Healthy Lifestyle Behaviors Research Articles

To Love Yourself: Psychological Approach to Predict Healthy Lifestyle Behaviour in Adolescents

Adolescents were susceptible to problems and negativity during the pandemic times. There was an increase in adolescents’ consumption of unhealthy foods by 36%, an increase in body weight by 48%, and a decrease in physical activity and exercise by 43% globally. To function optimally in this situation, adolescents needed to do healthy lifestyle behaviour. Adolescents tended to do this when they could love themselves, which was carried out by applying self-compassion and participating in activities that benefit health. This study was conducted in 2021 and aimed to determine the relationship between self-compassion and adolescent participation in healthy lifestyle behaviour. This study used a cross-sectional design. The population was adolescents in Kediri, aged 15-19. The sample was obtained by cluster sampling, totaling 111 respondents. Independent variables were self-compassion and adolescent participation. The dependent variable was healthy lifestyle behaviour. Data were collected by questionnaires and analyzed by regression. Results showed that variables related to healthy lifestyle behaviour were self-compassion and adolescent participation (p0.001). There was a significant relationship between self-compassion (p=0.02) and participation (p0.001) with healthy lifestyle behaviour. Self-compassion and participation were predictors of healthy lifestyle behaviour, simultaneously and individually. Based on the results, adolescents needed to increase their understanding and practice of self-love in performing healthy lifestyle behaviour.

Socio-demographic and lifestyle factors associated with intrinsic capacity among older adults: evidence from India

BackgroundSince the traditional models missed the possibility of formulating personalised programs centred on a person’s priorities and values, it was a pressing priority to shift from traditional disease-centred to a function-based approach of healthy ageing, which is defined as ‘the process of developing and maintaining the functional ability that enables well-being in older age’. The present study aimed to assess the prevalence of high intrinsic capacity (IC) of older adults and to examine the socio-demographic and lifestyle factors associated with IC among older adults in India.MethodsThe study utilises the individual-level data from the first wave of the Longitudinal Aging Study in India (LASI) conducted during 2017–18. The total sample size for the present study was 24,136 older adults (11,871 males and 12,265 females) aged 60 years and above. Descriptive statistics, along with bivariate analysis, was employed to present the preliminary results. Additionally, multivariable linear and logistic regression analyses were conducted to find out the association of socio-demographic and lifestyle factors with IC and its components.ResultsThe mean IC score was found to be 7.37 (SD = 1.6) in this study. A proportion of 24.56% of older adults was observed to be in the higher IC category. Increasing age was negatively associated with high IC for older men and women. Older people who smoke tobacco (β = -0.23; CI: -0.32—-0.13) and chew tobacco (β = -0.11; CI: -0.18—-0.03) were less likely to experience high IC compared to their respective counterparts. Older adults who reported episodic alcohol drinking were less likely to have high IC (β = -0.20; CI:-0.32—-0.07). The engagement in moderate physical activity (β = 0.12; CI:0.01–0.23), vigorous physical activity (β = 0.12; CI:0.05–0.20) and yoga-related activity (β = 0.18; CI:0.09–0.26) were significantly positively associated with high IC. Among the five domains of IC, education was significantly associated with higher capacity in each domain, and increasing age was found to be a significant predictor of lower capacity in each IC domain except locomotion. Older men and women engaged in vigorous physical activity had 35 and 19% significantly higher odds of high capacity in sensory (aOR = 1.35; CI: 1.12—1.62) and psychological (aOR = 1.19; CI: 1.06—1.34) domains, respectively.ConclusionsThe study revealed that lifestyle behaviours including tobacco use, episodic alcohol drinking and physical activity are strongly associated with IC among older adults in India. The findings suggest that healthy lifestyle behaviours should be encouraged among older adults as an effort to improve their IC, which is the key determinant of functional ability and quality of life in later years of life.

