Improve Health Status Research Articles

Understanding Adult’s Experiences and Perceptions of How to Maintain Physical Activity: A Systematic Review and Qualitative Synthesis

Abstract Background Many adults do not meet physical activity recommendations for optimal health, and this is often because people find it difficult to maintain physical activity in the long term. This study focuses on identifying and synthesising factors that may influence the maintenance of physical activity in adults with and without known health conditions. Method A systematic review and qualitative synthesis using thematic analysis was conducted. Four databases (MEDLINE, SPORT Discus, APA, and Web of Science) were systematically searched for studies published from inception to February 2023 that included qualitative data about people’s experiences of maintaining physical activity. Results A total of 9337 abstracts were screened and 68 studies from 14 countries were included. Six main themes were identified: (1) influence of others (e.g. four forms of social support, accountability); (2) contextual and environmental influences (e.g. cost and access of physical activity, weather); (3) health-related influences (e.g. reflexivity about how physical activity improves health conditions, weight control); (4) making it work (e.g. flexibility, prioritising exercise); (5) habits; and (6) psychological processes (e.g. enjoyment, identifying as a physically active person). Conclusion People who maintained their participation in physical activity found it enjoyable, prioritised it, and integrated it into their daily routine. Participants were motivated to continue being physically active when they realised the benefits for their health. Social support, in particular companion support, was a key component facilitating continued engagement. Findings specific to maintenance of physical activity included reflexivity of how physical activity benefited health, flexibility, and identifying as a physically active person.

Web-based pulmonary telehabilitation: a systematic review.

Web-based pulmonary telerehabilitation (WBPTR) can serve as a valuable tool when access to conventional care is limited. This review assesses a series of studies that explore pulmonary telerehabilitation programmes delivered via web-based platforms. The studies involved participants with moderate to severe chronic obstructive pulmonary disease (COPD). Of the 3190 participants, 1697 engaged in WBPTR platforms, while the remaining 1493 comprised the control groups. Sixteen studies were included in the meta-analysis. Web-based pulmonary telerehabilitation led to an increase in daily step count (MD 446.66, 95% CI 96.47 to 796.86), though this did not meet the minimum clinically important difference. Additionally, WBPTR did not yield significant improvements in the six-minute walking test (MD 5.01, 95% CI - 5.19 to 15.21), health-related quality of life as measured by the St. George's Respiratory Questionnaire (MD - 0.15, 95% CI - 2.24 to 1.95), or the Chronic Respiratory Disease Questionnaire (MD 0.17, 95% CI - 0.13 to 0.46). Moreover, there was no significant improvement in dyspnoea-related health status, as assessed by the Chronic Respiratory Disease Questionnaire (MD - 0.01, 95% CI - 0.29 to 0.27) or the modified Medical Research Council Dyspnoea Scale (MD - 0.14, 95% CI - 0.43 to 0.14). Based on these findings, this review concludes that WBPTR does not offer substantial advantages over traditional care. While slight improvements in exercise performance were observed, no meaningful enhancements were noted in dyspnoea or quality of life metrics. Overall, WBPTR remains a complementary and accessible option for managing and monitoring COPD patients. However, further research and innovation are required to improve its efficacy and adapt it to various clinical environments.

Abstract 4122763: Health Status Outcomes of Antianginal Therapies in Patients After Coronary Revascularization: Insights From the GREAT Disease Registry Study

Background: The impact of antianginal therapies on the health status of coronary artery disease (CAD) patients who have undergone coronary revascularization has not been extensively researched. This study aimed to investigate the effect of nicorandil on the health status in patients after coronary revascularization, measured by the Seattle Angina Questionnaire (SAQ). Methods: We analyzed data from 1,556 patients enrolled in the GREAT Disease Registry Study (Clinicaltrial No. NCT05050773) between September 2021 and May 2022. Changes in SAQ summary score (SAQ-SS) from baseline to 3, 6, 9, and 12 months were assessed. Statistical methods included a linear mixed-effects model and propensity score matching (PSM) for comparative analysis. Results: Among the 1,038 patients receiving revascularization analyzed (22.7% female; mean age [SD], 59.9 [10.2] years), 648 (62.4%) received nicorandil, while 390 (37.6%) did not. In the linear mixed-effects model analysis, statistically significant improvements were observed with nicorandil in SAQ-SS across all time points ( Table 1 ), indicating beneficial effects of nicorandil on health status outcomes after revascularization. Sensitive analysis was conducted using the PSM method. After PSM adjustment, both groups comprised 321 patients each. The change in SAQ-SS from baseline to 12 months was significantly greater in the nicorandil group (19.2 ± 14.06 points) compared to the non-nicorandil group (14.91 ± 12.9 points, p < 0.001). Conclusions: These findings indicated that nicorandil is associated with improved health status outcomes in CAD patients who have undergone coronary revascularization.

