Usual Lifestyle Research Articles

AGNIBALA SURVEY STUDY: HEMANT RITU W.S.R. TO RITUCHARYA THROUGHOUT CHHATTISGARH

Background:Ritucharya is a practical, health-promoting Ayurvedic regimen that facilitates internal adaptability, allowing us to Agnibala, keep our Doshas balanced, and modify our habits by the seasons. Each Ritu has its unique climate. Ritucharya is a practical, health-promoting Ayurvedic regimen that facilitates internal adaptabil-ity, allowing us to Agnibala, keep our Doshas balanced, and modify our habits by the seasons. Each Ritu has its unique climate, affecting Agnibala and the body. A cross-sectional survey is now being conducted to investigate the impact of Ayurveda on health behaviors among the people of Chhattisgarh, particularly about following Rit-u's recommended standards and regimen and eating the right amount of Ahar.At the moment, a cross-sectional. Aim- To improve the general public's knowledge of Ritucharya and the frequency of varied Agnibala in Hemant Ritu features. Study design- 145 people were given access to the easily understood questionnaire based on sea-sonal Agnibala stories described in Ayurveda. Result- When Hemant Ritu was observed, indications of Teeksh-nagni, the season-specific Prakupita Dosha, were noted in respondents from Chhattisgarh, of whom 70.3% had not altered their usual diet and lifestyle and 75.3% had not been following Ritucharya.Conclusion- The current thesis concludes thatin this Ritu, the body's heat is covered by constriction due to atmospheric cold. This leads to an increase in Jatharagni. So, if proper heavy food is not consumed, it will burn away the Rasadidhatus, as the food in the form of fuel is not an available symptom of Teekshna Agnibala in Hemant ritu.

Lifestyle Intervention Improves Parasympathetic Activity in Hypertrophic Cardiomyopathy

Background A limited number of studies have investigated the effects of lifestyle interventions in hypertrophic cardiomyopathy (HCM). This study evaluated the effect of a novel lifestyle intervention incorporating physical activity (PA) and dietary nitrate supplementation on heart rate variability (HRV) and haemodynamic measures in HCM. Methods Twenty-eight individuals with HCM were randomised into either the intervention or control group. Frequency-domain HRV measures including low frequency power (LF), high frequency power (HF) and LF/HF were recorded at rest using bioimpedance. Non-invasive haemodynamic variables were recorded at rest using bioreactance. Participants in the intervention group consumed 6 mmol of nitrate daily (concentrated beetroot juice) and were instructed to increase and maintain daily PA by ≥ 2000 steps/day above baseline for 16 weeks. Control group participants retained their usual lifestyle and monitored daily step counts. Results There was a significant increase in post-intervention HF power (7.54 ± 2.14 vs 8.78 ± 1.60 ms2, P < .01) and LF power (6.89 ± 2.33 vs 8.17 ± 1.55, P < .01) in the intervention but not in the control group. Resting mean arterial blood pressure (MABP) in the intervention group significantly reduced at follow-up (108 ± 6 vs 102 ± 7 mmHg, P < .01). Conclusions A novel lifestyle intervention including PA and dietary nitrate supplementation enhanced parasympathetic activity and resting MABP in HCM.

TRANSFORMING PERIMENOPAUSAL HEALTH: NUTRITIONAL AND MOVEMENT-BASED INTERVENTIONS

Perimenopause, a transitional phase preceding menopause, signifies a decline in estrogen levels, often manifesting in one's 40s or even 30s, with associated symptoms such as irregular menstrual cycles, hot flashes, mood swings, and altered body composition. These symptoms not only affect quality of life but also pose long-term health risks, including cardiovascular disease, hypertension and osteoporosis. Given the complex hormonal changes during perimenopause, effective interventions are imperative. This study in Ambala, Haryana, aimed to assess the impact of dietary and physical activity interventions on perimenopausal women's health. Fifty women aged 35 to 50, self-reporting perimenopause, underwent a three-month intervention. The experimental group received tailored nutrition and movement guidance, while the control group maintained their usual lifestyle. Noteworthy enhancements were observed in dietary habits, anthropometric measurements, and biochemical parameter in the experimental group. These improvements included increased intake of nutrient-rich foods, reduction in weight, BMI, WC, HC, WHR and improvements in perimenopausal symptoms and related biochemical marker like hypertension. These findings underscore the efficacy of personalized interventions in mitigating perimenopausal symptoms and improving overall health, emphasizing the importance of lifestyle modifications during this transitional phase. This study investigates the effects of dietary and exercise interventions on physical health markers, dietary habits, physical activity levels, BMI and biochemical assessment of perimenopausal women. By exploring the impact of lifestyle modifications, the research aims to alleviate symptoms, enhance quality of life and reduce the risk of lifestyle diseases during this transitional phase.