Perilaku Hidup Sehat dan Kejenuhan Akademik Mahasiswa Selama Pembelajaran Daring

The issue of COVID-19 pandemic has had a very significant impact and impact on the world of education. All academic activities are carried out online, causing students to experience academic burnout. The problem of academic saturation is expected to be handled appropriately by students so as not to risk short-term and long-term achievement. One of the predictable steps that can be taken is implementing healthy lifestyle behaviors. Therefore, this study aims to determine the relationship between healthy lifestyle behavior and student academic burnout during online learning. The method used is quantitative with a correlational design. The participants involved were 154 students using an incidental sampling technique. Measurement of the study using Health Promoting Lifestyle Profile II (α = 0.906) and School Burnout Inventory (α = 0.760), with data analysis using product moment correlation from Karl Pearson. The results of the study found that there was a negative relationship between healthy lifestyle behavior and student academic burnout during online learning (r = -0.149 with sig.= 0.033). These results indicate that the higher the healthy lifestyle behavior applied by students, the problem of academic burnout will be minimized properly.

Health-Promoting Lifestyle and its Determinants among University Students in Mogadishu, Somalia

This study aimed to determine the healthy lifestyle behaviors of students at a university in Mogadishu, Somalia. A cross-sectional study was conducted among 347 university students >16 in Mogadishu, Somalia, from October to December 2020. The data were collected by using a self-administered questionnaire and the Health-Promoting Lifestyle Profile-II (HPLP-II) Scale throughout that period. Demographic characteristics and health- promoting lifestyle were evaluated. T-test, Anova, post hoc (Tukey, LSD) and multiple regression analysis were used for statistical analyses. The healthy lifestyle behavior point averages of the students were found to be at a medium level (125.8±24.60). A significant difference was found in the total mean HPLP-II scores by gender, age, diagnosis of health problems, and exercise habits (p<0.05). The data showed significant associations among some subscales of the HPLP-II, gender, age, education level of mother, income status and have a chronic health problem, while participating in sporting activities was found to be statistically significant with all subscales of the HPLP-II (p < 0.05). Students’ lifestyle behaviors were found to be moderately healthy. Intervention studies are needed to support Somali students in making healthy lifestyle choices and improve their health promotion attitudes.

Adolescents’ and professionals’ experiences of metabolic and bariatric surgery and requirements for preoperative and postoperative support through mHealth: a qualitative study

ObjectivesThis study aimed to explore adolescents’ and professionals’ incentives and experiences of metabolic and bariatric surgery (MBS) and to explore perceived needs and requirements for preoperative and postoperative support through...

Allostatic Load in Clinical Practice

There is growing awareness of the role of allostatic load (the cost of chronic exposure to fluctuating or heightened physiologic responses resulting from repeated or chronic stress) in the balance between health and disease. When environmental challenges exceed the individual ability to cope, allostatic overload ensues. The determination of allostatic load initially relied on measurements of biomarkers, and then it was expanded to clinimetric criteria for allostatic overload. It provides a characterization of the individual psychosocial environment that is missing from current clinical diagnostic formulations and has major implications for identifying syndromes that are not included in traditional diagnostic classifications. Healthy lifestyle behavior and euthymia may modulate the vulnerabilities induced by allostatic overload. Here, we present a staging system for the longitudinal development of allostatic load. Consideration of allostatic load allows clinicians to create individually tailored interventions to prevent or decrease the negative impact of environmental factors on health.

A CROSS SECTIONAL STUDY OF CLINICAL PROFILE, MANAGEMENT AND LEVELS OF AWARENESS IN YOUNG HYPERTENSIVES AT A TERTIARY CARE HOSPITAL IN CHENGALPET

