scholarly journals Understanding Matters of the Mind in Obesity

2021 ◽  
Vol 47 (5) ◽  
pp. 22-26
Author(s):  
Adrian Toh
Keyword(s):  
Readiness To Change ◽  
Lifestyle Changes ◽  
Health Conditions ◽  
Obesity Management ◽  
Global Epidemic ◽  
Cognitive Behavioural ◽  
Increased Risk ◽  
Psychological Comorbidities ◽  
Global Concern ◽  
The Mind

Obesity is a growing global concern, and Singapore is not spared from the global epidemic. Apart from the increased risk for many serious diseases and health conditions, obese individuals are vulnerable to many psychological comorbidities. Obesity management through lifestyle changes can be limited by various barriers, increasing the challenge of implementation and leaving some clinicians feeling frustrated and stressed. The paper examines the barriers identified in the literature, discusses the use of cognitive behavioural concepts and techniques to facilitate the lifestyle change process and explores the use of motivation and readiness to change to guide the clinician’s strategies.

Outcomes of a digitally delivered, culturally-sensitive behaviour change platform for BAME adults with type 2 diabetes: 1 year health and engagement outcomes (Preprint)

2020 ◽  
Author(s):  
Charlotte Summers
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
Health Outcomes ◽  
Behavioural Change ◽  
Culturally Sensitive ◽  
Lifestyle Changes ◽  
Haemoglobin A1c ◽  
Central Asian ◽  
Increased Risk

BACKGROUND People from Black, Asian and Minority Ethnic (BAME) groups are known to have an increased risk of developing type 2 diabetes and face greater barriers to accessing healthcare resources compared to their “white British” counterparts. The main mediators of lifestyle behavioural change are gender, generation, geography, genes, God/religion, and gaps in knowledge and economic resources. Dietary and cultural practices of these individuals significantly vary according to gender, generation, geographical origin and religion. Recognition of these factors and implementing culturally sensitive interventions for type 2 diabetes prevention and management is essential in increasing knowledge of healthy eating, engagement in physical activity and improving health outcomes in BAME communities. Few health apps are tailored for BAME populations, and BAME communities are considered hard-to-reach. OBJECTIVE Our objective was to establish whether the Low Carb Program is a viable scalable solution that can be used as an effective tailored type 2 diabetes intervention for BAME communities. We hypothesized that by taking into account cultural sensitivities, providing the platform in native languages and personalising the platform in accordance with known barriers to health disparities including gender, generation, dietary preferences and religion, the app would engage BAME communities and improve type 2 diabetes related health outcomes. METHODS The study used a quasi-experimental research design comprised of an open-label, single-arm, pre-post intervention using a sample of convenience. All 705 adults with type 2 diabetes who had activated their referral to the Low Carb Program as a result of an NHS consultation between September 2018 and March 2019 were followed for a period of 12 months; mean age 54.61 (SD 16.69) years; 58.2% (410/705) women; 45.1% (318/705) white, 28.5% (201/705) Indian/Pakistani/Bangladeshi/Other Central Asian, 10.8% (76/705) Arab, 6.2% (44/705) Mixed/Multiple ethnic groups, 6% (43/705) black, 1.8% (13/705) other, (7/705) 1% Chinese/Japanese/Other East Asian. Mean starting glycated haemoglobin A1c (HbA1c) 7.99% (SD 2.05%); mean body weight 88.96kg (SD 23.25kg). RESULTS Of the 705 study participants, 513 (72.76%) had completed the Low Carb Program at 12 months. There were statistically significant reductions in body weight and HbA1c in white, Indian/Pakistani/Bangladeshi/Other Central Asian, Arabic and black participants with the most significant differences in the Indian/Pakistani/Bangladeshi/Other Central Asian population HbA1c -1.18% (SD 1.49%) and weight 8.03kg (SD 10.65kg). 82.9% of all participants (419/705) of all participants lost at least 5% of their body weight. CONCLUSIONS Offering the culturally tailored Low Carb Program that empowers members to make dietary and lifestyle changes to different BAME groups is an effective and engaging tool in the management of type 2 diabetes. Most importantly, BAME populations in particular people from Indian/Pakistani/Bangladeshi and Arabic groups who achieve better health outcomes than their white counterparts.