The role of supervision and motivation during exercise on physical and mental health in older adults: a study protocol for a randomized controlled trial (PRO-Training project)

BackgroundAlthough supervised exercise is frequently recommended for older adults, its superiority over unsupervised exercise remains uncertain. Furthermore, whether motivational techniques could help to enhance the effectiveness of the latter remains to be elucidated. The present randomized controlled trial aims to determine the role of supervision and motivational strategies on the safety, adherence, efficacy, and cost-effectiveness of different exercise programs for improving physical and mental health in older adults.MethodsParticipants (n = 120, aged 60–75 years) will be randomly allocated into five groups: 1-Control (CON), 2-Supervised exercise without motivational intervention (SUP), 3- Supervised exercise with motivational intervention (SUP +), 4- Unsupervised exercise without motivational intervention (UNSUP) and 5- Unsupervised exercise with motivational intervention (UNSUP +). Over 24 weeks, all exercise groups will participate in a multicomponent exercise program three times/week (performed in group classes at a center for SUP and SUP + , or home without supervision but with the help of a mobile app for UNSUP and UNSUP +), while the CON group will maintain their usual lifestyle. The motivational intervention (for SUP + and UNSUP + groups) will be based on the self-determination theory, including strategies such as phone calls, interactive workshops, motivational messages, informative infographics and videos. Primary outcomes will include safety, adherence, costs, and lower-body muscular function using a leg press machine. Secondary outcomes will include upper-body muscular function, physical and cardiorespiratory function, blood pressure and heart rate, body composition, health-related quality of life, cognitive performance, anxiety, depression, physical activity levels, sleep and sedentarism, biochemical markers, motivators and barriers to exercise. Assessments will be conducted at baseline, mid-intervention (i.e., week 13), at the end of the intervention (i.e., week 25), and 24 weeks later (i.e., week 49).DiscussionThe findings of this trial might provide valuable insights into the role of supervision and motivational strategies on the effectiveness of exercise programs for older adults. Additionally, the study could contribute to developing cost-effective interventions, supporting the design of future public policies for healthy aging.Trial registrationNCT05619250. Registered 16 November 2022.

A single all-out bout of 30-s sprint-cycle performed on 5 consecutive days per week over 6weeks does not enhance cardiovascular fitness, maximal strength, and clinical health markers in physically active young adults.

This study examined the effects of a single all-out bout of 30-s sprint-cycle performed daily for 5 consecutive days per week for 6weeks, on aerobic fitness, muscle strength and metabolic-health markers in physically active young males and females. Healthy, physically active 20-28year olds, were randomly assigned to either experimental (EXP, N = 11) or non-training control (CON, N = 8) group. With supervision, the EXP group performed one bout of 30-s sprint-cycle daily, Mondays to Fridays over 6weeks, while CON group continued with their usual lifestyle. The followings were measured at pre- and post-intervention: maximal aerobic power, peak torque of knee extensors and flexors at velocities 30°s-1 and 300°s-1, resting heart rate, resting blood pressure, body fat percentage, fasting lipid profile, fasting blood glucose, and fasting insulin levels. There were no significant improvements in the EXP group for all the measured variables (all P > 0.05); except for significant interaction effects in peak torque of knee extensors at 30°s-1 (P = 0.044) and low-density lipoprotein-cholesterol (P = 0.046). Post hoc test indicate that CON group showed decline in their low-density lipo-proteins levels (P = 0.024). Six weeks of one all-out bout of 30-s sprint-cycle per day, for 5 consecutive days per week, was ineffective in improving cardiovascular fitness, maximal strength, and most health markers in physically active young adults. The present results when combined with the previous literature suggest that there is a possibility of a minimum threshold for a number of sprint-cycle bouts needed to be performed before any form of cardio-metabolic-health benefit is accrued.