Introduction: Hypertension is a condition in which the force of blood against the arterial walls is excessive.Our study aims to describe the clinical profile and management of young hypertensives and to assess the levels of awareness of health care facilities. Material and Methods: This cross sectional study is conducted on young adult hypertensives 20-40 years of age attending the Out Patient Department of General Medicine,KarpagaVinayaga Institute of Medical Sciences and Research Centre, Chinnakolambakkam. Study duration is about 6 months. Young adults (males as well as females) in the age group of 20 to 40 years,who are diagnosed as hypertensives based on with/without comorbidities, visiting the General medicine out patient department who were willing to be a part of the study were included after obtaining an informed consent. Based on this reference and assuming a 95% confidence interval, 5% the minimum required sample size were 112 ~ 120.Data were collected and entered in Microsoft excel 2007. According to the data collected, appropriate statistical tests like Chi-square test was used. Results: In our study mean age of the study participants were 38.56±12.34 years. There were about 63.3% males and 36.7% females. About 62.8% were from rural areas and 37.2% from urban areas.Females comparatively had more awareness, treatment and control of hypertension than males. Urban areas and rural areas had around same percentage of awareness, treatment and control of hypertension.Knowledge about risk factors awareness present among 25.9% of the study participants. Around 58.7% checked blood pressure at least once in the past year among the study participants. Conclusion: Headaches were the most common symptom that young people with hypertension presented with when they were diagnosed. Enhanced awareness would assist in the adoption of healthy lifestyle behaviors and highlight the significance of maintaining adherence to medication.

Healthy lifestyle behaviors among field public health workers in a selected district of Sri Lanka

Background: Healthy lifestyle behaviors: diet, physical activity and non-consumption of tobacco and alcohol of health workers are important as they engage in educating the community and people follow them as role models. Objective of this study was to describe the healthy lifestyle practices among field public health workers in one of the districts in Sri Lanka. Methods: Descriptive cross-sectional study was carried out in the Galle district. 303 Public Health Midwives (PHMs) were taken to the sample and Lifestyle practices were assessed using a pre-tested self-administered questionnaire. Results: Overweight and obesity prevalence were 24% and 3.7% respectively. None of them used tobacco or alcohol. Regular balance diet consumption was 57%. 18.2% have consumed 2 or >2 servings of fruit per day. The majority (49.2%) consumed vegetables 3 times per day and 21.8% consumed four or >4 servings per day. 43.6% consumed Sugar and sugar containing food daily. Only 12.2% preferred low-salt food. 21.8% of PHMs consumed oily foods few times a day. The majority (56.8%) of PHMs have engaged in recommended moderate physical activity but only 6.9% engaged in vigorous physical activity. The mean duration of walking time was 463 minutes per week. Conclusions and recommendations: Most lifestyle practices (Dietary and physical activity) are not very healthy among PHMs except for their alcohol and smoking behaviors. Public health workers should be motivated to spend healthy lifestyles by increasing awareness and incorporating healthy lifestyle promotion programs into their routine field work.

Risk Factors for Obesity and Overweight in Children and Adolescents from Romania


 The fact that more and more people are suffering from obesity and that this condition is more and more common among children is an alarm signal and some measures must be taken in this direction. Nowadays, the most incriminating factor responsible for the development of childhood obesity is the excessive consumption of fast food, sweets and juices, as at the market there is a wide range and easily accessible. This study aims to evaluate the association between frequent consumption of fast food and other lifestyle factors with the presence of obesity and overweight in children of different ages in Romania. Applying a questionnaire with 31 questions we collected data from 328 people, 170 boys and 158 girls, residing in Romania. The analysis of the data collected showed a higher number of overweight children, compared to the number of mothers who consider that their children are overweight, for this we identified the factors with potential obesity and we looked for the associations between the lifestyle and obesity. The higher prevalence of fast food consumption and sedentary activities among overweight and obese children, highlighted in this study, further confirms the need to promote health through education for healthy eating and lifestyle behavior.

Inadequate sleep duration may attenuate the anti-inflammatory effects of fish consumption in a healthy Japanese population: a cross-sectional study.

