scholarly journals Is long-bout sedentary behaviour associated with long-term glucose levels 3 months after acute ischaemic stroke? A prospective observational cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037475
Author(s):  
Katinka Nordheim Alme ◽  
Anne-Brita Knapskog ◽  
Halvor Næss ◽  
Mala Naik ◽  
Mona Beyer ◽  
...  
Keyword(s):  
Cohort Study ◽  
Ischaemic Stroke ◽  
Sedentary Behaviour ◽  
Sedentary Time ◽  
The Body ◽  
Future Research ◽  
Activity Data ◽  
Glucose Levels ◽  
Link Type

Background and purposeSedentary behaviour is a risk factor for vascular disease and stroke patients are more sedentary than their age-matched peers. The association with glucose levels, as a potential mediator, is unclear, and we have investigated the association between long-bout sedentary behaviour and long-term glucose levels in stroke survivors.MethodsThis study uses data from the Norwegian Cognitive Impairment After Stroke study, a multicentre cohort study. The patients were recruited at hospital admission for acute stroke, and the follow-up was done at the outpatient clinic. Sedentary behaviour—being in a sitting or reclining position—was registered 3 months after stroke using position transition data from the body-worn sensor activPAL attached to the unaffected thigh. A MATLAB script was developed to extract activity data from 08:00 to 10:00 for 4 days and to categorise the data into four bout-length categories. The primary outcome was glycated haemoglobin (HbA1c), analysed at 3 months. Regression models were used to analyse the association between HbA1c and sedentary behaviour in the whole population and stratified based on a diagnosis of diabetes mellitus (DM). Age, body mass index and the use of antidiabetic drugs were added as covariates into the models.ResultsFrom a total of 815 included patients, 379 patients fulfilled the inclusion criteria for this study. We found no association between time in sedentary behaviour and HbA1c in the whole stroke population. We found time in sedentary behaviour in bouts of ≥90 min to be associated with a higher HbA1c in patients with DM.ConclusionLong-bout sedentary time is associated with a higher HbA1c in patients with DM 3 months after ischaemic stroke. Future research should investigate the benefit of breaking up sedentary time as a secondary preventive measure.Trial registration numberNCT02650531, https://clinicaltrials.gov/ct2/show/NCT02650531

Dams: Effects of Hydrological Infrastructure on Development

2019 ◽  
Vol 11 (1) ◽  
pp. 125-148
Author(s):  
Andrew Dillon ◽  
Ram Fishman
Keyword(s):  
Economic Development ◽  
Flood Control ◽  
The Body ◽  
Future Research ◽  
Emerging Issues ◽  
Potential Benefits ◽  
The Impact ◽  
Benefits And Costs ◽  
Distributional Impacts

Hydrological investments, particularly irrigation dams, have multiple potential benefits for economic development. Dams also have financial, environmental, and distributional impacts that can affect their benefits and costs. This article reviews the evidence on the impact of dams on economic development, focusing on the levels and variability of agricultural productivity, and its effect on poverty, health, electricity generation, and flood control. We also review the evidence on irrigation efficiency and collective action of dam maintenance. Throughout the discussion, we highlight the empirical challenges that restrict the body of causally interpretable impact estimates and areas in which the evidence is particularly thin. We conclude with a discussion of emerging issues pertaining to the long-term sustainability of dams’ impacts and suggest directions for future research.