The Effect of TRX Training on Liver Enzymes in Middle-Aged Obese Women

Obesity is a global health concern leading to various chronic diseases, including alterations in liver enzymes. This study aimed to investigate the effect of TRX training program on liver enzymes in obese middle-aged women. In this quasi-experimental study, 30 obese women with a BMI above 30 and an average age of 50.00 ± 6.87 years were randomly divided into two groups: TRX (n=15) and control (n=15). The TRX group engaged in TRX training for eight weeks, while the control group maintained their usual lifestyle. Blood samples were collected before and after the intervention to measure liver enzymes. Anthropometric measurements were also taken before and after the intervention. Data were analyzed using ANCOVA to control for pre-test differences and determine post-test differences between groups. The ANCOVA results revealed significant differences in post-test liver enzyme levels between the TRX and control groups, after controlling for pre-test scores. For ALT, F(1, 27) = 12.94, p = 0.001, partial eta squared = 0.324; for AST, F(1, 27) = 10.12, p = 0.003, partial eta squared = 0.273; and for ALP, F(1, 27) = 25.62, p < 0.001, partial eta squared = 0.487, indicating significant improvements in the TRX group compared to the control group. This study demonstrated that eight weeks of TRX training significantly improved liver enzymes ALT, AST, and ALP in obese women. Therefore, TRX training can be an effective intervention for enhancing liver enzyme health.

Does lifestyle modification (physical exercise and listening to music) improve symptoms in patients with a temporomandibular disorder? A randomized clinical trial.

The aim of the study was to compare pain relief in temporomandibular disorder (TMD) patients with or without lifestyle modification. This randomized clinical trial was performed on patients with TMD, who did not regularly exercise or listen to music. The participants were allocated into two groups. In the treatment group, the participants were instructed to exercise five times or more per week (30 minutes per session) and listen to the music of their choice five times or more per week (15 minutes per session) for 12 weeks. In the control group, the participants had their usual lifestyle without any modifications. The participants were examined for clicking and crepitus in the joint and maximum mouth opening before and after the intervention. The pain severity was also documented based on a visual analog scale. Thirty five patients were studied in each group. Twelve weeks after the intervention, the mean pain severity was 2.70 ± 0.73 in the treatment group and 4.63 ± 0.77 in the control group. The results of data analysis demonstrated a significant difference between the two groups regarding the mean pain severity at 12 weeks after the intervention (P <.001). Lifestyle modification through physical exercise and listening to music may reduce pain in TMD patients.

Вплив стресофакторів на стан організму людини та органів і тканин порожнини рота (огляд літератури)

Abstracts. In today’s environment, every citizen of Ukraine is exposed to varying degrees of psycho-emotional and physical stress. It is impossible to underestimate the negative impact of stressors on the tissues and organs of the oral cavity in particular, as quite often the first signs of general pathologies appear in this complex. The aim of the study is to analyse data from scientific literature sources and provide updated information on the impact of psycho-emotional stress on the development of periodontal diseases in the current conditions. Materials and Methods. The bibliosemantic method was used to clarify the state of the problem, to study the analysis of the results of previous scientific research based on the sources of literature and electronic resources. Research results and discussion. The current conditions dictated by the war on the territory of our country is cause a state of permanent stress among the population of Ukraine, which is related to the basic human instinct of survival. In general, a person can be affected by one or more groups of objective causes of stress. The citizens of Ukraine are experiencing severe stress as a result of the ongoing conflict. This includes combatants, relatives and friends of these combatants, civilians living in the area close to the hostilities, the wounded, medical workers, and internally displaced persons. The stress factor provokes the emergence and rapid development of new mental and somatic diseases, it leads to the progression of existing diseases, but the reaction to the stimulus is different for each person and is an individual manifestation. The state of the oral cavity is a very sensitive complex to any changes in the body’s homeostasis, and often the first signs of general pathologies appear in it. Among the significant risk factors that contribute to the development and aggravate the course of periodontal disease, stress is one of the most important. Long-term exposure to stress can suppress the acquired immune response, causing an imbalance between pro-inflammatory and anti-inflammatory factors. Experimental studies in rat glands have demonstrated that acute stress induces dystrophic and necrobiotic changes in the gland, resulting in a reduction in its protein synthesis function. Psychological stress can contribute to disruption of the usual lifestyle, which adversely affects hygiene. Conclusions. After analysing scientific research data and reports on the current state of psycho-somatic health of people in Ukraine in modern realities, it is obvious that the prevalence and intensity of periodontal tissue diseases may have a new negative development. The peculiarities of the development, prevention and treatment of periodontal diseases in people experiencing severe psycho-emotional and sometimes physical stress require additional study and analysis. Key words: psycho-emotional stress, stress factor, periodontium, oral cavity