Evaluation of Nutritional Composition of Ocimum gratissimum Leaf Extract

Vegetables are known to be vital sources of nutritive foods. This study evaluates the nutritional composition of Ocimum gratissimum leaf extract vis-a-vis proximate, minerals and vitamins analyses. Fresh leaves of O. gratissimum were purchased from a local market in Awka North Local Government Area of Anambra State, Nigeria and were washed, destalked, oven-dried at 40 0C, pulverized, and sieved through 2.0 mm mesh prior to analysis. Proximate, minerals, and vitamin analyses were carried out, using standard methods. Results indicated that O. gratissimum contained high levels of carbohydrate (51.78 ± 0.50 %), protein (10.50 ± 0.04 %), and fiber (9.38 ± 0.05 %), with minute quantity of crude fat (4.94 ± 0.03 %). Analysis of the mineral compositions showed that the vegetable contained considerable quantity of minerals that is sufficient to improve general well-being, while the vitamin analysis revealed that the leaves of O. gratissimum was sufficiently rich in Vitamin E and could, therefore, act as antioxidant and consequently help to improve health status of its consumers.

Food Consumption According to the NOVA Food Classification and Its Relationship with Symptoms of Depression, Anxiety, and Stress in Women.

Depression, anxiety, and stress are highly prevalent mental disorders worldwide, and food consumption can change in individuals with these conditions. We aimed to assess the food consumption of women with depressive symptoms and compare it to a control without symptoms. A cross-sectional study was conducted with 96 women, aged 18-59, allocated into two groups: control (n = 62) or depressive symptoms (n = 34). The participants underwent an anthropometric assessment, and food consumption was evaluated using a 24 h food recall and the NOVA classification. Depressive symptoms, anxiety, and stress were measured using the DASS-21 questionnaire. Anthropometric parameters did not differ between the groups. Women with depressive symptoms consumed fewer calories (p = 0.006), carbohydrates (p = 0.014), proteins (p = 0.036), and lipids (0.011) from unprocessed and minimally processed foods (UMPF) compared to the control women. A negative correlation was found between the dietary consumption energy of UMPF and symptoms of depression (r = -0.337; p = 0.001), anxiety (r = -0.262; p = 0.014), and stress (r = -0.260; p = 0.014), as well as a positive correlation between energy intake from ultra-processed foods (UPF) and symptoms of depression (r = 0.218; p = 0.042) and stress (r = 0.227; p = 0.034). Regression analysis showed that depressive symptoms accounted for 7.6% of the lower energy consumption from UMPF. Women with depressive symptoms displayed lower UMPF consumption, and this was negatively correlated with symptoms of depression, anxiety, and stress. Professional dietary advice can improve health status in these patients.

SGLT2 inhibitor, a new bullet in heart failure management

The global health landscape is confronted with substantial challenges stemming from diabetes mellitus and heart failure (HF). The escalating incidence of diabetes mellitus (DM), in correlation with HF, underscores the imperative necessity for efficacious strategies in the realm of prevention and management. The most recent advancements in therapeutic approaches, specifically Sodium-glucose transporter 2 inhibitors (SGLT2i), present a promising prospect for enhancing outcomes and addressing the existing gaps in HF management. This paper aims to elucidate the significance of SGLT2i in the therapeutic management of both reduced and preserved heart failure, with or without the presence of DM. SGLT2i are new heart failure drugs. In trials, SGLT2i improved diastolic dysfunction, reduced oxidative stress, inflammation, fibrosis, and myofilament rigidity. The first SGLT2 inhibitor studies, EMPA-REG OUTCOME, DECLARE-TIMI 58, and CANVAS, showed that Empagliflozin and Canagliflozin reduced HF mortality and rehospitalization in type 2 diabetes mellitus (T2DM) patients. Dapagliflozin reduces HF hospitalizations without impacting T2DM mortality. Canagliflozin avoided creatinine rises, kidney disease deaths, and cardiovascular deaths in the CREDENCE Study. SGLT2i improve health in heart failure with preserved ejection fraction (HFpEF). SGLT2i improved health status statistically in the PRESERVED-HF and EMPEROR-Preserved investigations. SGLT2i became known as a promising therapeutic choice in the treatment of HF. The substantial evidence from prominent large-scale clinical trials has substantiated the cardiovascular and renal protective effects of SGLT2i. Furthermore, the benefits of these medications are relevant for individuals who have been diagnosed with heart failure with reduced ejection fraction (HFrEF), as well as those who are experiencing heart failure with preserved ejection fraction (HFpEF). Keyword: diabetes mellitus, heart failure, management, SGLT2 inhibitor