Effective Inpatient and Outpatient Models of Treatment for Adolescents With Substance Use Disorders

2018 ◽  
pp. 760-786
Author(s):  
Marianne Pugatch ◽  
John R. Knight ◽  
Sarah Copelas ◽  
Tatiana Buynitsky ◽  
J. Wesley Boyd
Keyword(s):  
The Body ◽  
Treatment Programs ◽  
Future Research ◽  
Developmental Needs ◽  
Need For Treatment ◽  
Treatment Research ◽  
Day Hospitals ◽  
Therapeutic Schools ◽  
Outpatient Settings

This chapter provides an overview of the physical, psychological, and brain development of the adolescent, establishing the need for treatment tailored to their unique developmental needs. It also defines the goals and phases of treatment, describes the continuum of care and contextualizes the body of effectiveness treatment research. The chapter reviews the evidence based literature on inpatient and outpatient settings including short-term detoxification, acute and long-term residential care, sober houses, therapeutic schools, day hospitals, intensive outpatient as well as outpatient approaches. Overall, studies indicate that treatment in youth has small to moderate effects. The chapter concludes with recommendations for what professionals and parents should look for in treatment programs for adolescent clients and discusses future research and policy recommendations.

Effect of bariatric surgery on long-term cardiovascular outcomes: a nationwide nested cohort study

2020 ◽  
Vol 41 (28) ◽  
pp. 2660-2667 ◽  
Author(s):  
Osama Moussa ◽  
Maddalena Ardissino ◽  
Tobias Heaton ◽  
Alice Tang ◽  
Omar Khan ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Bariatric Surgery ◽  
Cohort Study ◽  
Ischaemic Stroke ◽  
Cardiovascular Events ◽  
Cardiovascular Outcomes ◽  
Incident Heart Failure ◽  
Fatal Myocardial Infarction

Abstract Aims  This study aims to evaluate the long-term effect of bariatric surgery on cardiovascular outcomes of patients with obesity. Methods and results  A nested cohort study was carried out within the Clinical Practice Research Datalink. The study cohort included the 3701 patients on the database who had undergone bariatric surgery and 3701 age, gender, and body mass index-matched controls. The primary endpoint was the composite of fatal or non-fatal myocardial infarction and fatal or non-fatal ischaemic stroke. Secondary endpoints included fatal or non-fatal myocardial infarction alone, fatal or non-fatal ischaemic stroke alone, incident heart failure, and mortality. The median follow-up achieved was 11.2 years. Patients who had undergone bariatric surgery had a significantly lower occurrence of major adverse cardiovascular events [hazard ratio (HR) 0.410, 95% confidence interval (CI) 0.274–0.615; P < 0.001]. This was mainly driven by a reduction in myocardial infarction (HR 0.412, 95% CI 0.280–0.606; P < 0.001) and not in acute ischaemic stroke (HR 0.536, 95% CI 0.164–1.748; P = 0.301). A reduction was also observed in new diagnoses of heart failure (HR 0.403, 95% CI 0.181–0.897; P = 0.026) and mortality (HR 0.254, 95% CI 0.183–0.353; P < 0.001). Conclusion  The results of this large, nationwide cohort study support the association of bariatric surgery with lower long-term risk of major cardiovascular events and incident heart failure in patients with obesity.

scholarly journals Child Growth Curves in High-Altitude Ladakh: Results from a Cohort Study

2020 ◽  
Vol 17 (10) ◽  
pp. 3652
Author(s):  
Wen-Chien Yang ◽  
Chun-Min Fu ◽  
Bo-Wei Su ◽  
Chung-Mei Ouyang ◽  
Kuen-Cheh Yang
Keyword(s):  
Cohort Study ◽  
High Altitude ◽  
Body Height ◽  
Child Growth ◽  
Growth Patterns ◽  
World Health ◽  
Future Research ◽  
Growth Standards ◽  
Z Scores