Protocol For Intervention Study In Reducing Elevated Blood Pressure Through Intermittent Fasting.

To chart out a protocol for conducting an intervention-based study to compare the efficacy of intermittent fasting intervention and usual diet in reducing elevated blood pressure among working adults. The quasi-experimental study with single-blinded parallel groups will comprise subjects from two civil departments. The intervention group will be required to conduct 2 days of fasting and 5 days of ad libitum diet in a week, while the control group will follow the usual healthy lifestyle. The largest sample size will be taken to achieve a power of 80% and an alpha value of 5%. Based on the 30% attrition rate, the total sample size needed in the study will be 140 participants, with 70 in each of the two arms. This study will use SPSS 24 for statistical analysis. The study describes a unique protocol of intermittent fasting mimicking the Muslim Sunnah of fasting among people with elevated blood pressure. The findings will contribute to decrease blood pressure among those with elevated blood pressure. If proven to be effective, the intermittent fasting method would be useful for developing an effective programme to prevent elevated blood pressure among adults. The protocol will contribute to efforts to find whether or not intermittent fasting can improve elevated blood pressure as well as body weight, body mass index, waist circumference and nutrition status among adults. The study was registered with clinicaltrials.gov (NCT04953650).

COVID-19 PANDEMIYASI DAVRIDA TIBBIYOT SOHASIDA AXBOROT KOMMUNIKATSIYA TEXNOLOGIYALARIDAN FOYDALANISHNING HUQUQIY JIHATLARI

Since the introduction of information and telecommunication technologies into the health sector, the demand for medical services has been increasing, and the health system has been developing. In our country and around the world, in early 2020, the severe acute respiratory syndrome coronavirus disease COVID-19 began to spread and the normal life of the whole world came to a standstill. The COVID-19 pandemic has created the need for people around the world to change their usual lifestyle, in particular, self-isolation, staying at home, reducing human activity, including minimizing contact with people. With the spread of the COVID-19 pandemic, the whole world has realized how necessary it is to develop telemedicine services. In this article, we will study the practice of telemedicine and telemedicine services in the period of the COVID-19 pandemic and what laws are regulated by the states, as well as the digitalization in the health sector during the COVID-19 pandemic. The pros and cons of the process of the COVID-19 pandemic, licensing, and its structure process, statistical data provided by the World Health Organization, payment of fees to doctors for these services, procedures of patients using telemedicine services, and directions of telemedicine services are considered in detail.

The "STAR WARS: The First Jedi" Program-Effects of Gamification on Psychological Well-Being of College Students.

Background: College students are particularly susceptible to developing mental health problems. Gamification can be a powerful teaching strategy to favor motivation and behavioral changes for the improvement of psychological well-being. Purpose: To analyze the effect of a 14-week gamification-based physical education teaching program on psychological well-being of college students. Materials and Methods: A total of 112 college students (21.22 ± 2.55 years) were recruited and assigned to a gamification-based group or a control group. The intervention group participated in a gamification-based program under the framework of "STAR WARS" science fiction sage. Participants from this group used a mobile app with a countdown timer and the way for them to gain lifetime was by doing physical activity (PA) and formative challenges. The control group did not experience the gamification approach itself as their classes were based on traditional methodology. They were asked to maintain their usual lifestyle and were not required to do PA. Emotional intelligence, personal initiative, entrepreneurial attitude, resilience, and self-efficacy were self-reported. Results: The gamification-based group showed a significantly higher improvement of emotional intelligence (P ≤ 0.006), personal initiative (P ≤ 0.033), entrepreneurial attitude (P < 0.001), resilience (P = 0.002), and self-efficacy (P < 0.001), compared with the control group. Overall effect sizes were of medium magnitude for emotional intelligence and personal initiative, large magnitude for entrepreneurial attitude, and small magnitude for resilience and self-efficacy. Conclusion: Gamification and the use of mobile apps may become powerful teaching strategies to motivate college students toward healthier lifestyle behaviors that have psychological well-being benefits.