scholarly journals Role of occupational therapy in musicians’ health: a scoping review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040922
Author(s):  
Bethany Villas ◽  
Uira Duarte Wisnesky ◽  
Sandra Campbell ◽  
Lauren Slavik ◽  
Amynah S. Mevawala ◽  
...  
Keyword(s):  
Occupational Therapy ◽  
Scoping Review ◽  
Health Conditions ◽  
Study Selection ◽  
Increased Risk ◽  
Scoping Reviews ◽  
Review Protocol ◽  
And Performance ◽  
Meta Analyses

Review question/objectiveThe purpose of this proposed review is twofold: first, to understand the role of occupational therapy presented in the musicians’ health literature; and second, to explore the potential for this role.IntroductionThe intense movement, awkward postures, concentration and emotional communication required of musicians can place them at increased risk of music-related health conditions, such as musculoskeletal disorders and performance anxiety. The development of music-related health conditions can be emotionally and financially devastating. The role of occupational therapy in musicians’ health has been previously discussed; however, no rigorous reviews of the scholarly literature have been published. We will, therefore, undertake a scoping review with the following research questions: (1) what is known about the role of occupational therapy in instrumental musicians’ health? and (2) what is the potential role of occupational therapy in musicians’ health?Methods and analysisA preliminary search of Medline, CINAHL, SCOPUS and Web of Science was previously undertaken by the first author to determine the extent of the research on this topic and to confirm that no other reviews have been conducted or are in progress. Study selection and analysis will follow the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines for conducting a scoping review.Ethics and disseminationFormal ethics approval is not required at our institution for a review of published literature. The results of this review will be shared through peer-reviewed publications, conference presentations and traditional and social media.

scholarly journals Causes of death and comorbidities in hospitalized patients with COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sefer Elezkurtaj ◽  
Selina Greuel ◽  
Jana Ihlow ◽  
Edward Georg Michaelis ◽  
Philip Bischoff ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Causes Of Death ◽  
Pulmonary Infection ◽  
Diffuse Alveolar Damage ◽  
University Hospital ◽  
Health Conditions ◽  
Teaching Hospitals ◽  
Increased Risk ◽  
Clinical Records ◽  
Full Body

AbstractInfection by the new corona virus strain SARS-CoV-2 and its related syndrome COVID-19 has been associated with more than two million deaths worldwide. Patients of higher age and with preexisting chronic health conditions are at an increased risk of fatal disease outcome. However, detailed information on causes of death and the contribution of pre-existing health conditions to death yet is missing, which can be reliably established by autopsy only. We performed full body autopsies on 26 patients that had died after SARS-CoV-2 infection and COVID-19 at the Charité University Hospital Berlin, Germany, or at associated teaching hospitals. We systematically evaluated causes of death and pre-existing health conditions. Additionally, clinical records and death certificates were evaluated. We report findings on causes of death and comorbidities of 26 decedents that had clinically presented with severe COVID-19. We found that septic shock and multi organ failure was the most common immediate cause of death, often due to suppurative pulmonary infection. Respiratory failure due to diffuse alveolar damage presented as immediate cause of death in fewer cases. Several comorbidities, such as hypertension, ischemic heart disease, and obesity were present in the vast majority of patients. Our findings reveal that causes of death were directly related to COVID-19 in the majority of decedents, while they appear not to be an immediate result of preexisting health conditions and comorbidities. We therefore suggest that the majority of patients had died of COVID-19 with only contributory implications of preexisting health conditions to the mechanism of death.

scholarly journals An integrated motivational interviewing and cognitive-behavioural intervention promoting physical activity maintenance for adults with chronic health conditions: A feasibility study