Automated digital counselling with social network support for chronic heart failure fails to improve health status but promotes health-related quality of life: ODYSSEE-vCHAT pilot trial

Abstract Background Automated digital counselling programs have the potential to provide a scalable, complementary behavioural intervention to improve clinical outcomes for chronic heart failure (CHF). Purpose The primary hypothesis for this pilot trial was that automated digital counseling with social network support (ODYSSEE-vCHAT) vs. Usual Care would decrease the incidence of all-cause re-hospitalization or ED visits. Secondary outcomes included: minimal clinically important difference for improvement on the Kansas City Cardiomyopathy Questionnaire-Overall Summary (KCCQ-OS), and improvement on ENRICHD Social Support Index (ESSI), Patient Health Questionnaire for Depression (PHQ-9) Godin-Shephard Leisure Time Physical Activity Scale (GSLTPAQ), and Self-Efficacy in Managing Chronic Disease (SEMCD6). Methods This 2-arm, parallel group, single-blind pilot trial randomized patients to ODYSSEE-vCHAT vs. Usual Care. Patients were ≥18 years of age with CHF (reduced ejection fraction [HFrEF] < 40%, mid-range [HFmrEF] 40-49%, or preserved [HFpEF] ≥ 50%). Exclusion was based on inability to participate due to co-morbidities. All-cause hospitalization or ED visit were assessed digitally by hospital administrative data. Questionnaires were administered at baseline and end-of-study (approximately 8 months). The digital counselling protocol aimed to improve CHF self-care, HRQL, and adherence to medications, exercise, diet, and smoke-free living (Figure 1). The primary outcome was assessed using multivariable binary logistic regression. Secondary outcomes were assessed using multivariable linear regression analyses with ethno-racial group as a covariate. Results 61 patients were randomized: ODYSSEE-vCHAT, n = 30 (49%), vs. Usual Care, n = 31 (51%). There were 2 deaths, 3 withdrawals, and 12 patients failed to complete secondary outcome assessments. Sample characteristics included mean age = 59 years (95% Confidence Interval, CI, 30, 76), gender identity as women, n = 23 (38%), ethno-racial group other than White, n = 17, (28%) and CHF with HFrEF, n = 47 (77%), HFmrEF, n = 8 (13%), and HFpEF, n = 4 (7%). Duration of enrollment to trial endpoint: mean = 247 days, (95% CI, 75, 382). Figure 2 indicates that ODYSSEE-vCHAT was not associated with lower incidence of all-cause hospitalization/ED visit: composite index events for Usual Care, n = 8 (28%), ODYSSEE-vCHAT, n = 7 (23%). However, ODYSSEE-vCHAT was associated with greater prevalence of KCCQ-OS change (≥ 5 points), and greater improvement in self-efficacy (SEMCD6) for managing CHF. There was a statistical trend to decreased prevalence of depression. Social support was inversely associated with ODYSSEE-vCHAT. No benefit was observed for physical activity (Figure 2). Conclusions Automated digital counselling with social network support promotes improvement in HRQL indices, but not health status. Findings for this pilot trial support a follow-up phase 2 randomized controlled trial.Digital Counselling ProtocolODYSSEE-vCHAT Outcomes

Relationship Between Training Frequency and Training Session Duration on Vitality in Recreational Runners: A Cross-Sectional Study