Effect of Voice and Articulation Parameters of a Home-Based Serious Game for Speech Therapy in Children With Articulation Disorder: Prospective Single-Arm Clinical Trial.

Articulation disorder decreases the clarity of language and causes a decrease in children's learning and social ability. The demand for non-face-to-face treatment is increasing owing to the limited number of therapists and geographical or economic constraints. Non-face-to-face speech therapy programs using serious games have been proposed as an alternative. The aim of this study is to investigate the efficacy of home therapy on logopedic and phoniatric abilities in children with articulation disorder using the Smart Speech game interface. This study is a prospective single-arm clinical trial. Children with articulation disorders, whose Urimal Test of Articulation and Phonology (U-TAP) was -2 SDs or less and the Receptive and Expressive Vocabulary Test score was -1 SD or more, were enrolled. A preliminary evaluation (E0) was conducted to check whether the children had articulation disorders, and for the next 4 weeks, they lived their usual lifestyle without other treatments. Prior to the beginning of the training, a pre-evaluation (E1) was performed, and the children trained at home for ≥30 minutes per day, ≥5 times a week, over 4 weeks (a total of 20 sessions). The Smart Speech program comprised oral exercise training, breathing training, and speech training; the difficulty and type of the training were configured differently according to the participants' articulation error, exercise, and vocal ability. After the training, postevaluation (E2) was performed using the same method. Finally, 8 weeks later, postevaluation (E3) was performed as a follow-up. A voice evaluation included parameters such as maximum phonation time (MPT), fundamental frequency (F0), jitter, peak air pressure (relative average perturbation), pitch, intensity, and voice onset time. Articulation parameters included a percentage of correct consonants (PCC; U-TAP word-unit PCC, U-TAP sentence-unit PCC, and three-position articulation test) and alternate motion evaluation (diadochokinesis, DDK). Data obtained during each evaluation (E1-E2-E3) were compared. A total of 13 children with articulation disorders aged 4-10 years were enrolled in the study. In voice parameters, MPT, jitter, and pitch showed significant changes in repeated-measures ANOVA. However, only MPT showed significant changes during E1-E2 (P=.007) and E1-E3 (P=.004) in post hoc tests. Other voice parameters did not show significant changes. In articulation parameters, U-TAP, three-position articulation test (TA), and DDK showed significant changes in repeated-measures ANOVA. In post hoc tests, U-TAP (word, sentence) and TA showed significant changes during E1-E2 (P=.003, .04, and .01) and E1-E3 (P=.001, .03, and .003), and DDK showed significant changes during E1-E2 only (P=.03). Home-based serious games can be considered an alternative treatment method to improve language function. Clinical Research Information Service KCT0006448; https://cris.nih.go.kr/cris/search/detailSearch.do/20119.