2018 ◽  
Vol 15 (4) ◽  
pp. 276-292
Author(s):  
Sarah E Scott ◽  
Jeff D Breckon ◽  
Robert J Copeland
Keyword(s):  
Physical Activity ◽  
Motivational Interviewing ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Behavioural Intervention ◽  
Chronic Health ◽  
Cognitive Behavioural ◽  
Cognitive Behavioural Intervention ◽  
Physical Activity Maintenance

Objectives Physical activity is recommended for managing chronic health conditions but is rarely maintained. This feasibility study aimed to evaluate the preliminary efficacy of a motivational interviewing and cognitive-behavioural intervention for long-term physical activity for adults with chronic health conditions. Methods Participants ( N = 37) with stable conditions (e.g. diabetes) were randomized into a three-month motivational interviewing and cognitive-behavioural group ( N = 20) or usual care ( N = 17) after completing a physical activity referral scheme. Participants completed physical activity (e.g. average steps per day and kilocalorie expenditure), psychological (e.g. self-efficacy) and epidemiological (e.g. body mass index) standardized measures at baseline, three- and six-month follow-up. Treatment fidelity and feasibility were assessed. Results Thirty-five participants completed the study (96% retention). The motivational interviewing and cognitive-behavioural group maintained kilocalorie expenditure at three ( p = 0.009) and six months ( p = 0.009). Exercise barrier self-efficacy ( p = 0.03), physical ( p = 0.02) and psychological ( p = 0.01) physical activity experiences were increased at three months only. No difference was found for average steps/day, social support, coping skills and epidemiological factors. Discussion This is the first study to demonstrate the feasibility and preliminary efficacy of motivational interviewing and cognitive-behavioural interventions for promoting physical activity maintenance in a clinical population. A large-scale trial with a longer follow-up (≥6 months) is warranted with treatment fidelity assessment.

scholarly journals P093 A Systematic Review of Adherence to Cognitive Behavioural Therapy for Insomnia (CBT-I) - Key Findings

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A51-A51
Author(s):  
A Mellor ◽  
E Kavaliotis ◽  
S Drummond
Keyword(s):  
Systematic Review ◽  
Treatment Outcomes ◽  
Psychosocial Support ◽  
Behavioural Therapy ◽  
Sleep Diary ◽  
Sleep Diaries ◽  
Cognitive Behavioural ◽  
Psychological Comorbidities ◽  
Digital Studies ◽  
Sleep Questionnaires

Abstract Introduction Research into factors influencing adherence to CBT-I and how adherence impacts treatment outcomes remains scarce. Through a systematic review, we aimed to determine how adherence is assessed; which factors predict adherence; and which treatment outcomes are predicted by adherence. Methods Included publications met the following criteria: adults with insomnia; an intervention of CBT-I, including sleep restriction (SRT) and/or stimulus control (SCT); a reported measure of adherence; and written in English. Results Final n=103 papers. Measures assessed either global adherence or adherence to specific components of CBT-I via questionnaires, sleep diaries, interviews, or actigraphy. Most common measures were sleep diary-derived CBT-I components for therapist-led studies, and module completion for digital studies. Twenty-eight papers (27.2% of total) examined predictors of adherence. Depression, pre- and post-session sleep, psychosocial support, and dysfunctional beliefs about sleep predicted adherence. Demographic variables, other psychological comorbidities, insomnia severity, and sleep questionnaires did not predict adherence. Twenty-eight papers (27.2%) examined whether adherence predicted treatment outcomes. Neither global adherence nor adherence to any specific component of therapist-led CBT-I reliably predicted sleep outcomes. For digital CBT-I, completion of treatment modules was linked to improvements in ISI, however there were only five studies. Conclusion There was a high degree of heterogeneity in how adherence was measured, and in predictors and outcome variables assessed. This heterogeneity likely explains why adherence does not appear to predict treatment outcome. The field needs to develop a standardised method for assessing each specific adherence construct to fully understand the role of adherence in CBT-I.

