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Objectives Research about the effects of magnesium (Mg) supplementation on chronic kidney disease-mineral bone disorder (CKD-MBD) among hemodialysis (HD) patients is controversial. Thus, we conducted a meta-analysis to examine Mg supplementation's effects on CKD-MBD in patients requiring dialysis. Methods The PubMed and EMBASE databases were searched for English language studies up to September 2020. The main indicators of our study were changes in serum Mg, calcium (Ca), phosphate, parathyroid hormone (PTH), and C-reactive protein levels, and carotid intima-media thickness (CIMT) after Mg supplementation. Mg efficacy was evaluated by weighted mean difference (WMD) and confidence intervals (CIs), and subgroup analyses of intervention type and intervention duration were also performed. Results Eight eligible studies comprising 309 HD patients were included in our meta-analysis. Mg supplementation alone produced a negative effect on serum PTH levels (WMD = −236.56; 95% CI −349.71 to −123.41) and CIMT (WMD = −0.18; 95% CI −0.34 to −0.01). A subgroup analysis based on intervention type showed a significant improvement in serum Mg (WMD = 1.08; 95% CI 0.51-1.64) and Ca (WMD = −0.50; 95% CI −0.77 to −0.23) levels when Mg was administered via dialysate and oral medication, respectively. Different intervention durations had no effect on serum Mg levels. Mg supplementation had no significant effect on serum phosphate (WMD = −0.25; 95% CI −0.64 to 0.14) and C-reactive protein levels (WMD = −0.02; 95% CI −2.80 to 2,76). Conclusions Our results showed that Mg supplementation alone could improve CKD-MBD by regulating serum Ca and PTH metabolism and decreasing CIMT among HD patients.

In this study, we aimed to systematically review and critically appraise the available literature concerning the effectiveness of marsupialisation and decompression on the reduction of cystic jaw lesions. The 'Preferred Reporting Items for Systematic Reviews and Meta-Analysis' guidelines were followed and the study protocol was registered at the 'International Prospective Register of Systematic Reviews' (CRD42019116099). Six main databases were searched: Embase, LILACS, PubMed, Scopus, The Cochrane Library, and Web of Science. Searches were complemented with three grey literature sources: Google Scholar, ProQuest, and Open Grey. Any reduction measures, compared with preoperative status or other procedures, were considered. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Tool. Thirty-one studies were included, of which five were judged with low, 24 with moderate, and two with high risk of bias. Considering surgical approach, 20 studies assessed the decompression and 11 the marsupialisation technique. Most studies considered these techniques as preliminary treatments, followed by enucleation. From 1088 lesions found, most were odontogenic keratocysts (33.8%), followed by unicystic ameloblastomas (21.0%), dentigerous cysts (20.6%), and radicular cysts (8.4%). Large lesions and younger individuals frequently presented more favourable responses to treatment and anatomical location was not associated with lesion reduction overall. The intervention duration generally ranged between one to two years. In conclusion, marsupialisation and decompression were mostly considered as preliminary treatments, followed by enucleation. Lesion reduction was generally considered insufficient for these techniques to be used as definitive therapies, although benefits concerning the diminished invasiveness of the secondary surgery were often proposed.

Mindfulness-based interventions (MBIs) are being increasingly used toward improving mental health. Previous studies reached inconsistent conclusions regarding the effects of MBIs on the well-being and psychological distress of children and adolescents. Therefore, we conducted a meta-analysis summarizing the effects of MBIs on the well-being and psychological distress (i.e., anxiety, depression, and stress) of children and adolescents. We searched electronic databases for reports on randomized controlled trials (RCTs) published until November 2020. Random effects models were used to calculate the overall effect size of each outcome variable for all participants. Subgroup and meta-regression analyses were conducted for categorical and continuous variables, respectively. A total of 28 RCT studies (48 independent samples), comprising 7943 participants, were included in the final synthesis. The MBIs had a small effect on anxiety (g = 0.39), depression (g = 0.28), and stress (g = 0.30), and no significant effect on well-being. Subgroup analyses showed intervention time, mindfulness type, control type, and intervention population to be significant moderators. However, meta-regression analyses indicated that effect sizes were not moderated by intervention duration or study quality. Our results confirmed MBI to be an alternative intervention for reducing psychological distress among both children and adolescents. The development and application of a shorter MBI, adapted for adolescents, could be addressed in future studies.

The present study adopted a meta-analytic approach to evaluate reflective interventions that were conducted with the intention to promote learning outcomes in higher education, using controlled exp...