High fish consumption may be associated with lower inflammation, suppressing atherosclerotic CVD (ASCVD). Long sleep duration, as well as short sleep, may contribute to inflammation, thus facilitating ASCVD. This study investigated the overall association between fish consumption, sleep duration and leucocytes count. We conducted a cross-sectional study between April 2019 and March 2020 with a cohort of 8947 apparently healthy participants with no history of ASCVD (average age, 46·9 ± 12·3 years and 59 % males). The average frequency of fish consumption and sleep duration were 2·13 ± 1·26 d/week and 6·0 ± 0·97 h/d. Multivariate linear regression analysis revealed that increased fish consumption was an independent determinant of sleep duration (β = 0·084, P < 0·0001). Additionally, habitual aerobic exercise (β = 0·059, P < 0·0001) or cigarette smoking (β = −0·051, P < 0·0001) and homoeostasis model assessment-insulin resistance (HOMA-IR) (β = −0·039, P = 0·01) were independent determinants of sleep duration. Furthermore, multivariate linear regression analysis identified fish consumption as an independent determinant of leucocytes count (β = −0·091, P < 0·0001). However, a significant U-shaped curve was found between leucocytes count and sleep duration, with 6–7 h of sleep as the low value (P = 0·015). Higher fish consumption may be associated with a lower leucocytes count in the presence of adequate sleep duration and healthy lifestyle behaviors. However, long sleep duration was also related to increased inflammation, even in populations with high fish consumption. Further studies are needed to clarify the causality between these factors.

Early Postinjury Screen Time and Concussion Recovery.

To determine the association between early screen time (7-10 days postinjury) and postconcussion symptom severity in children and adolescents with concussion, as compared to those with orthopedic injury (OI). This was a planned secondary analysis of a prospective longitudinal cohort study. Participants were 633 children and adolescents with acute concussion and 334 with OI aged 8 to 16, recruited from 5 Canadian pediatric emergency departments. Postconcussion symptoms were measured using the Health and Behavior Inventory at 7 to 10 days, weekly for 3 months, and biweekly from 3 to 6 months postinjury. Screen time was measured by using the Healthy Lifestyle Behavior Questionnaire. Generalized least squares models were fit for 4 Health and Behavior Inventory outcomes (self- and parent-reported cognitive and somatic symptoms), with predictors including screen time, covariates associated with concussion recovery, and 2 3-way interactions (self- and parent-reported screen time with group and time postinjury). Screen time was a significant but nonlinear moderator of group differences in postconcussion symptom severity for parent-reported somatic (P = .01) and self-reported cognitive symptoms (P = .03). Low and high screen time were both associated with relatively more severe symptoms in the concussion group compared to the OI group during the first 30 days postinjury but not after 30 days. Other risk factors and health behaviors had stronger associations with symptom severity than screen time. The association of early screen time with postconcussion symptoms is not linear. Recommending moderation in screen time may be the best approach to clinical management.

Relationship between teacher fidelity to an early childhood obesity prevention program and the Child care center nutrition and physical activity environment

BackgroundChild care centers (CCC) can be strategic settings to establish healthy lifestyle behaviors through obesity prevention programs. Fidelity to the implementation of such programs is a vital evaluation component, but is often not measured. This study assessed CCC teacher fidelity to the implementation of “Healthy Caregivers, Healthy Children (HC2)”, a CCC-based obesity prevention intervention. MethodsCCCs serving low-resource, ethnically diverse families with ≥ 50 children ages 2-to-5 years old that were randomized to the HC2 intervention and that had teacher fidelity data collected (n = 9 CCC) were included in this analysis. The Environment and Policy Assessment and Observation (EPAO) tool assessed the CCC nutrition and physical activity (PA) environment at the beginning/end of the school year. Fidelity assessments were conducted in CCCs randomized to HC2 in Spring 2016 (n = 33 teachers) and 2017 (n = 39 teachers) by a trained observer. The relationship between teacher fidelity and EPAO was assessed via mixed models. ResultsFor every-one unit rise in teacher fidelity, EPAO nutrition increased 0.055 points (p =.006). No significant relationship was shown between teacher fidelity and EPAO PA score (p =.14). ConclusionTeacher fidelity to obesity prevention program implementation may support a healthy CCC obesity prevention and nutrition environment but might require continued support for all components.

Applying the behavior change wheel to design de-implementation strategies to reduce low-value statin prescription in primary prevention of cardiovascular disease in primary care.