scholarly journals COVID-19 Mortality is Associated with Impaired Innate Immunity in Pre-existing Health Conditions

2021 ◽  
Author(s):  
Matthew E Lee ◽  
Yung Chang ◽  
Navid Ahmadinejad ◽  
Crista E Johnson-Agbakwu ◽  
Celeste Bailey ◽  
...  
Keyword(s):  
Risk Factors ◽  
Innate Immunity ◽  
Viral Infections ◽  
Enrichment Analysis ◽  
Gene Set Enrichment Analysis ◽  
Therapeutic Interventions ◽  
Health Conditions ◽  
Molecular Abnormalities ◽  
Hazard Ratios ◽  
Increased Risk

Background: COVID-19 poses a life-threatening endangerment to individuals with chronic diseases. However, not all comorbidities affect COVID-19 prognosis equally. Some increase the risk of COVID-19 related death by more than six folds while others show little to no impact. To prevent severe outcomes, it is critical that we comprehend pre-existing molecular abnormalities in common health conditions that predispose patients to poor prognoses. In this study, we aim to discover some of these molecular risk factors by associating gene expression dysregulations in common health conditions with COVID-19 mortality rates in different cohorts. Methods: We focused on fourteen pre-existing health conditions, for which age-and-sex-adjusted hazard ratios of COVID-19 mortality have been documented. For each health condition, we analyzed existing transcriptomics data to identify differentially expressed genes (DEGs) between affected individuals and unaffected individuals. We then tested if fold changes of any DEG in these pre-existing conditions were correlated with hazard ratios of COVID-19 mortality to discover molecular risk factors. We performed gene set enrichment analysis to identify functional groups overrepresented in these risk factor genes and examined their relationships with the COVID-19 disease pathway. Results: We found that upregulated expression of 70 genes and downregulated expression of 181 genes in pre-existing health conditions were correlated with increased risk of COVID-19 related death. These genes were significantly enriched with endoplasmic reticulum (ER) function, proinflammatory reaction, and interferon production that participate in viral transcription and immune responses to viral infections. Conclusions: Impaired innate immunity in pre-existing health conditions are associated with increased hazard of COVID-19 mortality. The discovered molecular risk factors are potential prognostic biomarkers and targets for therapeutic interventions.

scholarly journals Global, regional, and national estimates of the population at increased risk of severe COVID-19 due to underlying health conditions in 2020: a modelling study

2020 ◽  
Vol 8 (8) ◽  
pp. e1003-e1017 ◽  
Author(s):  
Andrew Clark ◽  
Mark Jit ◽  
Charlotte Warren-Gash ◽  
Bruce Guthrie ◽  
Harry H X Wang ◽  
...  
Keyword(s):  
Health Conditions ◽  
Increased Risk ◽  
National Estimates ◽  
Modelling Study

scholarly journals The Risks of Cardiovascular Disease and Mortality Following Weight Change in Adults with Diabetes: Results from ADVANCE

2019 ◽  
Vol 105 (1) ◽  
pp. 152-162 ◽  
Author(s):  
Alexandra K Lee ◽  
Mark Woodward ◽  
Dan Wang ◽  
Toshiaki Ohkuma ◽  
Bethany Warren ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Weight Change ◽  
Cox Regression ◽  
Lifestyle Changes ◽  
Baseline Body Mass Index ◽  
Diabetes Medication ◽  
Increased Risk ◽  
All Cause Mortality