Zusammenfassung Hintergrund E‑Mental-Health (EMH) spielt im ambulanten Versorgungssetting depressiver Störungen zunehmend eine Rolle. Ziel dieser Studie war die Implementierung und Evaluierung der Anwendbarkeit und des Nutzens des onlinebasierten Selbstmanagementprogramms „iFightDepression“ (iFD) als Zusatzangebot im Rahmen einer leitliniengerechten Behandlung auf einer Spezialstation für affektive Störungen. Methodik Es wurden insgesamt 78 stationäre PatientInnen mit einer unipolaren Depression unterschiedlichen Schweregrades (ICD-10 F32.0‑3, F33.0-3) oder einer Dysthymie (F34) rekrutiert. Die Interventionsdauer mit dem iFD-Tool belief sich vom Zeitpunkt der stationären Aufnahme bis zur Entlassung und wurde vom Stationspersonal begleitet. Die Erhebung der Symptomschwere sowie von Parametern zur Behandlungserwartung und Therapievorerfahrung erfolgte online vor der Intervention (T0), die Interventionszufriedenheit wurde unmittelbar vor der stationären Entlassung (T1) mittels eines Paper-pencil-Fragebogens erfasst. Ergebnisse Von den 78 Teilnehmenden loggten sich 42 mindestens einmal in das iFD-Tool ein. Es zeigten sich moderat hohe Erwartungswerte sowie leicht überdurchschnittliche Zufriedenheitswerte bezüglich der Behandlung. 67 % der aktiven NutzerInnen gaben an, das iFD-Tool poststationär weiter nutzen zu wollen. Wesentliche Gründe gegen die Nutzung waren eine kurze Aufenthaltsdauer, eine schwere depressive Symptomatik und fehlende Medienkompetenz. Diskussion Eine Implementierung des iFD-Tools im stationären Setting ist prinzipiell machbar und führte zu positiven Rückmeldungen seitens der NutzerInnen. Auch konnten sich die meisten aktiv an der Studie Teilnehmenden eine weitere Nutzung des iFD-Tools nach der Entlassung gut vorstellen. Allerdings weisen die insgesamt geringen Nutzungs- (42/78, 54 %) und Komplettierungsraten auf Nutzungsbarrieren hin, deren Überwindung entsprechende Anpassungen der Intervention speziell für den stationären Einsatz erforderlich machen.

Abstract. L-arginine is an important factor in several physiological and biochemical processes. Recently, scientists studied L-arginine effect on inflammatory mediators such as C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). We conducted a systematic review on randomized controlled trials assessing L-arginine effect on inflammatory mediators. We searched data bases including Google scholar, ISI web of science, SCOPUS, and PubMed/Medline up to April 2019. Randomized clinical trials assessing the effect of L-arginine on inflammatory mediators in human adults were included. Our search retrieved eleven articles with 387 participants. Five articles were on patients with cancer and 6 articles were on adults without cancer. L-arginine was applied in enteral form in 5 articles and in oral form in 6 articles. Eight articles were on both genders, two articles were on women, and one article was on men. L-arginine could not reduce inflammatory mediators among patients with and without cancer except one article which indicated that taking L-arginine for 6 months decreased IL-6 among cardiopathic nondiabetic patients. Our results indicated that L-arginine might not be able to reduce selected inflammatory mediators, but for making a firm decision more studies are needed to be conducted with longer intervention duration, separately on male and female and with different doses of L-arginine.

STUDY DESIGN A prospective nutritional intervention study for adult spinal deformity (ASD) patients. OBJECTIVE To investigate how a nutritional intervention affects the incidence of postoperative medical complications and the nutritional status. SUMMARY OF BACKGROUND DATA The medical complication rate in ASD surgery is very high, and one risk factor is malnutrition. Nutritional intervention may improve the patient's nutritional status and reduce risk, but this is unexplored regarding ASD surgery. METHODS Malnourished patients (i.e., a Prognostic Nutritional Index (PNI) score of

Context Psychosocial behavioral interventions (PBIs) that target patients with cancer and their caregivers face challenges in participant enrollment and retention. Objectives 1) Describe characteristics of the patient-caregiver PBI studies; 2) examine participant enrollment and retention rates; 3) identify factors influencing participant enrollment and retention rates; and 4) explore the strategies to promote enrollment and retention rates. Methods We identified randomized controlled trials that tested PBIs among adult patients with cancer and caregivers in five electronic databases. We conducted narrative and quantitative analyses to synthesize our findings. Results Among 55 qualified studies reviewed, most tested the efficacy of PBIs (n = 42) and used two study arms (n = 48). In-person meeting was the most common PBI delivery mode. The primary outcomes included quality of life, physical health, and symptoms. The average of enrollment rates of patient-caregiver dyads was 33% across studies (range 8%–100%; median = 23%). The average retention rate at the end of follow-ups was 69% (range 16%–100%; median = 70%). The number of study arms, recruitment method, type of patient-caregiver relationship, and intervention duration influenced enrollment rates. Study design (efficacy vs. pilot), follow-up duration, mode of delivery, type of relationship, and intervention duration influenced retention rates. Sixteen studies reported retention strategies, including providing money/gift cards upon study completion and/or after follow-up survey, and excluding patients with advanced cancer. Conclusion Researchers need to incorporate effective strategies to optimize enrollment and retention in patient-caregiver PBI trials. Researchers need to report detailed study processes and PBI information to improve research transparency and increase consistency.

Objectives Determine the feasibility of implementing an evidence-based training program compared to a control during a basic infantry training course, and compare their effectiveness on measures of injuries and associated burdens. Design Prospective, cohort, feasibility study. Methods Infantry candidates awaiting course between 01-April-2019 and 31-March-2020 were invited to participate while those releasing from the military, awaiting occupational transfer or having >5 medical employment limitation days were excluded. Consenting participants were allocated to an infantry course prospectively scheduled to host either the evidence-based program or a control. The evidence-based program adapted modified physical training strategies from previous studies reporting reduced injuries in recruits and was supervised by certified fitness professionals, while the control was at the discretion of infantry instructors. Results With the exception of intervention duration which was limited due to operational factors, all feasibility outcomes were met including a recruitment rate of 171/203 = 84.2% and an intervention adherence of 126/144 = 87.5%. Stakeholders reported that the evidence-based program implementation was feasible, posing a manageable demand on resources without compromising operations. Evidence-based program participants reported 68% fewer overuse musculoskeletal injuries, 296 fewer medical employment limitation days and 11 fewer attritions than control participants. Conclusions An evidence-based training program is feasible to implement on a basic infantry training course, and results in fewer musculoskeletal injuries, medical employment limitation days and attrition. Given these results, this program should be generalizable for a full experimental trial, and may be scaled for intermediate/advanced infantry and/or other combat occupation courses to promote an evolution towards evidence-based training.