Features of the natural course of subclinical hypothyroidism in young athletes

Objective: to assess the natural course of subclinical hypothyroidism in young athletes.Methods: In the prospective single-center uncontrolled study, data from 3,062 outpatient records of young athletes (members of the Russian national team) of both sexes (middle age — 15 [14; 16] years) and underwent medical examination in the period from January 2021 to September 2022 were studied. All athletes were divided into 2 groups according to the presence of subclinical hypothyroidism (an increase in the level of thyroid-stimulating hormone from 5 to 10 mUn/l with a normal level of T4 free). During a dynamic follow-up (1 year), athletes with subclinical hypothyroidism underwent a repeated study of the concentration of thyroid-stimulating hormone, free thyroxine and antibodies to thyroperoxidase.Results: Signs of subclinical hyperthyroidism were found in 58 young athletes (30 boys (51.7 %) and 28 (48.3 %) girls). During dynamic observation with continued habitual physical activity, spontaneous normalization of the level of thyroid-stimulating hormone was observed in 74 % of young athletes. At the same time, normalization of thyroid-stimulating hormone in girls was observed less often compared to boys (p = 0,272). In no case did clinically pronounced hypothyroidism develop.Conclusion: The majority of young male and female athletes with subclinical hypothyroidism have spontaneous normalization of hormonal profile against the background of persistent physical and psycho-emotional stress. The data obtained make it possible, subject to the possibility of dynamic observation, to recommend doctors working with young elite athletes not to prescribe hormonal replacement therapy and not to modify the usual lifestyle.

Music therapy on depression in college students

BackgroundThe incidence of depression among college students is increasing year by year, which has a serious impact on social development. As a non-drug intervention, music therapy can affect individual psychological state through emotional catharsis, emotion regulation and other ways, which has attracted more and more attention in recent years, and is expected to provide an effective auxiliary means for the management of depression in college students.Subjects and MethodsA total of 200 college students were randomly divided into the control group and the experimental group. The students in the control group maintained their usual learning lifestyle. The experimental group received 30 minutes of music therapy four times a week for a total of 8 weeks. Beck Depression Checklist was used to evaluate the degree of depression symptoms, and SPSS statistical software was used to analyze the data.ResultsThe results showed that the mean score of depressive symptoms in the experimental group decreased from 28.4±5.2 before the intervention to 15.2±3.8 after the intervention, while the score of the control group decreased by less than 1 (P&lt; 0.001). The BDI score of the music therapy group was significantly lower than that of the control group (P&lt; 0.05), and the difference was statistically significant.ConclusionsThe results show that music therapy has a significant therapeutic effect on depression intervention of college students, which can effectively reduce the symptoms of depression and improve the emotional state of college students.

Resistance Exercise Program in Cognitively Normal Older Adults: CERT-Based Exercise Protocol of the AGUEDA Randomized Controlled Trial

ObjectivesTo provide a comprehensive CERT (Consensus on Exercise Reporting Template)-based description of the resistance exercise program implemented in the AGUEDA (Active Gains in brain Using Exercise During Aging) study, a randomized controlled trial investigating the effects of a 24-week supervised resistance exercise program on executive function and related brain structure and function in cognitively normal older adults.Design and Participants90 cognitively normal older adults aged 65 to 80 were randomized (1:1) to a: 1) resistance exercise group; or a 2) wait-list control group. Participants in the exercise group (n = 46) performed 180 min/week of resistance exercise (3 supervised sessions per week, 60 min/session) for 24 weeks.InterventionThe exercise program consisted of a combination of upper and lower limb exercises using elastic bands and the participant’s own body weight as the main resistance. The load and intensity were based on the resistance of the elastic bands (7 resistances), number of repetitions (individualized), motor complexity of exercises (3 levels), sets and rest (3 sets/60 sec rest), execution time (40–60 sec) and velocity (as fast as possible).SettingsThe maximum prescribed-target intensity was 70–80% of the participants’ maximum rate of perceived exertion (7–8 RPE). Heart rate, sleep quality and feeling scale were recorded during all exercise sessions. Those in the wait-list control group (n = 44) were asked to maintain their usual lifestyle. The feasibility of AGUEDA project was evaluated by retention, adherence, adverse events and cost estimation on the exercise program.Results and ConclusionsThis study details the exercise program of the AGUEDA trial, including well-described multi-language manuals and videos, which can be used by public health professionals, or general public who wish to implement a feasible and low-cost resistance exercise program. The AGUEDA exercise program seems to be feasible by the high retention (95.6%) and attendance rate (85.7%), very low serious adverse event (1%) and low economic cost (144.23 € /participant/24 weeks). We predict that a 24-week resistance exercise program will have positive effects on brain health in cognitively normal older adults.