High prevalence of child underweight and stunting in high-altitude areas has often been reported. However, most previous studies on this topic were cross-sectional. Another critical concern is that using the World Health Organization (WHO) Child Growth Standards to evaluate child growth in high-altitude areas may lead to overestimations of underweight and stunting. Our study aimed to evaluate the long-term growth pattern of children (3 to 18 years) above the altitude of 3500 m in Ladakh, India. The participants’ body weight (BW), body height (BH), and body mass index (BMI) were measured annually according to the WHO Child Growth Standards for children under 5 years old and the WHO reference data for children aged 5 to 19 years. The generalized estimating equation (GEE) was used to estimate the means and z-scores of BW, BH, and BMI at different ages. A total of 401 children were enrolled from 2012 to 2018. Their mean z-scores of BW, BH, and BMI were −1.47, −1.44, and −0.85 in 2012 and increased to −0.74, −0.92, and −0.63 in 2018. This population’s specific growth curve was also depicted, which generally fell below the 85th percentile of the WHO standards. This is the first cohort study about long-term child growth patterns in a high-altitude area. The detailed underlying mechanisms of our findings need future research on more representative data of high-altitude populations.

Loneliness is strongly linked to depression among older adults, a long term study suggests

BMJ ◽  
2021 ◽  
pp. n2524
Author(s):  
Helen Saul ◽  
Deniz Gursul
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Depressive Symptoms ◽  
Population Based ◽  
Term Study ◽  
Link Type ◽  
Long Term Study

The study Lee SL, Pearce E, Ajnakina O, et al. The association between loneliness and depressive symptoms among adults aged 50 years and older: a 12-year population-based cohort study. Lancet Psychiatry 2021;8:1. To read the full NIHR Alert go to https://evidence.nihr.ac.uk/alert/loneliness-strongly-linked-depression-older-adults/

scholarly journals Are context-specific measures of parental-reported physical activity and sedentary behaviour associated with accelerometer data in 2–9-year-old European children?

2014 ◽  
Vol 18 (5) ◽  
pp. 860-868 ◽  
Author(s):  
Vera Verbestel ◽  
Stefaan De Henauw ◽  
Karin Bammann ◽  
Gianvincenzo Barba ◽  
Charalambos Hadjigeorgiou ◽  
...  
Keyword(s):  
Physical Activity ◽  
Sedentary Behaviour ◽  
Sedentary Time ◽  
Sports Participation ◽  
Cross Sectional Study ◽  
Future Research ◽  
Accelerometer Data ◽  
Cross Sectional ◽  
Context Specific ◽  
Outdoor Playtime

AbstractObjectiveThe aim of the present study was to investigate if context-specific measures of parental-reported physical activity and sedentary behaviour are associated with objectively measured physical activity and sedentary time in children.DesignCross-sectional study.SettingSeven European countries taking part in the IDEFICS (Identification and Prevention of Dietary- and Lifestyle-induced Health Effects in Children and Infants) study.SubjectsData were analysed from 2–9-year-old children (n 5982) who provided both parental-reported and accelerometer-derived physical activity/sedentary behaviour measures. Parents reported their children’s daily screen-time, weekly sports participation and daily outdoor playtime by means of the Outdoor Playtime Checklist (OPC) and Outdoor Playtime Recall Questions (OPRQ).ResultsSports participation, OPC- and OPRQ-derived outdoor play were positively associated with accelerometer-derived physical activity. Television viewing and computer use were positively associated with accelerometer-derived sedentary time. All parental-reported measures that were significantly associated with accelerometer outcomes explained only a minor part of the variance in accelerometer-derived physical activity or sedentary time.ConclusionsParental-reported measures of physical activity and sedentary behaviour are not useful as a proxy for 2–9-year-old children’s physical activity and sedentary time. Findings do not preclude the use of context-specific measures but imply that conclusions should be limited to the context-specific behaviours that are actually measured. Depending on the aim of the study, future research should carefully consider the choice of measurements, including the use of subjective or objective measures of the behaviour of interest or a combination of both.

scholarly journals Long-term mortality and recurrent vascular events in lacunar versus non-lacunar ischaemic stroke: A cohort study