Background: Running can improve health status from a biopsychosocial perspective. However, isolation strategies, like the COVID-19 pandemic-induced lockdown, produce deleterious effects on both health status and sport performance. The aim of our study was to investigate recreational runners’ sporting habits, subjective vitality (SV), and well-being after the COVID-19 pandemic-induced lockdown. Methods: After data filtration, 5542 recreational runners (74.5% men and 25.5% women, >18 years) were selected for further analyses. The participants answered preliminary questions regarding sporting habits and completed the validated Spanish version of the Subjective Vitality as a Dynamic Reflection of Well-Being questionnaire for assessing their SV after lockdown. Results: Subjective vitality scores did not differ between men and women, nor between age groups (p = 0.41 and p = 0.11, respectively). Subjective vitality was greater with weekly training frequency up to 5 days/week, where this enhancement plateaued, while average training session duration was positively related to SV, stabilizing at 91–120 min/session (p < 0.001 for both). Conclusions: There is a dose–response relationship between both weekly training frequency and training session duration, and mental health benefits in recreational runners. Further longitudinal studies are needed in order to determine the optimal dose–response relationship for simultaneously enhancing mental health outcomes and running performance in recreational runners, especially regarding weekly training frequency, training session duration, and exercise intensity.

The Effect of Stigmatization on Diabetes Health Promotion Self-Care Behaviours and Predictors of Stigma and Self-Care Behaviours in Individuals With Type 2 Diabetes.

Individuals with type 2 diabetes are at risk of delaying or not performing diabetes health promotion self-care behaviours because of their social or self-stigmatization. The study aimed to reveal the effect of stigmatization on diabetes health promotion self-care behaviours and predictors of stigma and diabetes health promotion self-care behaviours in individuals with type 2 diabetes. This cross-sectional study included 235 individuals with type 2 diabetes. The Diabetes Stigma Assessment Scale (DSAS) and Diabetes Health Promotion Self-Care Scale (DHPSCS) were used for data collection. There was a significant, negative correlation between the DSAS and DHPSCS scores. High mean scores on the DSAS and its subscales treated differently, blame/judgement and self-stigma were predictors of a negative effect on diabetes self-care behaviours. Poor health status, alcohol intake and diabetes complications are predictive of stigma. Insulin use and self-monitoring blood glucose are predictors of self-care behaviours. Stigma negatively affects diabetes self-care behaviours in individuals with type 2 diabetes. Nurses could provide education on improvement of health status, harms of alcohol intake and management of diabetes complications. Counselling for coping with stigma and performing self-care could be provided. Nurses could organize interventions to raise awareness about diabetes in society.

Effects of fermented Chinese herbal medicine feed additives on growth performance and intestinal microbiota of piglets.

Fermented Chinese medicine (FCM), as a functional feed additive, has been widely recognized to play a significant role in protecting the intestinal health of piglets and enhancing productive performance. However, the relationship between the active components of FCM, gut microbiota, and their beneficial effects on animal performance remains unclear. In this study, metabolomics analysis revealed a significant increase in the main contents of lactic acid and propionic acid in FCM, while most glycosides and their derivatives decreased after three days of microbial fermentation. Subsequently, piglets were fed a basic diet supplemented with 1% FCM, while the control group received only the basic diet. The results indicated a significant increase in feed intake and average daily gain within 14 days (P<0.05) due to FCM supplementation. Additionally, FCM significantly improved feed efficiency from 1.76 to 1.50 (P<0.05), and piglets in the FCM group exhibited significantly lower frequencies of diarrhea and coughing, which indicated improved health condition by FCM. Moreover, high-throughput sequencing analysis revealed higher abundances of Lactobacillus agilis, Megasphaera elsdenii, Ligilactobacillus, and Veillonellaceae in FCM group. In summary, FCM increased the content of active metabolites through microbial fermentation and regulated the intestinal microbiota to improve the health of piglets. FCM offers a promising potential for enhancing production performance and economic efficiency in the livestock industry.

The Effect of Synbiotics and Probiotics on Ochratoxin Concentrations in Blood and Tissues, Health Status, and Gastrointestinal Function in Turkeys Fed Diets Contaminated with Ochratoxin A.