War-Related Life-Making Landscapes: Ukrainian Context

The full-scale military invasion has changed the lives of all Ukrainians forever. The necessity to understand how the traumatic experiences of the first months of the war affected people’s ability of life-making, how it changed this ability was the reason for conducting this study. In April–May 2022, 169 respondents wrote essays based on 4 questions about their experience. The sample consisted of 78% women, 22% men (age M = 43.2, SD = 12), 43.2% had personal experience of being under fire. Descriptive and interpretative analyses, multiple correspondence analyses, and comparative analyses were conducted to identify key variables, types of life-making landscapes, and their possible correlations. The landscape of service (27.8%), care (23.7%), and existential landscape (24.3%) were the most spread. More than half of respondents (54.4%) described the experience of losses of relationship, usual lifestyle, home or earnings. In addition, 16.6% mentioned feeling of guilt. The trajectories of the value-time dynamics that set the type of landscape during war differ from that revealed during the pandemic. The loss of relationships is mentioned most often and the most painful part of the guilt experience is the feeling of helplessness in relation to loved ones. A passive or active position in responding to events and multi-contextual or narrow individual perception of the situation turned out to be the most important for a respondent’s place in the psychological space of the studied variables. Limitations and perspectives are discussed.

Cost-effectiveness and potential budget impact of non-pharmacological interventions for early management in prehypertensive people: an economic evaluation for China

BackgroundNon-pharmacological interventions (NPIs) could be considered in the early management of prehypertensive population. This study aimed to evaluate the potential cost-effectiveness of NPIs and the budget impact of implementing NPIs on prehypertensive population in China and provide evidence of chronic disease management innovation for decision-makers.MethodsFive NPIs including usual care, lifestyle, strengthen exercise, relaxation, and diet therapy were selected based on the practice of hypertension management in China. A nine-state Markov model was constructed to evaluate the lifetime costs and health outcomes of five NPIs and a non-intervention group from the perspective of Chinese healthcare system. The effectiveness of NPIs was obtained from a published study. Parameters including transition probabilities, costs and utilities were extracted or calculated from published literature and open-access databases. Sensitivity analyses were conducted to test the uncertainty of all parameters. The impact of duration of intervention was considered in scenario analyses. A budget impact analysis (BIA) was conducted to evaluate the total cost and the medical cost saving of a hypothetical nationwide implementation of potential cost-effective NPI in prehypertensive people. Management strategies including focusing on patients with specific ages or different CVE risk levels, and different duration of implementation were taken into consideration.ResultsStrengthen exercise was the most cost-effective intervention with a probability of 78.1% under the given WTP threshold. Our results were sensitive to the cost of interventions, and the utility of prehypertension and hypertension. The duration of implementation had limited impact on the results. BIA results showed that the program cost was hefty and far more than the medical cost saving with the course of simulation time. Applying management strategies which focused on individual characteristics could largely reduce the program cost despite it remained higher than medical cost saving.ConclusionsStrengthen exercise was a potential NPI that can be considered in priority for early management in prehypertensive population. Although early management can acquire medical cost saving, the related program cost can be quite hefty. Precise strategies which may help reduce the cost of early management should be taken into consideration in program design.

Results of preoperative application of micronised purified flavonoid fraction as part of a multimodal analgesic regimen in anorectal surgery: a prospective, randomised, placebo-controlled, double-blind study

This study aims to assess the efficiency of micronised purified flavonoid fraction (MPFF) administration prior to open haemorrhoidectomy on postoperative pain severity reduction.Methods. The prospective clinical study involved patients with haemorrhoidal disease. Participants were randomly divided into two groups: the first one received 1000 mg of MPFF (Detralex®) 15 days before surgery, seven days after surgery, according to the acute haemorrhoid treatment scheme, and 1000 mg per day until 30 days after surgery; the second one received a placebo. The primary endpoint was the frequency of opioid intake.Results. The study included 182 participants (102 and 82 in the experimental and control group, respectively). Postoperative pain at rest and during defecation was significantly lower in the experimental group on days 6—9 postoperatively (p &lt; 0.05). The use of opioids and other NSAIDs after surgery did not differ between groups. There was no significant difference between groups in side effects frequency and time to return to the usual lifestyle. As for the quality of life, the control group had significantly higher levels of self-care difficulty, anxiety and lingering pain/discomfort, being more likely to suffer from other persistent complaints.Conclusion. The preoperative administration of MPFF as analgesia has demonstrated safety and efficacy, effectively reducing postoperative pain in anorectal surgery while avoiding an increase in side effects. Hence, it is recommended for routine implementation in patient care as an essential component of multimodal analgesia during anorectal surgery.