Abstract Context Weight loss is strongly recommended for overweight and obese adults with type 2 diabetes. Unintentional weight loss is associated with increased risk of all-cause mortality, but few studies have examined its association with cardiovascular outcomes in patients with diabetes. Objective To evaluate 2-year weight change and subsequent risk of cardiovascular events and mortality in established type 2 diabetes. Design and Setting The Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation was an international, multisite 2×2 factorial trial of intensive glucose control and blood pressure control. We examined 5 categories of 2-year weight change: >10% loss, 4% to 10% loss, stable (±<4%), 4% to 10% gain, and >10% gain. We used Cox regression with follow-up time starting at 2 years, adjusting for intervention arm, demographics, cardiovascular risk factors, and diabetes medication use from the 2-year visit. Results Among 10 081 participants with valid weight measurements, average age was 66 years. By the 2-year examination, 4.3% had >10% weight loss, 18.4% had 4% to 10% weight loss, and 5.3% had >10% weight gain. Over the following 3 years of the trial, >10% weight loss was strongly associated with major macrovascular events (hazard ratio [HR], 1.75; 95% confidence interval [CI], 1.26-2.44), cardiovascular mortality (HR, 2.76; 95% CI, 1.87-4.09), all-cause mortality (HR, 2.79; 95% CI, 2.10-3.71), but not major microvascular events (HR, 0.91; 95% CI, 0.61-1.36), compared with stable weight. There was no evidence of effect modification by baseline body mass index, age, or type of diabetes medication. Conclusions In the absence of substantial lifestyle changes, weight loss may be a warning sign of poor health meriting further workup in patients with type 2 diabetes.

scholarly journals Current management of NAFLD

2016 ◽  
Vol 89 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Mihai Alexandru Munteanu ◽  
Georgiana Anca Nagy ◽  
Petru Adrian Mircea
Keyword(s):  
Liver Disease ◽  
General Population ◽  
Pharmacological Therapy ◽  
Lifestyle Changes ◽  
Current Management ◽  
Alcoholic Fatty Liver ◽  
Risk Of Death ◽  
Increased Risk ◽  
Diet And Lifestyle ◽  
Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in Western countries. It affects about 1 billion individuals worldwide. While people with simple steatosis have no higher risk of death than the general population, people with non-alcoholic steatohepatitis are at increased risk of death compared to general population. Current management for NAFLD includes diet and lifestyle changes, management of underlying metabolic risk factors and pharmacological therapies. The objective of therapy is to prevent the complications. The problem with dietary and lifestyle interventions is that they are hard to implement. Compliance is the key. Until now, there is still no approved drug for the treatment of NAFLD. Insulin resistance is the main target of pharmacological therapy, but the question that we ask ourselves as physicians is who should receive medical treatment among NAFLD patients and for how long.

Coping among adolescents with long-term health conditions: a mixed-methods study

2020 ◽  
Vol 29 (13) ◽  
pp. 762-769
Author(s):  
Nabeel Al-Yateem ◽  
Muhammad Arsyad Subu ◽  
Arwa Al-Shujairi ◽  
Intima Alrimawi ◽  
Hend Mohd Ali ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Coping Strategies ◽  
School Health ◽  
Stressful Events ◽  
Health Conditions ◽  
Mixed Methods Design ◽  
Care Environment ◽  
Psychological Comorbidities ◽  
Negative Coping

Background: Adolescents with long-term health conditions may be at risk of developing psychological comorbidities and adopting ineffective coping mechanisms if they are not adequately supported at home or school. Aim: To understand the strategies adolescents use when dealing with challenging health situations, and gain an in-depth understanding of the characteristics of their preferred care environment if they have unexpected health crises. Design: The study used a concurrent mixed-methods design, with data gathered between January and May 2019. Descriptive and non-parametric tests were used to analyse quantitative and qualitative data. Results: ‘Problem-focused disengagement’ was the most-often used coping strategy. The second and third most common strategies were ‘problem-focused engagement’ and ‘emotion-focused engagement’. Finally, girls tended to adopt more negative coping strategies than boys. The analysis revealed that most adolescents preferred home over school as the care environment because these caring agents were close and available, knew how to care for them and had the resources to provide or access care, and listened and understood them. Conclusion: Adolescents adopted disengagement and negative coping strategies early in their attempts to cope with stressful events before adopting more positive strategies. This is alarming, especially as school health services are not sufficiently supportive of adolescents at times of stress and illness. Adolescents often perceive school providers as unavailable and lacking knowledge about their health needs.

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