The aim of this study was to evaluate carcass quality and analyze gastrointestinal functional status, ochratoxin A (OTA) accumulation in tissues and organs, and the health status of turkeys fed diets contaminated with OTA and supplemented with synbiotic preparations in comparison with commercial probiotic feed additives. The research involved 120 female BIG 6 turkeys, divided into six treatment groups (five replicates, four birds per replicate). Wheat naturally contaminated with OTA (662.03 μg/kg) was used in turkey diets. Turkeys in group 1 received an OTA-contaminated diet without additives. Groups 2 and 3 received 0.4 g/kg of probiotic preparation BioPlus 2B or Cylactin. Groups 4, 5, and 6 received 0.5 g/kg of synbiotics S1, S2, or S3. The following parameters were monitored: growth performance, carcass quality, gastrointestinal tract structure and digesta pH, health status, and concentrations of OTA in the blood and tissues of turkeys. The study found no significant differences in the growth performance and carcass quality of turkey. However, the introduction of probiotics or synbiotics into OTA-contaminated feed mixtures resulted in a reduced pH of the digesta in certain sections of the turkey digestive tract (p < 0.05). Additionally, the tested synbiotic additives significantly reduced liver weight in turkeys at weeks 6 and 15 (p < 0.05). The addition of probiotic and synbiotic preparations based on lactic acid bacteria strains, inulin, and S. cerevisiae yeasts to OTA-contaminated diets in commercial turkey farming may improve health status (p < 0.05) and reduce mycotoxin accumulation in organs and tissues of poultry (p < 0.05).

Spatial characteristics of health outcomes and geographical detection of its influencing factors in Beijing.

Social determinants of health (SDOH) broadly influence health levels. Research on health and its influencing factors can help improve health status. There is limited research on the spatial stratified heterogeneity of health status and the interactions between the factors influencing it. This study aimed to analyze the spatial characteristics of health outcomes in Beijing and identify its influencing factors. Based on the Healthy Beijing Initiative (2020-2030), we constructed health outcomes and five dimensions of the SDOH evaluation system. Our study measured the health outcomes and SDOH based on the latest data from 16 districts in Beijing in 2020-2022. We explored the spatial characteristics of health outcomes through descriptive and spatial autocorrelation analyses. Moreover, the Geographical Detector (GeoDetector) technique has been used to reveal the effect of SDOH and its interactions on health outcomes. A significant spatial stratified heterogeneity of health outcomes was observed, with the health outcomes mainly exhibiting two clustering types (high-high and low-low) with positive autocorrelation. The results of the geodetector showed that social and economic factors (q = 0.85), healthy lifestyle (q = 0.68) and health service (q = 0.53) could mainly explain the heterogeneity of health outcomes. Social and economic factors, healthy lifestyle and healthy environment gradually became the main influential factor in health outcomes over time. Furthermore, the interaction of any two factors on health outcomes was found to be more pronounced than the impact of a single factor. There existed obvious spatial stratified heterogeneity of health outcomes in Beijing, which could be primarily explained by social and economic factors, and healthy lifestyle and health service.

Laboratory medicine and sports: where are we now?

Laboratory medicine in sport and exercise has significantly developed during the last decades with the awareness that physical activity contributes to improved health status, and is present in monitoring both professional and recreational athletes. Training and competitions can modify concentrations of a variety of laboratory parameters, so the accurate laboratory data interpretation includes controlled and known preanalytical and analytical variables to prevent misleading interpretations. The paper represents a comprehensive summary of the lectures presented during the 35th Annual Symposium of the Croatian Society of Medical Biochemistry and Laboratory Medicine. It describes management of frequent sport injuries and sums up current knowledge of selected areas in laboratory medicine and sports including biological variation, changes in biochemical parameters and glycemic status. Additionally, the paper polemicizes sex hormone disorders in sports, encourages and comments research in recreational sports and laboratory medicine. In order to give the wider view, the connection of legal training protocols as well as monitoring prohibited substances in training is also considered through the eyes of laboratory medicine.