IntroductionA substantial proportion of individuals with low cardiovascular risk receive inappropriate statin prescription for primary prevention of cardiovascular disease (CVD) instead of the evidence-based recommendations to promote healthy lifestyle behaviors. This study reports on the structured process performed to design targeted de-implementation strategies to reduce inappropriate prescription of statins and to increase healthy lifestyle promotion in low cardiovascular risk patients in Primary Care (PC).MethodsA formative study was conducted based on the Theoretical Domains Framework and the Behavior Change Wheel (BCW). It comprised semi-structured interviews with PC professionals to define the problem in behavioral terms; focus groups with Family Physicians and patients to identify the determinants (barriers and facilitators) of inappropriate statin prescription and of healthy lifestyle promotion practice; mapping of behavioral change interventions operationalized as de-implementation strategies for addressing identified determinants; and consensus techniques for prioritization of strategies based on perceived effectiveness, feasibility and acceptability.ResultsIdentified key determinants of statin prescription and healthy lifestyle promotion were: the lack of time and clinical inertia, external resources, patients' preferences and characteristics, limitation of available clinical tools and guidelines, social pressures, fears about negative consequences of not treating, and lack of skills and training of professionals. Fourteen potential de-implementation strategies were mapped to the identified determinants and the following were prioritized: 1) non-reflective decision assistance strategies based on reminders and decision support tools for helping clinical decision-making; 2) decision information strategies based on the principles of knowledge dissemination (e.g., corporative diffusion of evidence-based Clinical Practice Guidelines and Pathways for CVD primary prevention); 3) reflective decision-making restructuring strategies (i.e., audit and feedback provided along with intention formation interventions).ConclusionsThis study supports the usefulness of the BCW to guide the design and development of de-implementation strategies targeting the determinants of clinicians' decision-making processes to favor the abandonment of low-value practices and the uptake of those recommended for CVD primary prevention in low-risk patients. Further research to evaluate the feasibility and effectiveness of selected strategies is warranted.Clinical trial registrationSanchez A. De-implementation of Low-value Pharmacological Prescriptions (De-imFAR). ClinicalTrials.gov, Identifier: NCT04022850. Registered July 17, 2019. In: ClinicalTrials.gov. Bethesda (MD): U.S. National Library of Medicine (NLM). Available from: https://www.clinicaltrials.gov/ct2/show/NCT04022850.

Association of Healthy Lifestyle Behaviors and the Risk of Developing Rheumatoid Arthritis Among Women.

To investigate whether a healthy lifestyle, defined by a healthy lifestyle index score (HLIS), was associated with rheumatoid arthritis (RA) risk, overall and with seropositive/seronegative subtypes. We analyzed female nurses in the Nurses' Health Study (NHS, 1986-2016) and NHSII (1991-2017). Lifestyle and medical information were collected on biennial questionnaires. Medical records confirmed incident RA and serostatus. The HLIS index includes 5 modifiable components: smoking, alcohol consumption, body mass index, physical activity, and diet. Cox regression, adjusted for confounders, modeled associations between HLIS and incident RA. The population attributable risk estimated the proportion of incident RA preventable if participants adopted ≥4 healthy lifestyle factors. A total of 1,219 incident RA cases (776 seropositive, 443 seronegative) developed in 4,467,751 person-years. Higher (healthier) HLIS was associated with lower overall RA risk (hazard ratio [HR] 0.86 [95% confidence interval (95% CI) 0.82-0.90]), seropositive RA risk (HR 0.85 [95% CI 0.80-0.91]), and seronegative RA risk (HR 0.87 [95% 0.80-0.94]). Women with 5 healthy lifestyle factors had the lowest risk (HR 0.42 [95% CI 0.22-0.80]). The population attributable risk for adhering to ≥4 lifestyle factors was 34% for RA. In this prospective cohort, healthier lifestyle was associated with a lower RA risk. A substantial proportion of RA may be preventable by a healthy lifestyle.