Motor competence is an important predictor of health behaviours. However, levels of motor competence are low in children and adolescents. Many interventions have improved motor competence, yet intervention effects were highly variable. Potential causes of such variations are not fully understood. Process evaluation can assist with the understanding of why an intervention worked or not, but its application and reporting in motor competence interventions has received little attention. The primary aim of this review was to investigate whether process evaluations have been reported in interventions to improve motor competence and, if reported, which process evaluation measures have been used. A secondary aim was to explore the association of intervention characteristics and process evaluation findings (outcomes of process evaluation measures) with intervention outcomes, in a search for what process evaluation measures may impact on intervention functioning and outcomes. The process of conducting and reporting this review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review protocol was registered with PROSPERO (CRD42019124412). A systematic search of seven electronic databases (i.e. MEDLINE [via EBSCOhost], Cochrane Central Register of Controlled Trials [CENTRAL], CINAHL, Academic Search Complete, Education Database, SPORTDiscus and Scopus) was conducted with no date restrictions. Eligibility criteria included the following: (1) a study sample of typically developing children and adolescents aged 5–18 years, (2) an intervention aimed to improve motor competence, (3) an intervention included a control group, (4) a report of motor competence outcome at both pre- and post-intervention. Only original articles published in English in peer-reviewed journals were considered. Process evaluation measures and findings were extracted using the UK Medical Research Council’s process evaluation framework in order to provide overarching descriptions on the implementation, mechanism of change and context of interventions. Univariable meta-regressions were performed to ascertain whether selected study-level covariates moderated the improvement in motor competence outcomes in interventions. The search identified 60 intervention studies. Only 30 studies (50%) reported process evaluation measures. No studies reported (or employed) theoretical frameworks to guide process evaluation. Process evaluation measures relating to implementation were most commonly reported, with the most prevalent aspect being fidelity. This was followed by reporting on measures relating to mechanism of change and context of the intervention. Meta-analysis results suggested intervention duration, dose, inclusion of process evaluation aim, provision of lesson plans, sample size and sex as potential moderators. Reporting of process evaluation measures may help build our understanding of the optimal characteristics of motor competence interventions. However, process evaluation is under-used and/or under-reported. This review serves as a call for more process evaluations and better reporting in motor competence interventions.

Objective Automated digital interventions (ADIs) represent a potentially promising approach to enhance the outcomes of human coach-delivered weight loss interventions. However, the extent to which ADIs provide additive benefit is unclear. This study represents the first systematic review and meta-analysis of the effectiveness of ADIs for improving the outcomes of human coach-delivered weight loss treatment. Method Electronic database searches were used to identify trials that compared differences in weight change between (a) weight loss interventions that were delivered exclusively by coaches and (b) interventions supplementing this same human coaching with an ADI. Subgroup and moderator analyses examined the influence of intervention duration, duration of human coach contact, presence of tailored coaching, modality of the ADI and demographic variables on ADI effectiveness outcomes. Results Thirteen studies met inclusion criteria (1,471 participants). Random-effects meta-analysis revealed a mean difference in weight change between conditions of 2.18 kg at postintervention, representing a medium effect size of .54 (95% CI [.13, .95]). Subgroup analyses suggested that lower duration of coach contact was associated with improved additive effectiveness of ADIs. No other subgroup differences were found. Publication bias appeared to be a potential concern, though high levels of heterogeneity and a small number of included studies likely limited the ability to infer its presence. Conclusions Results support the use of ADIs to augment coach-delivered behavioral weight loss treatment, and also suggest that ADIs have the greatest impact when coaching is relatively low in frequency or duration. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Background: Plyometric training is a blend of training for strength and stamina. This enables muscles to exert full strength in short time intervals, with the intention of increasing power (speed-strength) in order to ensure stronger police cadet agility. Preparation for physical health, Preparation for Technical Event, Tactics Preparation and psychological preparation these are four important components for the Sports which makes athletes more-strong and achieve high success. Agility is characterized by sudden change in the direction by maintaining the ability in which quickly changing the direction of the body. Objective: Analyse the result of the 12-week Plyometric Agility Program in Police Cadets. Diagnosis, Therapeutic Intervention and Outcomes: The cadet was examined for any deformity and any problems regarding the lower limb soft tissue and Range of motion, Manual muscle testing and agility test were carried out. 40 Cadets aged above 18 years were grouped into two. Analysis was then carried out with assessment of T-test Agility test, Illinois Agility Test, Edgren Side Step Test. Intervention duration is 12-weeks, completed successfully. Assessment was done on 1st day of visit then at the end of 6th week and again at the end of 12th week. Cadet would have to perform 4 session of Plyometric Training per week. Plyometric Training is best to increase the agility which was evident in this case. Conclusion: Plyometric training is very beneficial to increase the Agility of the lower limb as the time period required to complete the Agility test were more and now the time period is less. It comes under the “Good” Grades. Hence, it is proved that Plyometric Training is more helpful to increase the agility.