2021 ◽  
pp. 239698732110620
Author(s):  
Suzanne Portegijs ◽  
Ariel Y Ong ◽  
Nynke Halbesma ◽  
Aidan Hutchison ◽  
Cathie LM Sudlow ◽  
...  
Keyword(s):  
Cohort Study ◽  
Ischaemic Stroke ◽  
Cox Regression ◽  
Small Vessel Disease ◽  
Recurrent Stroke ◽  
Vascular Events ◽  
All Cause Mortality ◽  
One Year ◽  
Long Term Mortality

Introduction Studies of differences in very long-term outcomes between people with lacunar/small vessel disease (SVD) versus other types of ischaemic stroke report mixed findings, with limited data on myocardial infarction (MI). We investigated whether long-term mortality, recurrent stroke and MI risks differ in people with versus without lacunar/SVD ischaemic stroke. Patients and methods We included first-ever strokes from a hospital-based stroke cohort study recruited in 2002–2005. We compared risks of death, recurrent stroke and MI during follow-up among lacunar/SVD versus other ischaemic stroke subtypes using Cox regression, adjusting for confounding factors. Results We included 812 participants, 283 with lacunar/SVD ischaemic stroke and 529 with other stroke. During a median of 9.2 years (interquartile range 3.1–11.8), there were 519 deaths, 181 recurrent strokes and 79 MIs. Lacunar/SVD stroke was associated with lower mortality (adjusted HR 0.79, 95% CI 0.65 to 0.95), largely due to markedly lower all-cause mortality in the first year. From one year onwards this difference attenuated, with all-cause mortality only slightly and not statistically significantly lower in the lacunar/SVD group (0.86, 95% CI 0.70 to 1.05). There was no clear difference in risk of recurrent stroke (HR 0.84, 95% CI 0.61–1.15) or MI (HR 0.83, 95% CI 0.52–1.34). Conclusion Long-term risks of all-cause mortality, recurrent stroke and MI are similar, or only slightly lower, in patients with lacunar/SVD as compared to other ischaemic stroke. Patients and physicians should be as vigilant in optimising short- and long-term secondary prevention of vascular events in lacunar/SVD as for other stroke types.

scholarly journals Persistent Post-COVID-19 Syndrome in Hemodialyzed Patients—A Longitudinal Cohort Study from the North of Poland

2021 ◽  
Vol 10 (19) ◽  
pp. 4451
Author(s):  
Aleksander Och ◽  
Piotr Tylicki ◽  
Karolina Polewska ◽  
Ewelina Puchalska-Reglińska ◽  
Aleksandra Parczewska ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
The Body ◽  
Longitudinal Cohort Study ◽  
Health Consequences ◽  
Longitudinal Cohort ◽  
Persistent Symptoms ◽  
The North

Background: After recovery from COVID-19, patients frequently face so-called “Post-COVID-19 Syndrome” defined by clusters of persistent symptoms lasting for >12 weeks which may arise from any system in the body. The long-term health consequences of COVID-19 in maintenance hemodialyzed (HD) patients remain to be investigated. Methods: In this longitudinal cohort study we described the health consequences in HD patients requiring hospitalization due to COVID-19. They were interviewed three and six months (M3 and M6) after discharge with a series of standardized questionnaires. Results: Of 144 HD patients discharged from the 7th Naval Hospital in Gdansk, 79 participants were enrolled, 39 m (49.4%) and 40 f (50.6%) with a median age of 70.0 (64.0–76.5) and an HD vintage of 40 months (17.5–88). After discharge, 93.7% and 81% reported at least one persistent symptom at M3 and M6, respectively. The most common symptoms were fatigue or muscle weakness (60.76% and 47.04%) and palpitations (40.51% and 30.14%). Dyspnea with an mMRC scale grade of at least 1 was reported by 21.5% before infection, and by 43.03% and 34.25% at M3 and M6, respectively. A decrease in the quality of life was reported in all domains of the EQ-5D-5L questionnaire but mainly in the pain/discomfort and anxiety dimensions. Mean EQ-VAS scores were 69.05, 61.58 and 64.38, respectively. Conclusion: Our study showed that HD patients may still experience persistent symptoms six months after recovery from COVID-19, which can further reduce their already poor health-related quality of life. This study highlights the need for long-term follow-up on these patients for diagnostic and rehabilitation programs.