Protocol for a cross-sectional study on factors affecting health-related quality of life among Afghan refugees in Pakistan

Background Pakistan served as a host for more than 1.4 million Afghan refugees for more than 40 years. Access to health care is the most important issue faced by refugees, because they might be at a higher risk for certain diseases. This risk can be attributed to a lack of awareness of health care facilities, health beliefs, inadequate hygiene, cultural differences, and malnutrition. Health of individuals is closely associated with their quality of life. Quality of life over the whole lifespan is pivotal to overall life satisfaction. It includes physical wellbeing, mental health, education, occupation, income, personal safety, as well as (religious) freedom. Until now, the health status of Afghan refugees has never been comprehensively investigated in Pakistan. Therefore, an assessment in this regard is needed to explore their health-related quality of life, for securing their human right to health. Methods A cross-sectional study has been designed to describe and explain the health-related quality of life of Afghan refugees in Pakistan. Multistage cluster sampling was applied for selection of study participants. The number of respondents from two regions in Pakistan was drawn through a proportionate sampling technique. A quantitative research method using pre-validated questionnaires was used for data collection. The questionnaire included items to assess well-being, mental health, health literacy, and factors affecting health and health care. Descriptive analysis was used, whereas inferential statistical tests (binary logistic regression model) was also performed. The study received ethically permission by the Advanced Studies and Research Board of the University of the Punjab, Lahore, Pakistan. Discussion The assessment of Afghan refugee’s quality of life in Pakistan should lead to recommendations disseminated to public and health care officials. This evidence is needed for policymaking related to adequate measures for improving health conditions of Afghan refugees in Pakistan.

Evolving trends, regional differences, determinants, and disease sources of provincial-level health inequalities in china 1990–2019: a temporal convergence and novel triple decomposition analysis

BackgroundPromoting health equity has been a worldwide goal, but serious challenges remain globally and within China. Multiple decomposition of the sources and determinants of health inequalities has significant implications for narrowing health inequalities and improve health equity.MethodsLife expectancy (LE), healthy life expectancy (HALE), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life-year (DALY) rates in 31 provinces of mainland China were selected as health status indicators, obtained from the Global Burden of Disease (GBD) database. Temporal convergence analysis was used to test the evolving trends of health status. Dagum’s Gini coefficient decomposition was used to decompose the overall Gini coefficient based on intraregional and interregional differences. Oaxaca-Blinder decomposition was used to calculate contributions of determinants to interregional differences. The factor-decomposed Gini coefficient was used to analyze the absolute and marginal contribution of each component to overall Gini coefficients.ResultsFrom 1990-2019, China witnessed notable improvements in health status measured by LE, HALE, ASMR and age-standardized DALY rates.Nevertheless, the three regions (East, Central and West) exhibited significant inter-regional differences in health status, with the differences between the East and West being the largest. The adjusted short-term conditional β-convergence model indicated that the inter-provincial differences in LE, HALE, ASMR, and age-standardized DALY rates significantly converged at annual rates of 0.31%, 0.35%, 0.19%, and 0.28% over 30 years. The overall Gini coefficients of LE, HALE, and age-standardized DALY rates decreased, while the ASMR exhibited an opposite trend. Inter-regional and intra-regional differences accounted for >70% and<30% of overall Gini coefficients, respectively. Attribution analysis showed that socioeconomic determinants explained 85.77% to 91.93% of the eastern-western differences between 2010-2019, followed by health system determinants explaining 7.79% to 11.61%. The source-analysis of Gini coefficients of ASMR and age-standardized DALY rates revealed that noncommunicable diseases (NCDs) made the largest and increasing absolute contribution, while communicable, maternal, neonatal, and nutritional diseases (CMNNDs) had a diminishing and lower impact. However, NCDs exerted a negative marginal effect on the Gini coefficient, whereas CMNNDs exhibited a positive marginal effect, indicating that controlling CMNNDs may be more effective in reducing health inequities.ConclusionsRegional differences are a major source of health inequities in China. Prioritizing prevention and control of CMNNDs, rather than NCDs, may yield more pronounced impacts on reducing health inequalities from the perspective of marginal effect, although NCDs remain the largest absolute contributor to health inequalities.

Exploring the Probiotic Potential of Bacteroides spp. Within One Health Paradigm.