Background The first Patient-Centered Medical Home (PCMH) demonstration in Singapore was launched in November 2016, which aimed to deliver integrated and patient-centered care for patients with bio-psycho-social needs. Implementation was guided by principles of comprehensiveness, coordinated care, shared decision-making, accessible services, and quality and safety. We aimed to investigate the impact of implementing the PCMH in primary care on quality of life (QoL) and patient activation. Methods The study design was a prospective single-arm pre-post study. We applied the 5-level EuroQol 5-dimension (EQ-5D-5L) and Visual Analog Scale (EQ VAS) instruments to assess health-related QoL. The CASP-19 tool was utilised to examine the degree that needs satisfaction was fulfilled in the domains of Control, Autonomy, Self-realisation, and Pleasure. The 13-item Patient Activation Measure (PAM-13) was used to evaluate knowledge, skills and confidence in management of conditions and ability to self-care. Multivariable linear regression models with random intercepts were applied to examine the impact of the PCMH intervention on outcome measures at 3 months and 6 months post-enrolment, compared to baseline. Results We analysed 165 study participants enrolled into the PCMH from November 2017 to April 2020, with mean age 77 years (SD: 9.9). Within-group pre-post (6 months) EQ-5D-5L Index (β= -0.01, p-value = 0.35) and EQ VAS score (β=-0.03, p-value = 0.99) had no change. Compared to baseline, there were improvements in CASP-19 total score at 3 months (β = 1.34, p-value = 0.05) and 6 months post-enrolment (β = 1.15, p-value = 0.08) that were marginally out of statistical significance. There was also a significant impact of the PCMH on the CASP-19 Pleasure domain (β = 0.62, p = 0.03) at 6 months post-enrolment, compared to baseline. We found improved patient activation from a 15.2 % reduction in the proportion of participants in lower PAM levels, and a 23.4 and 16.7 % rise in proportion for higher PAM levels 3 and 4, respectively, from 3 months to 6 months post-enrolment. Conclusions Preliminary demonstration of the PCMH model shows evidence of improved needs satisfaction and patient activation, with potential to have a greater impact after a longer intervention duration.

Although preoperative physical exercise has been demonstrated to be associated with clinical improvements among abdominal cancer patients, there remains heterogeneity in exercise strategies and uncertainty of what the optimal strategies should be. This scoping review aimed to review and summarize the existing knowledge about preoperative exercise strategies for abdominal cancer patients. The Joanna Briggs Institute (JBI) framework for conducting scoping reviews was adopted to investigate preoperative physical exercise strategies for patients undergoing major abdominal cancer surgery. A total of 1563 studies were identified and 24 were included in this review. Most of the study populations were colorectal cancer (n = 14). The most common type of exercise was a combination of aerobic and resistance exercises (n = 19). The most common form of aerobic exercise was walking (n = 13) or cycling (n = 12). Most resistance exercises were targeting at major muscle groups (n = 12). Most of the studies were performed at moderate intensity (n = 14) with frequency of 2 ~ 3 times/week (n = 14). The time of a training session was 30 ~ 60 min in half studies (n = 12). The intervention duration for most studies was less than 4 weeks (n = 11). Exercise locations included home (n = 10), facility (n = 7), and a combination of home and facility (n = 5). Phone calls were utilized by nearly half of the home-based exercise studies to supervise the exercise adherence (n = 7). This review provides a comprehensive summary of preoperative physical exercise strategies. It has the potential to inform clinical practice and future studies.

PurposeThis review aims to describe the effectiveness of education with the transtheoretical model (TTM)-based on the self-care behavior of hypertension patients.Design/methodology/approachA systematic literature search was carried out on four databases: PubMed, Science Direct, Cochrane and Grey literature to identify studies reported in English which were published in the last ten years. The literature search was conducted from November 13 to December 10, 2020.FindingsBased on the six studies that have been analyzed, TTM is effective in changing the stage of change and behavior of hypertension patients. These behavioral changes have an impact on the patient's controlled blood pressure. Various types of TTM-based educational interventions can be used, but the tailored behavior intervention is the most appropriate one with a minimum intervention duration of six months. Educational intervention is carried out through combine counseling and education using electronic media.Originality/valueThis review presents the effectiveness of transtheoretical-based health education in changing the self-care behavior of hypertension patients accompanied by evidence-based on its implementation. There is a high and unclear risk of bias on several items influence this systematic outcome. Nevertheless, this review can still provide an overview of the effectiveness of education based on the TTM in hypertension patients about the quality results of the reviewed studies.

Objectives Virtual reality (VR) exergames are an innovative approach to promote older adults' mental health. VR exergames are active video games controlled by bodily movements in a safe surrounding with advantages of physical activity engagement and interactions. The purpose of this study was to explore the effectiveness of VR exergames in improving older adults’ cognition and ameliorating depressive outcome by a systematic review, meta-analysis, subgroup analysis, and meta-regression. Design This is a systematic review and meta-analysis. Setting and Participants Adults over 60 years old. Methods Four electronic databases, including PubMed, Embase, Medline, and Cochrane, were searched for related articles. After evaluation, 18 randomized control trials were selected for qualitative and quantitative synthesis. Results The meta-analytical results found moderate effects of VR exergames on overall cognitive function and memory, and a large effect on depressive outcomes in older adults. Commercial VR games had more-significant and larger effects on depressive outcomes than exergames with VR devices. The meta-regression results revealed that the total intervention duration had a significant effect on depressive outcomes. A higher intervention duration had greater effects on depressive outcomes. Conclusions and Implications This meta-analytical study suggests that VR exergames can provide potential positive influences on cognition, memory, and depression in older adult populations. VR exergames could be an interesting strategy for active aging and a good mental health status.