Dietary Supplement Intake is Associated with Healthier Lifestyle Behaviors in College Students Attending a Regional University in the Southeast: A Cross-Sectional Study

The relationship between intake of dietary supplements and biomarkers such as insulin and insulin-like growth factor has not been well explored. The primary aim of this cross-sectional study was to investigate the associations between supplement intake and biological and lifestyle factors. We hypothesized that dietary supplement intake was associated with healthier lifestyle behaviors. College students attending a Southeast university were recruited between January 2018 and April 2019. Blood samples were collected to measure insulin, insulin-like growth factor 1 (IGF-1) and alanine aminotransferase (ALT). Statistical tests employed were linear regression and analysis of variance. Ninety-eight participants completed the study and 91% reported taking at least one supplement, while 5.1% reported taking 9+ supplements once per week. There were no differences in levels of insulin, IGF-1 and ALT by levels of dietary supplement intake. Although there were no differences in HEI-2015 score among the groups, those who consumed five or more supplements met a higher percentage of the recommended intake for fruits, performed aerobic exercise for longer duration, and had lower body fat percentage compared to participants who consumed two or less supplements at least once per week. These findings are consistent with previous studies and suggest that dietary supplement intake is highly prevalent in college students, and it may be related to healthy lifestyle behaviors. Future studies should employ mixed methodology to examine reasons by which college students consume dietary supplements and to assess perceived and direct health benefits associated with consumption.

Examining the relation between self-realization and burnout levels of nurses.

Self-realization involves the realization of one’s aims, revealing his/her potential, self-satisfaction, personal accomplishment, and scientific inventions. It is important to know nurses’ self-realization levels and the variables that affect it, because self-fulfillment is necessary for the personal and professional development of nurses. This study was conducted to determine the relation between self-realization and burnout levels of nurses. The study is a cross-sectional study that was conducted on 136 nurses who worked at Çukurova University, Faculty of Medicine Hospital in Adana, Turkey. The data were collected with the Personal Information Form and the “Self-realization” sub-dimension of the “Healthy Lifestyle Behaviors Scale” and the “Maslach Burnout Scale.” The analyses of the data were made in the SPSS demo packet Program with percentages, averages, variance analysis, Student t test, and Mann–Whitney U test. The Ethical Board Approval and Institutional Approval were obtained for the study. The self-realization score average of the nurses was 32.93 ± 6.43. The self-realization scores of the nurses who preferred their jobs willingly were found to be higher, and their burnout levels were found to be lower. It was also determined that female nurses experienced more emotional burnout compared to male nurses. In the present study, it was determined that the personal accomplishment score averages were higher and the desensitization and emotional burnout score averages, which are among the burnout scale sub-dimensions, were lower in those who had higher self-realization scores.

Socio-demographic factors and healthy lifestyle behaviours among Malaysian adults: National Health and Morbidity Survey 2019

This study aimed to investigate the association between socio-demographic factors and designated healthy lifestyle behaviours in a nationally-representative sample of Malaysian adults aged 18 years and above. Secondary data involving 7388 participants aged 18–96 years from the National Health and Morbidity Survey 2019, a national cross-sectional survey, was used in this study. A healthy lifestyle score (0–5 points) was calculated based on five modifiable lifestyle factors: non-smoker, body mass index < 25 kg/m2, physically active, moderate (or less) alcohol intake, and daily consumption of ≥ 5 servings of fruits and vegetables. Associations between socio-demographic factors and healthy lifestyle behaviours were examined using multinomial logistic regression adjusted for sampling design. About 30.6% of the participants met at least four out of the five healthy lifestyle factors. In multinomial model, subjects who were female (aOR = 3.26, 95%CI = 2.58, 4.12), of Chinese (aOR = 2.31, 95%CI = 1.62, 3.30 or other ethnicity (aOR = 1.44, 95%CI = 1.05, 1.98), and aged 18–30 years (aOR = 1.74, 95% CI = 1.12, 2.71) showed significant association with achieving healthy lifestyle compared to male, Malay and ≥ 61 years old as reference categories. Our results indicated that gender, age and ethnicity associated with healthy lifestyle behaviours. Information on the influence of socio-demographic factors on the prevalence of healthy lifestyles will facilitate the development of effective intervention strategies to improve the adaptation of healthy lifestyle practices.