Probiotics are pivotal in maintaining or restoring the balance of human intestinal microbiota, a crucial factor in mitigating diseases and preserving the host's health. Exploration into Bacteroides spp. reveals substantial promise in their development as next-generation probiotics due to their profound interaction with host immune cells and capability to regulate the microbiome's metabolism by significantly impacting metabolite production. These beneficial bacteria exhibit potential in ameliorating various health issues such as intestinal disorders, cardiovascular diseases, behavioral disorders, and even cancer. Though it's important to note that a high percentage of them are as well opportunistic pathogens, posing risks under certain conditions. Studies highlight their role in modifying immune responses and improving health conditions by regulating lymphocytes, controlling metabolism, and preventing inflammation and cancer. The safety and efficacy of Bacteroides strains are currently under scrutiny by the European Commission for authorization in food processing, marking a significant step towards their commercialization. The recent advancements in bacterial isolation and sequencing methodologies, coupled with the integration of Metagenome-Assembled Genomes (MAGs) binning from metagenomics data, continue to unveil the potential of Bacteroides spp., aiding in the broader understanding and application of these novel probiotics in health and disease management.

Improvement in health-related quality of life questionnaires with biologic treatment in severe asthma and comorbid chronic rhinosinusitis with or without nasal polyposis: a real-life experience.

Patients with severe asthma frequently have comorbid chronic rhinosinusitis (CRS) with or without nasal polyps, that can increase the symptom burden and complicate treatment. Real-life clinical data on the impact of biologic treatments on CRS-specific quality-of-life questionnaires are still lacking. In this retrospective real-life study, we collected data from patients with severe asthma with comorbid CRS with/without nasal polyposis at baseline, and after 3, 6 and 12 months of treatment with omalizumab, mepolizumab, benralizumab or dupilumab. In particular, we evaluated improvements in HRQoL as measured by SinoNasal Outcome Test-22 (SNOT-22, 0 - 110), Visual Analog Scale symptom scores (VAS, 0-10), and Asthma Control Test (ACT, 5-25) and the proportion of patients meeting the minimal clinically important difference (MCID). Disease-specific HRQoL, as measured by SNOT 22 and VAS score improved in all patients at 3, 6, and 12 months of treatment compared with baseline (SNOT-22: 14, IQR: 0-52 vs 10, IQR:0-30 vs 0, IQR:0-15 vs 0, IQR:0-12, p < 0.001, VAS score: 1, IQR: 0-5 vs 0, IQR:0-3 vs 0, IQR:0-2 vs 0, IQR 0-1, p < 0.001). After 3 months of treatment >80% of patients reached the MCID for ACT, while only patients on dupilumab showed to reach a MCID in 100% of cases. The effect size depended upon the symptom burden at baseline. The study confirms the efficacy of omalizumab, mepolizumab, benralizumab, and dupilumab in a real-life setting, with a rapid improvement in CRS-specific HRQoL and general health status. These data highlight the importance of targeting type 2 inflammation in asthmatic patients with co-existing upper and lower airways disease.The Authors disclose that preliminary data and analysis of the present study have been presented in abstract form during the "X International Workshop on Lung Health - Respiratory Disease and Immune Response", held in Nice on 19-21 January 2023.

Crowding-out effect of tobacco consumption on household food expenditures in Cameroon

This study delves into the critical issue of household budgets in Cameroon, specifically focusing on the impact of tobacco expenditure. Tobacco use often represents a significant portion of a household’s financial resources, potentially leading to a phenomenon known as the “crowding-out effect.” This effect describes a situation where increased tobacco spending leads to a decrease in the budget allocated to other essential goods and services. To gain a deeper understanding of this phenomenon, this study employs a quantitative approach. The analysis utilizes data from a nationally representative household survey conducted in Cameroon during 2014 (ECAM4). A two-stage least squares (2SLS) technique is implemented to address a potential statistical issue known as endogeneity, which could otherwise skew the results. The study’s findings reveal a concerning trend: tobacco expenditure has a negative impact on the budget shares allocated to essential goods such as food, clothing, and household equipment. This negative impact appears to be particularly pronounced for male consumers within households. Based on these findings, the study suggested that implementing tobacco control policies could lead to significant improvements in household well-being and overall health status. These policies, by encouraging a reduction in tobacco use, could free up resources that could then be reallocated towards essential goods, ultimately improving household financial stability and health outcomes.