This study aims to examine the effectiveness of Computer-Supported Collaborative Learning (CSCL) on academic achievement. The study was conducted using the meta-analysis method. In the present study, a total of 40 studies that were carried out between 2010 and 2020 and met the inclusion criteria were subjected to meta-analysis. In the present study, the values of the effect size and combined effect size of each study included in the meta-analysis were calculated using Comprehensive Meta-Analysis (CMA) software. The sample of the study consists of 3474 participants. The results of the study revealed that the studies were usually conducted at the university stage with a medium sample size, and published as articles. It was also revealed that most of the studies were carried out in the field of sciences and social sciences. Considering the intervention durations, it was observed that the studies were particularly carried out within a period between 1 and 4 weeks (37.8%). According to the results of the analysis, the average effect size was calculated as 0.523. Considering the results, it can be stated that CSCL has a positive and moderate effect on academic achievement. Also, the results of the moderator analysis revealed that the effect of CSCL on academic achievement did not change by the learning stage, domain subject, and the sample size but it changed by the intervention duration.

Objective:Fruits and vegetables (FV) distribution interventions have been implemented as a public health strategy to increase children’s intake of FV at school settings. The purpose of this review was to examine whether snack-based FV distribution interventions can improve school-aged children’s consumption of FV.Design:Systematic review and meta-analysis of articles published in English, in a peer-reviewed journals, were identified by searching six databases up to August 2020. Standardised mean differences (SMD) and 95 % CI were calculated using a random effects model. Heterogeneity was quantified using I2 statistics.Setting:Population-based studies of interventions where the main focus was the effectiveness of distributed FV as snacks to schoolchildren in North America, Europe and Pacific were included.Results:Forty-seven studies, reporting on fifteen different interventions, were identified; ten studies were included in the meta-analysis. All interventions were effective in increasing children’s consumption of FV, with only one intervention demonstrating a null effect. Pooled results under all classifications showed effectiveness in improving children’s consumption of FV, particularly for multi-component interventions at post-intervention (SMD 0·20, 95 % CI 0·13, 0·27) and free distribution interventions at follow-up (SMD 0·19, 95 % CI 0·12, 0·27).Conclusions:Findings suggest that FV distribution interventions provide a promising avenue by which children’s consumption can be improved. Nonetheless, our results are based on a limited number of studies, and further studies should be performed to confirm these results. More consistent measurement protocols in terms of rigorous study methodologies, intervention duration and follow-up evaluation are needed to improve comparability across studies.

Objectives Chronic inflammation is independently associated with the incidence and progression of chronic disease. Exercise has been found to reduce chronic inflammation, however the role of exercise intensity (work rate) is unknown. This review aimed to determine the pooled effect of higher- compared to lower-intensity aerobic and resistance exercise on chronic inflammation in adults. Design Systematic review and meta-analysis. Methods Five electronic databases were searched. Intervention trials that assessed the effect of ≥2 different exercise intensities on peripheral markers of chronic inflammation [c-reactive protein (CRP), interleukin (IL)-6, tumour necrosis factor (TNF)-α and IL-10] in adults were included. Random-effect meta-analyses were conducted to calculate the mean difference in change scores between groups [effect size (ES)]. Sub-group analyses were performed to explore the influence of age, chronic disease, body mass index and intervention duration on inflammation heterogeneity. Results Of 3952 studies identified, 27 were included. There were no significant effects of exercise intensity on IL-6 (ES=-0.039, 95%CI=-0.353–0.275; p = 0.806), TNF-α (ES = 0.296, 95%CI=-0.184–0.777; p = 0.227) and IL-10 (ES = 0.007, 95%CI=-0.904–0.919; p = 0.987). A significant pooled ES was observed for higher- versus lower-intensity exercise on CRP concentrations, in studies of middle-aged adults (ES=-0.412, 95%CI=-0.821– -0.004, p = 0.048) or interventions >9 weeks in duration (ES=-0.520, 95%CI=-0.882–-0.159, p = 0.005). Conclusions Exercise intensity did not influence chronic inflammatory response. However, sub-analyses suggest that higher-intensity training may be more efficacious than lower-intensity for middle-aged adults, or when longer duration interventions are implemented (>9 weeks), in the most commonly-reported analyte (CRP).