Effects of the COVID-19 Pandemic on Pediatric and Adolescent ASCVD Risk Factors.

In this review, we provide insight into and raise awareness of the impact of the COVID-19 pandemic on the prevalence of acquired atherosclerotic cardiovascular disease (ASCVD) risk factors in adolescents. We highlight data that could be used to guide the response to a future pandemic with the goal of reducing premature cardiovascular disease (CVD)-related morbidity and premature mortality. During the global COVID-19 pandemic, many individuals, including youth, voluntarily or were mandated to alter the usual lifestyle in order to limit exposure and reduce the spread of the virus. Some of these changes resulted in unintended consequences, particularly acquisition of risk factors such as excessive weight gain, insulin resistance/diabetes, and dyslipidemia, commonly associated with ASCVD. A study from China examined changes in the prevalence of obesity and found a 2.4% rise attributable to the pandemic. Adequate daily physical activity plays an important role in ASCVD risk reduction. A systematic review and meta-analysis showed a 20% (90% CI, -34 to -4%) reduction in physical activity from before vs. during the COVID-19 pandemic. Another study of patients with type 2 diabetes found the mean HbA1c was significantly elevated during the COVID-19 pandemic (7.53 ± 1.02% in 2020) compared with the previous 2 years. In addition, there has been an alarming rise of childhood mental health concerns and suicide during the pandemic. Early identification and optimum management of CVD risk factors play an important role helping prevent future cardiovascular disease. Following the rapid spread of the virus, the World Health Organization (WHO) officially declared COVID-19 a global pandemic on March 11th, 2020. In an attempt to avoid infection and reduce the spread of the virus, many alterations in lifestyle were adopted on an international scale. While necessary, these modifications resulted in many adverse unintended health consequences in children and adolescents. This paper reviews the impact of the pandemic and the associated lifestyle changes on the prevalence of acquired atherosclerotic cardiovascular disease (ASCVD) risk factors in youth. In addition to providing insight, we hope to raise awareness of the pandemic's impact, and highlight specific data that could be used to guide the response to a future pandemic.

Effects of a back school-based intervention on non-specific low back pain in adults: a randomized controlled trial

BackgroundNon-specific low back pain is a common condition with significant global prevalence and socio-economic impact. Back School programs, which combine exercise and educational interventions, have been used to address back pain. This study aimed to investigate the effects of a Back School-based intervention on non-specific low back pain in adults. Secondary objectives included evaluating the impact of the program on disability, quality of life, and kinesiophobia.MethodsA randomized controlled trial was conducted involving 40 participants with non-specific low back pain, who were divided into two groups. The experimental group underwent an 8-week Back School-based program. The program comprised 14 practical sessions focusing on strengthening and flexibility exercises, along with two theoretical sessions covering anatomy and concepts related to a healthy lifestyle. The control group maintained their usual lifestyle. Assessment instruments included the Visual Analogue Scale, Roland Morris disability questionnaire, Short-Form Health Survey-36, and Tampa Scale of Kinesiophobia.ResultsThe experimental group showed significant improvements in the Visual Analogue Scale, Roland Morris disability questionnaire, physical components of the Short-Form Health Survey-36, and Tampa Scale of Kinesiophobia. However, there were no significant improvements in the psychosocial components of the Short-Form Health Survey-36. In contrast, the control group did not show significant results in any of the study variables.ConclusionsThe Back School-based program has positive effects on pain, low back disability, physical components of quality of life, and kinesiophobia in adults with non-specific low back pain. However, it does not appear to improve the participants' psychosocial components of quality of life. Healthcare professionals can consider implementing this program to help reduce the significant socio-economic impact of non-specific low back pain worldwide.Trial registrationNCT05391165 (registered prospectively in ClinicalTrials.gov: 25/05/2022).