Early integration of palliative care versus standard cardiac care for patients with heart failure (EPCHF): a multicentre, parallel, two-arm, open-label, randomised controlled trial

Heart failure is a substantial global health concern that severely affects patients' quality of life. We aimed to compare the effects of early integration of palliative care (EIPC) and standard cardiac care on health status and mood of patients with non-terminal heart failure. EPCHF was a multicentre, parallel, two-arm, open-label, randomised controlled trial carried out at University Hospital Bonn and University Hospital Düsseldorf in Germany. Eligible patients (aged 18years or older) had heart failure, with New York Heart Association class IIor more and NT-proBNP concentrations greater than or equal to 400pg/mL. Patients were randomly assigned (1:1) to receive EIPC with standard cardiac care or standard cardiac care alone. Randomisation was computer-generated with allocation concealment, variable block sizes, and stratification by investigational site. The primary endpoints were health status and mood, measured every 3months over 12months using the Functional Assessment of Chronic Illness Therapy-Palliative Care (FACIT-PAL) and the Kansas City Cardiomyopathy Questionnaire (KCCQ), analysed by intention to treat. This trial is registered with DRKS.de, DRKS00013922. Between May 21, 2019, and Nov 15, 2021, 843patients were assessed for eligibility, 205of whom were enrolled (100 assigned to EIPC and 105assigned to standard cardiac care). 143 (70%) patients were male and 62 (30%) were female. Over 12months, both groups significantly improved in FACIT-PAL and KCCQ Overall Summary Score(OSS) with no significant differences between the groups (FACIT-PAL adjusted mean difference 0·98points [95% CI -1·28to 3·23]; p=0·40; KCCQ-OSS adjusted mean difference -2·06points [-7·89to 3·78]; p=0·49). Nine (9%) patients in the EIPC group and seven (7%) patients in the standard cardiac care group died from any cause, with no significant differences in time to death between the two groups (hazard ratio [HR] 1·32 [95% CI 0·49 to 3·54]; p=0·58). 22 (22%) patients in the EIPC group and 21 (21%) patients in the standard cardiac care group were hospitalised at least once due to heart failure, with no significant differences in time to heart-failure-related hospitalisation between the two groups (HR 1·09 [0·61 to 1·98]; p=0·77). 70 (70%) patients in the EIPC group and 62 (59%) in the standard cardiac care group had any adverse events (p=0·10). In this open-label, randomised clinical trial, standard cardiac care, featuring guideline-directed optimisation of medical therapy and regular 3-monthly follow-ups was found to be as effective as when combined with EIPC in improving health status and mood in patients with non-terminal heart failure. Future clinical practices should consider EIPC based on individual patient needs. Federal Ministry of Education and Research.

Effects of Tai Chi and Qigong on Heart Rate Variability: A Systematic Review and Meta-Analysis

Background: Intervention studies examining meditative movement (MM) often demonstrate benefits on physiological and psychological health. A potential mechanism associated with these outcomes is heart rate variability (HRV), an important neurophysiological biomarker of optimal and resilient health and functioning. Objective: We aimed to synthesize existing literature on the effects of two related forms of MM, Tai Chi (TC) and Qigong (QG) on HRV parameters in adult populations. Methods: Following PRISMA guidelines and Cochrane Collaboration recommendations, four databases (MEDLINE, Google Scholar, Academic Search Premier, and PubMed) were searched for articles (through December 15, 2023) that included TC and/or movement-based QG intervention versus any control condition (active or inactive) and reported at least one HRV outcome. Two reviewers independently completed study selection, data extraction, and risk-of-bias assessment. Results: We identified 148 for potential inclusion. After removing 61 duplicates, 87 full-text reviews yielded 23 articles, and 16 qualified for meta-analysis based on common HRV outcomes. Meta-analyses indicated a significant overall effect of TC/QG interventions on high-frequency power and standard deviation of the beat-to-beat intervals (SDNN), two critical HRV parameters, compared with control conditions: for HF power, standardized mean difference (SMD) = 0.29, P = 0.003, 95% Confidence interval (CI) [0.10, 0.48]; heterogeneity: I 2 = 46%, χ2 (8) = 14.89, P = 0.06; and for SDNN: SMD = 0.83, P = 0.02, 95% CI [0.16, 1.51]; heterogeneity: I 2 = 90%, χ2 (7) = 71.62, P &lt; 0.001. Other HRV parameters did not demonstrate significant changes upon meta-analyses, but overall effect sizes showed a trend toward the expected direction. Conclusion: Based on the strength of the evidence, we conclude TC/QG interventions may shift HRV parameters toward improved health status and resilience. In addition, we offer suggestions to improve the design and measurement of future TC/QG research interventions exploring HRV.