Objective. Tai Chi shows potential as a safe and cost-effective intervention to improve bone mineral density (BMD). However, the various effects caused by different training durations and frequencies have not been evaluated. This updated systematic review aims to explore the effectiveness of Tai Chi in attenuating bone mineral density loss based on different training durations and frequencies. Methods. We conducted an extensive database search in Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Web of Science, Chinese Biomedical Literature Database, China Knowledge Resource Integrated Database, Wanfang Data, and China Science and Technology Journal Database on randomized controlled trials that examined Tai Chi for BMD improvement. Two reviewers independently performed data screening and extraction. Study quality was evaluated using the Cochrane Handbook for Systematic Reviews of Interventions. Results. A total of 23 randomized controlled trials involving 1582 patients were identified. The aggregated results have shown significant benefits in favor of Tai Chi on BMD improvement in the lumbar spine (SMD = 0.36, 95% [0.13, 0.59], P = 0.002 ), femoral neck (SMD = 0.40, 95% [0.16, 0.63], P = 0.0009 ), femoral trochanter (SMD = 0.43, 95% CI [0.20, 0.66], P = 0.0002 ), and Ward’s triangle (SMD = 0.31, 95% [0.15, 0.48], P = 0.002 ). Such favorable benefits in Tai Chi can only be seen when compared with the nonexercise group, and Tai Chi showed no significant improvement in BMD change when compared with other exercises group. Subgroup analyses showed various effects of BMD improvement based on different training durations and frequencies of Tai Chi. Tai Chi is effective in attenuating BMD loss with an intervention frequency of >4 days/week in the lumbar spine, with an intervention frequency of >4 days/week or an intervention duration of >10 months in the femoral neck, and with an intervention duration of >10 months or a frequency of ≤4 days/week in Ward’s triangle. Conclusions. The results demonstrated that Tai Chi may have benefits in attenuating BMD loss. Different training durations and frequencies may result in variable effectiveness. Researchers should focus more on the training durations and frequencies of Tai Chi so that a more definitive claim can be made regarding the beneficial effects for BMD improvement.

Background Technology holds promise for delivery of accessible, individualized, and destigmatized obesity prevention and treatment to youth. Objectives This review examined the efficacy of recent technology-based interventions on weight outcomes. Methods Seven databases were searched in April 2020 following PRISMA guidelines. Inclusion criteria were: participants aged 1–18 y, use of technology in a prevention/treatment intervention for overweight/obesity; weight outcome; randomized controlled trial (RCT); and published after January 2014. Random effects models with inverse variance weighting estimated pooled mean effect sizes separately for treatment and prevention interventions. Meta-regressions examined the effect of technology type (telemedicine or technology-based), technology purpose (stand-alone or adjunct), comparator (active or no-contact control), delivery (to parent, child, or both), study type (pilot or not), child age, and intervention duration. Findings In total, 3406 records were screened for inclusion; 55 studies representing 54 unique RCTs met inclusion criteria. Most (89%) included articles were of high or moderate quality. Thirty studies relied mostly or solely on technology for intervention delivery. Meta-analyses of the 20 prevention RCTs did not show a significant effect of prevention interventions on weight outcomes (d = 0.05, p = 0.52). The pooled mean effect size of n = 32 treatment RCTs showed a small, significant effect on weight outcomes (d = ‒0.13, p = 0.001), although 27 of 33 treatment studies (79%) did not find significant differences between treatment and comparators. There were significantly greater treatment effects on outcomes for pilot interventions, interventions delivered to the child compared to parent-delivered interventions, and as child age increased and intervention duration decreased. No other subgroup analyses were significant. Conclusions Recent technology-based interventions for the treatment of pediatric obesity show small effects on weight; however, evidence is inconclusive on the efficacy of technology based prevention interventions. Research is needed to determine the comparative effectiveness of technology-based interventions to gold-standard interventions and elucidate the potential for mHealth/eHealth to increase scalability and reduce costs while maximizing impact.

Purpose This review provides an updated overview of observational and intervention studies investigating the effect of a low-FODMAP (fermentable oligo-, di- and monosaccharides, and polyols) diet (LFD) on gastrointestinal (GI) symptoms, quality of life (QoL), nutritional adequacy, and gut microbiome in irritable bowel syndrome (IBS) patients. Methods We systematically searched available literature until October 2020 for studies that investigated the effect of LFDs on GI symptoms, QoL, nutritional adequacy, and the gut microbiome in IBS patients. The data were represented as standardized mean differences (SMD) for IBS severity, and as mean differences (MD) for IBS-QoL. Meta-analyses were performed for the quantitative analyses using random effects models with inverse variance weighing. Results Twelve papers (nine parallel trials, three crossover studies) were included for the meta-analysis. The LFD reduced IBS severity by a moderate-to-large extent as compared to a control diet (SMD − 0.66, 95% CI − 0.88, − 0.44, I2 = 54%). When analyzing only studies that used the validated IBS-SSS questionnaire, a mean reduction of 45 points (95% CI − 77, − 14; I2 = 89%) was observed. Subgroup analyses on adherence, age, intervention duration, IBS subtype, outcome measure, and risk of bias revealed no significantly different results. The LFD also increased IBS-QoL scores, when compared with a control diet (MD 4.93; 95% CI 1.77, 8.08; I2 = 42%). Conclusions The low-FODMAP diet reduces GI symptoms and improves quality of life in IBS subjects as compared to control diets. Future work is required to obtain definitive answers regarding potential long-term effects of such diets on nutritional adequacy and the gut microbiome. PROSPERO registration number CRD42020175157.