scholarly journals Prevalence and long-term clinical significance of intracranial atherosclerosis after ischaemic stroke or transient ischaemic attack: a cohort study

BMJ Open ◽  
2013 ◽  
Vol 3 (10) ◽  
pp. e003724 ◽  
Author(s):  
Christian Ovesen ◽  
Annemette Abild ◽  
Anders Fogh Christensen ◽  
Sverre Rosenbaum ◽  
Christine Krarup Hansen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Ischaemic Stroke ◽  
Clinical Significance ◽  
Transient Ischaemic Attack ◽  
Intracranial Atherosclerosis ◽  
Ischaemic Attack

1349Effect of bariatric surgery on long-term cardiovascular outcomes in patients with obesity: a nation-wide nested cohort study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Ardissino ◽  
O M Moussa ◽  
A R Tang ◽  
T Heaton ◽  
P Ziprin ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Bariatric Surgery ◽  
Cohort Study ◽  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
All Cause Mortality ◽  
Secondary Endpoints ◽  
Fatal Myocardial Infarction

Abstract Background Obesity is a cardinal risk factor for the development of atherosclerotic cardiovascular disease. Bariatric surgery is an effective method of achieving weight reduction and improving control of cardiovascular risk factors in patients with obesity. However, the effect of bariatric surgery on long-term cardiovascular outcomes has yet to be defined. Purpose The aim of this study is to evaluate the effect of bariatric surgery on long-term risk of major adverse cardiovascular events in a large population of patients with obesity. Methods A nested cohort study was carried out; including the 3,701 patients of the Clinical Practice Research Datalink database who had undergone bariatric surgery, and 3,701 age, gender and BMI matched controls. The primary endpoint was the composite of fatal or non-fatal myocardial infarction; and fatal or non-fatal acute ischaemic stroke. Secondary endpoints included all-cause mortality, new diagnosis of heart failure, fatal or non-fatal myocardial infarction, and fatal or non-fatal acute ischaemic stroke. Data was analysed using a Cox proportional hazards model to account for multiple covariates. Results Patients were followed up for a median of 11.2 years; 20.3% of the population were female, the median age was 36 years and median BMI was 40.4 kg/m2. Patients who had undergone bariatric surgery had a significantly lower occurrence of the primary composite outcome (HR 0.450; 95% CI 0.312–0.671, p<0.001, NNT=62); this was driven by a reduction in myocardial infarction (HR 0.444; 95% CI 0.302–0.654, p<0.001, NNT=64) and not in acute ischaemic stroke (HR 0.528; 95% CI 0.159–1.751, p=0.296). A significant reduction was observed in rates all-cause mortality (HR 0.254; 95% CI 0.183–0.353; p<0.001, NNT=27) and of new diagnosis of heart failure (HR 0.519; 95% CI 0.311–0.864, p=0.012, NNT=153). Table 1. Primary and secondary endpoints during follow-up Events No Bariatric Surgery Bariatric Surgery HR 95% CI p (n=3,701) (n=3,701) Primary endpoint 93 37 0.458 0.312–0.671 <0.001 Secondary endpoints   All-cause mortality 182 45 0.254 0.183–0.353 <0.001   Heart failure 46 22 0.519 0.311–0.864 0.012   Fatal or non-fatal myocardial infarction 93 36 0.444 0.302–0.654 <0.001   Fatal or non-fatal ischaemic stroke 9 4 0.528 0.159–1.751 0.296 Adjusted primary endpoint rates Conclusion The results of this large, nation-wide nested cohort study support the role of bariatric surgery in reducing the risk of major cardiovascular events, all-cause mortality and new onset of heart failure in patients with obesity.

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