A synergistic impact of early rhythm control and lifestyle modification on the risk of stroke in patients with new-onset atrial fibrillation: a Korean nationwide population-based cohort study

Abstract Background Early rhythm control therapy and lifestyle modification have both been associated with a lower risk of stroke in patients with atrial fibrillation (AF). Although guidelines have emphasized integrated care for patients with AF to improve clinical outcomes, the synergistic impact of early rhythm control therapy and lifestyle modification on the risk of stroke is unclear. Purpose To evaluate the impact of the combination of early rhythm control therapy and lifestyle modification on the risk of stroke Methods Based on data from the Korean National Health Insurance Service database, we included patients with new-onset AF between January 2009 and December 2016. Based on questionnaires from health checks, patients with ≥2 healthy lifestyle behaviors among quitting smoking, abstaining from alcohol, and performing regular exercise were defined as “healthy lifestyle” group. Patients who received rhythm control therapy within 2-year after new-onset AF were defined as the early rhythm control group. With a two-by-two factorial design, patients were categorized into 4 groups as follows: (i) those without early rhythm control and healthy lifestyle (group 1); (ii) those with a healthy lifestyle but without early rhythm control (group 2); (iii) those with early rhythm control but without healthy lifestyle (group 3); and (iv) those with both early rhythm control and healthy lifestyle (group 4). The primary outcome was stroke. Results Among a total of 208,662 patients, 46,972, 110,479, 15,133, and 36,078 patients were included in group 1, 2, 3, and 4, respectively. For the early rhythm control group, the mean duration from AF diagnosis to rhythm control therapy was 27±76 days. During a median follow-up of 4.2 years, 9905 patients had an incident stroke (incidence rate, 10.6 per 100 person-years). After multivariable adjustment, compared to group 1, group 2 (healthy lifestyle only) and group 3 (early rhythm control only) were associated with a lower risk of stroke (HR and 95% CI: 0.769, 0.728–0.881, and 0.774, 0.703–0.852, respectively) (Figure 1). Group 4 with early rhythm control and a healthy lifestyle had the lowest risk of stroke among all groups (HR 0.575, 95% CI 0.536–0.617 compared to group 1) (Figure 1). After propensity score (PS) weighting for group 2 and 4, additional early rhythm control based on healthy lifestyle was associated with a lowered risk of stroke by 22% (Figure 2). After PS weighting between groups 3 and 4, additional lifestyle modification based on early rhythm control was associated with a lowered risk of stroke by 27% (Figure 2). Conclusion In this large-scale observational cohort study, early rhythm control therapy and healthy lifestyle behavior might reduce the risk of stroke in patients with new-onset AF, consistent with the results from recent randomized clinical trials. Furthermore, implementing both early rhythm control therapy and a healthy lifestyle could synergize stroke prevention in these populations. Funding Acknowledgement Type of funding sources: None.

Using the Omaha System to Determine Health and Social Problems of Roma Population in Istanbul: Secondary Data Analysis.

The aim of this study was to determine the health and social problems and related behaviors of the Roma population by using the Omaha System. The data were collected from 650 Roma individuals. This study was a cross-sectional secondary data analysis and the data were collected in two stages. First, the "Technical Assistance for Promoting Social Inclusion in Densely Roman Populated Areas Project (SIROMA)" Act team evaluated health problems among Roma individuals. Second, data were reanalyzed using the Omaha System. When sociodemographic and economic characteristics were evaluated, low education level, adolescent marriages, a high number of live births, soiled living areas, unemployment, and substance use were found in the Roma population. In this context, using the Omaha System, the frequently diagnosed health and social problems were Sanitation (13.5%), Healthcare supervision (11.8%), Nutrition (11.0%), Income (9.8%), Respiration (8.3%), Substance use (7.3%), and Neighborhood/workplace safety (6.0%). This study results found out that the Roma population is less prone than natives to have healthy lifestyle behaviors and more prone to experience a deterioration in both their general and mental health. The Omaha System is a valid method used to collect and analyze data for a vulnerable population in the community. Also, it has been proven that the Omaha System Problem Classification Scheme can provide a more detailed and comprehensive assessment.

Clinician Wellness—Healthy Lifestyle Behaviors, Don't Just Think, ACT

Clinician Wellness—Healthy Lifestyle Behaviors, Don't Just Think, ACT