Importance: Weight loss may be difficult for young women with obesity to achieve due to competing priorities (caring for children and/or full-time work), limiting their ability to engage in weight loss interventions. Older or postmenopausal women may also face challenges to weight loss such as caring responsibilities and menopause. Menopausal status may reflect differences in weight loss.Objective: This study compared changes in weight, fat mass, and lean mass in premenopausal versus postmenopausal women in dietary weight loss trials.Evidence review: We reviewed publications from January 2000 to June 2020 evaluating a weight loss intervention with a dietary component, with or without exercise, and reporting weight loss of premenopausal and postmenopausal women. Where available, data on mean change from baseline for weight, fat mass, and lean mass of premenopausal and postmenopausal groups were entered into Review Manger for meta-analyses. Differences between menopausal groups were compared in subgroups of studies for intervention characteristics (diet-only vs diet and exercise; dietary modification vs meal replacement; = 24 wks duration).Findings: Seven publications (10 interventions, n = 791) were included; three single-arm trials, two randomized controlled trials, and two comparative effectiveness trials. In meta-analyses, there were no statistically significant differences between premenopausal and postmenopausal women (shown as premenopausal minus postmenopausal) for change in weight (0.58 [95% confidence interval -0.12 to 1.28] kg, n = 7 interventions), fat mass (0.73 [-0.25 to 1.70] kg, n = 6 interventions), or lean mass (-0.5 6[-1.48 to 0.36] kg, n = 4 interventions). However, a statistically significant subgroup difference was observed for fat mass change between menopausal groups (premenopausal minus postmenopausal) when comparing diet-only (1.28 [0.23 to 2.33] kg, n = 4 interventions) versus diet and exercise interventions (-0.09 [-0.51 to 0.32]kg, n = 2 interventions). No differences were shown in any other subgroups.Conclusions and relevance: This review provides some evidence to suggest weight loss interventions may not need to be tailored to women's menopausal status. However, given the small number of studies, short intervention duration in most publications (

Objective To observe the effect of the early intervention with moxibustion at “Shenshū (肾俞 BL23) ” on learning and memory of Alzheimer's disease (AD) rats modeled by ovariectomy and D-Galactose (D-Gal) injection and the effect on Ca2+/CaMKII/CREB signaling pathway so as to provide the evidence for the acupoint selection in the early intervention with acupuncture and moxibustion for AD. Methods Sixty female SD rats at the age of 3 months were selected and randomly divided into a normal group, a sham-operation group, a model group, a “BL23” group, a “Weishū” (胃俞BL21) group, and a non-acupoint group, 10 rats in each group. Except in the normal group and the sham-operation group, bilateral ovaries were removed in the other 4 groups. 3 days after the operation, D-Gal was injected intraperitoneally at a dose of 150 mg/kg/d for 90 days to establish AD rat model. In the sham-operation group, only the peripheral fat of ovarian was removed and 0.9% normal saline was injected intraperitoneally of the same dose for 90 days. In the “BL23” group, the “BL21” group and the non-acupoints group, since the 2nd day after ovariectomy, moxibustion was applied at 9:00 a.m. every day in the rats. The rats were fixed on a fixed table, the mild moxibustion with self-prepared moxa stick was applied to bilateral “BL23” “BL21” and the non-acupoint of each rat, the ignited end of moxa stick was 2 cm to 3 cm far from skin surface. The infrared thermometer was adopted to measure the temperature of the epidermis of each acupoint from time to time so as to maintain the local temperature to be (41 ± 0.5) °C. Mild moxibustion lasted for 10 min each time, consecutively for 5 days a week and at an interval of 2 days. The total consecutive intervention duration was 12 weeks. In the normal group and the sham-operation group, no moxibustion intervention was performed, but the rats were restricted in a same way during the experiment. At the end of modeling and intervention, water maze test was adopted to detect the learning and memory abilities of rats in each group. The western blotting was used to detect the expressions of p-CREB, p-CaMKII, CaMKII and CREB in hippocampus of rats in each group. Results (1)Navigation test: since Day 72, compared with the sham-operation group, the escape latencies in all of the consecutive 5 days were longer in the model group (all P Conclusion Moxibustion at “BL23” achieves a better effect in improving the learning and memory of AD rats modeled by ovariectomy and D-Gal injection as compared with moxibustion at “BL21” and the non-acupoint. The effect mechanism is potentially related to the effective activation of Ca2+/CaMKII/CREB signaling pathway.

Introduction and Aim: Balance synergy includes a number of postural response that enable an individual to arise and remain erect during standing and locomotion. Balance deficits causes an insufficient coordination, postural instability and impaired gait. Maintaining the independence in activities of activities of daily living is an important factor for the quality of life. Hence this study is done to promote Hemiplegic Gait in stroke patients. Materials and Methods: 150 community dwelling hemiparetic subjects from Chennai aged

Postmenopausal women face a high risk of bone loss. Exercise has a beneficial effect to prevent bone deterioration in elderly women. This study was conducted to investigate the effect of different types of exercise on bone mineral density at the lumbar spine and femoral neck in postmenopausal women.This review followed the guidelines recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was registered in advance in the International prospective register of systematic reviews (PROSPERO) (ID: CRD42018095097). Literature searches with no language restriction were conducted through PubMed, Scopus, Web of Science, Cochrane, Science Direct, Eric, ProQuest, and Primo up to March 1 2019 using related MeSH terms and key words. Controlled trials with ≥ 6 months intervention duration among postmenopausal women that comprised at least one exercise and one control group were included in this study. Meta-analyses were performed using random-effects models and effect sizes calculated using the standardised mean difference (SMD). Seven categories of exercise were classified and used in sub-group analyses. P-values Seventy-five studies were included, assessing the bone mineral density of 5300 (range of mean age: 50–79) postmenopausal women who performed exercise or control protocols. Interventions ranged from six to 30 months and the most common exercise frequency was three sessions per week. The majority of studies employed multicomponent exercise interventions. Results of the meta-analyses showed a significant effect (SMD = 0.37, 95%-CI: 0.25–0.50) for lumbar spine and femoral neck (SMD = 0.33, 0.23–0.43) (all P Sub-group analysis revealed large heterogeneity and no significant differences in exercise categories at the lumbar spine (P = 0.36) and femoral neck (P = 0.43). However, weight-bearing exercise + jumping + resistance training exhibited the largest effect (SMD = 0.71, 0.33–1.10) at the lumbar spine. Moreover, non-weight-bearing combined + resistance exercise revealed the largest effect (SMD = 0.68, 0.16–1.19) at the femoral neck. Contrary to our expectation, jumping alone indicated a greater decrease in bone mineral density compared to the control group at both the lumbar spine (−0.07, −0.46–0.32) and femoral neck (−0.12, −0.62–0.37).In conclusion, the current study provided a positive small effect of exercise on bone mineral density at the lumbar spine and femoral neck. Findings from sub-group analyses suggest larger benefits in multicomponent interventions that include weight-bearing and resistance training exercises compared to them as a single mode of exercise. Unequal numbers of studies were found for each category (e. g. jumping: two trials; dynamic resistance training: 15 trials), affecting the comparison between them. Therefore, findings should be interpreted with caution; they are not yet generalizable to specific types of exercise.

