from the peak consumer organisation. Participants completed a survey measuring community attachment, internalised stigma, personal wellbeing, injecting frequency, and equipment sharing. Greater attachment to a PWID community was associated with lower internalised stigma, but also with sharing of injecting equipment and increased frequency of injecting behaviour. The relationship between community attachment and personal wellbeing was mediated by internalised stigma, however this was only the case for PWID who reported no sharing of injecting equipment. This research highlights the significance of community attachment for PWID while also noting the complexity of this relationship and the potential negative consequences. It is important to view networks of PWID communities as sources of positive social capital, where norms about health behaviours and harm reduction can be promoted and which can buffer community members from the harms associated with stigma.

Built environment correlates of walking for transportation: Differences between commuting and non-commuting trips

As a sustainable mode of travel, walking for transportation has multiple environmental, social, and health-related benefits. In existing studies, however, such walking has rarely been differentiated between commuting and non-commuting trips. Using multilevel zero-inflated negative binomial regression and multilevel Tobit regression models, this study empirically examines the frequency and duration of commuting and non-commuting walking and their correlates in Xiamen, China. It finds that (1) non-commuting walking, on average, has a higher frequency and longer duration than commuting walking; (2) most socio-demographic variables are significant predictors, and age, occupation, and family size have opposite-direction effects on commuting and non-commuting walking; and (3) different sets of built environment variables are correlated with commuting and non-commuting walking, and the built environment collectively influences the latter more significantly than the former. The findings provide useful references for customized interventions concerning promoting commuting and non-commuting walking.

Mapping Individual Differences on the Internet: Case Study of the Type 1 Diabetes Community.

BackgroundSocial media platforms, such as Twitter, are increasingly popular among communities of people with chronic conditions, including those with type 1 diabetes (T1D). There is some evidence that social media confers emotional and health-related benefits to people with T1D, including emotional support and practical information regarding health maintenance. Research on social media has primarily relied on self-reports of web-based behavior and qualitative assessment of web-based content, which can be expensive and time-consuming. Meanwhile, recent advances in natural language processing have allowed for large-scale assessment of social media behavior.ObjectiveThis study attempts to document the major themes of Twitter posts using a natural language processing method to identify topics of interest in the T1D web-based community. We also seek to map social relations on Twitter as they relate to these topics of interest, to determine whether Twitter users in the T1D community post in “echo chambers,” which reflect their own topics back to them, or whether users typically see a mix of topics on the internet.MethodsThrough Twitter scraping, we gathered a data set of 691,691 tweets from 8557 accounts, spanning a date range from 2008 to 2020, which includes people with T1D, their caregivers, health practitioners, and advocates. Tweet content was analyzed for sentiment and topic, using Latent Dirichlet Allocation. We used social network analysis to examine the degree to which identified topics are siloed within specific groups or disseminated through the broader T1D web-based community.ResultsTweets were, on average, positive in sentiment. Through topic modeling, we identified 6 broad-bandwidth topics, ranging from clinical to advocacy to daily management to emotional health, which can inform researchers and practitioners interested in the needs of people with T1D. These analyses also replicate prior work using machine learning methods to map social behavior on the internet. We extend these results through social network analysis, indicating that users are likely to see a mix of these topics discussed by the accounts they follow.ConclusionsTwitter communities are sources of information for people with T1D and members related to that community. Topics identified reveal key concerns of the T1D community and may be useful to practitioners and researchers alike. The methods used are efficient (low cost) while providing researchers with enormous amounts of data. We provide code to facilitate the use of these methods with other populations.

Health-related benefits and adverse events associated with yoga classes among participants that are healthy, in poor health, or with chronic diseases

BackgroundOur previous study demonstrated that 42% of yoga class participants in Japan had chronic diseases requiring medication. This raises the question as to whether those with chronic diseases would benefit from practicing yoga or if they are at higher risk for specific adverse events compared to healthy individuals receiving the same instruction.MethodsTo address these questions, 328 adults who started practicing yoga for the first time were asked to complete the Profile of Mood States (POMS), Perceived Stress Scale (PSS), and Medical Outcomes Study Short Form 8, standard version (SF-8™) and to record any adverse events on the first day of the yoga class and again three months later. The participants consisted of three groups: a healthy (H) group (n = 70), a poor health (PH) group (n = 117), and a chronic disease (CD) group (n = 141). The degree of subjective symptoms was also compared between the pre- and post-intervention period in the PH and CD groups.ResultsTypically, yoga classes were held once a week for 60–90 min. The programs included asanas, pranayamas, meditation, isometric yoga, and sukshma vyayama. In the PH and CD groups, the POMS tension-anxiety and fatigue scores decreased and the vigor score increased significantly after the first class. Furthermore, PSS scores decreased and the SF-8™ scores increased significantly three months later. The degree of subjective symptoms such as easy fatigability, shoulder stiffness, and insomnia also decreased over three months. Individuals in these groups experienced more frequent adverse events than those in the H group. The PH and CD groups also experienced a greater variety of symptoms, including psychological ones, not reported by the H group. Adverse events were not so serious that participants stopped practicing yoga during the class. About 60% of all participants were highly satisfied with participating in yoga classes.ConclusionsIf yoga classes are conducted with attention to possible adverse events, yoga practice in a yoga studio may have beneficial effects for people with functional somatic symptoms and chronic diseases, as well as healthy participants. These benefits include reductions in perceived stress and uncomfortable symptoms as well as improved mood and quality of life.

Assessment of biochemical compounds and antioxidant enzyme activity in barley and wheatgrass under water-deficit condition.

Wheatgrass and barley grass are freshly sprouted leaves of wheat and barley seeds and are rich sources of phytochemicals. This study was conducted to investigate the effects of drought stress on the biochemical compounds and antioxidant activities of barley grass and wheatgrass extracts. The grass was cultivated in an organic soil growing medium with different levels of drought stress (a control with 100% water holding capacity (WHC), mild drought stress with 75% WHC, moderate drought stress with 50% WHC, and severe drought stress with 25% WHC) in a growth chamber by controlling temperature (20/15 °C, day/night), light (12/12 h, light/dark; intensity 150 μmol m-2 s-1 with quantum dot light-emitting diodes), and relative humidity (60%) for 7 days. The drought stress showed increased levels of biochemical compounds, especially phenolics, flavonoids, and vitamin C, in both barley grass and wheatgrass extracts. The wheatgrass extracts showed 1.38-1.67 times higher phenolics, flavonoids, and vitamin C contents than the barley grass extracts did. The antioxidant (2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid), 2,2-diphenyl-1-picrylhydrazyl radical-scavenging activity, and nitrite-scavenging activity) and antioxidant enzymes (guaiacol peroxidase, catalase, and glutathione reductase) were the highest under severe drought stress in both barley grass and wheatgrass extracts; and the wheatgrass extracts showed 1.20-5.70 times higher antioxidant enzyme activities than the barley grass extracts did. Proper drought-stress treatment of barley grass and wheatgrass may be a convenient and efficient method to increase biochemical compounds and antioxidants in our diet to exploit the related health benefits. © 2021 Society of Chemical Industry.

To persist or not to persist? The dilemma of goal adjustment in chronic pain.

To persist or not to persist? The dilemma of goal adjustment in chronic pain.

An Update on the Recent Advances in Cubosome: A Novel Drug Delivery System.

Cubosomes are highly stable nanostructured liquid crystalline dosage delivery form, derived from amphiphilic lipids and polymer-based stabilizers converting it in a form of effective biocompatible carrier for the drug delivery. The delivery form comprised of bicontinuous lipid bilayers arranged in three-dimensional honeycombs like structure provided with two internal aqueous channels for the incorporation of many s biologically active ingredients. In contrast to liposomes, they provide a large surface area for the incorporation of different types of ingredients. Due to the distinct advantages of biocompatibility and thermodynamic stability, cubosomes have remained the first preference as a method of choice in the sustained release, controlled release, and targeted release dosage forms as new drug delivery system for the better release of the drugs. As a lot of advancement in the new form of dosage form brought the novel avenues in drug delivery mechanisms, so it was a matter of worth to compile the latest updates on the various aspects of the mentioned therapeutic delivery system including its structure, routes of applications along with the potential applications to encapsulate variety drugs to serve health-related benefits.