Background Knee osteoarthritis (KOA) is a common joint disease in people over 60 years old. Exercise therapy is one of the most effective non-pharmacological treatments for KOA, but low exercise adherence needs to be improved. The present study aimed to evaluate the effect of the transtheoretical model-lead home exercise intervention (TTM-HEI) program on exercise adherence, KOA symptoms, and knee function in older adults with KOA. Methods A two-arm, superiority, assessor-blinded, cluster randomized trial was conducted. Community-dwelling older adults with KOA were recruited from 14 community centers in Beijing, China, via print and social media advertisements from April to October 2018. The present study lasted 48 weeks, with an intervention duration of 0–24 weeks and follow-up time of 24–48 weeks. The intervention was a two-stage and 24-week TTM-based exercise program, and the control group underwent a same-length exercise program guidance without any exercise adherence interventions. The primary outcome was exercise adherence to the prescribed home exercise program and was measured using an 11-point numerical (0 = not at all through and 10 = completely as instructed) self-rating scale at weeks 4, 12, 24, 36, and 48 after the program started. KOA symptoms (pain intensity and joint stiffness) were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and knee function (lower limb muscle strength and balance) was measured using the Five-Times-Sit-to-Stand Test (FTSST) and the Timed Up and Go Test (TUG) at baseline, week 24, and week 48. Latent growth model (GLM), repeated measures ANOVA, and independent t test were the main statistical tests used. Results A total of 189 older adults (intervention group: n = 103, control group: n = 86) were enrolled. Differences of any outcome measures at baseline were not significant between groups. The growth rate of exercise adherence in the intervention group increased 2.175 units compared with that in the control group (unstandardized coefficient of slope on group B2 = 2.175, p Conclusion Over time, TTM-HEI could improve participants’ exercise adherence, KOA symptoms, and knee function. Trial registration This study was approved by the ethics committee (IRB00001052-17066) in July 2017 and was registered at the Chinese Clinical Trial Registry (website: www.chictr.org.cn, registry number: ChiCTR1800015458).

Many factors may influence the magnitude of individual responses to resistance training (RT). How the manipulation of training volume and frequency affects responsiveness level for muscle mass gain in older women has not been investigated. This study had the objective of identifying responders (RP) and non-responders (N-RP) older women for skeletal muscle mass (SMM) gain from a 12-week resistance training (RT) program. Additionally, we analyzed whether the N-RP could gain SMM with an increase in weekly training volume over 12 additional weeks of training. Thirty-nine older women (aged ≥ 60 years) completed 24 weeks of a whole-body RT intervention (eight exercises, 2–3×/week, 1–2 sets of 10–15 repetitions). SMM was estimated by DXA, and the responsive cut-off value was set at two times the standard error of measurement. Participants were considered as RP if they exceeded the cut-off value after a 12-week RT phase, while the N-RP were those who failed to reach the SMM cut-off. Of the 22 participants considered to be N-RP, only 3 accumulated SMM gains (P = 0.250) that exceeded the cut-off point for responsiveness following 12 additional weeks of training, while 19 maintained or presented negative SMM changes. Of the 17 participants considered to be RP, all continued to gain SMM after the second 12-week RT phase. No significant correlation was observed between the changes in SMM and any baseline aspect of the participants. Our results suggest that some older women are RP, while others are N-RP to SMM gains resulting from RT. Furthermore, the non-responsiveness condition was not altered by an increase of training volume and intervention duration while RP participants continue to increase SMM; it appears that RP continue to be RP, and N-RP continue to be N-RP.

Existing meta-analyses of mindfulness-based programs (MBPs) suggest inconsistent effects, and few focus on technology-enabled MBPs. Technology-enabled MBPs are programs delivered via the Internet in web apps, which are accessed through Internet browsers, or native apps, which are applications installed directly on smart mobile devices. This meta-analysis provides an updated synthesis of technology-enabled MBPs’ effects on negative affect and mindfulness and discusses the role of moderators in these effects. A search was conducted through August 2019 of databases PubMed, Ovid MEDLINE, PsychINFO, and the website MINDFULNET.org for original randomized clinical trials focused on technology-enabled MBPs. Additional inclusion criteria included English language publications and outcome measures of negative affect and/or measures of mindful awareness. A medium effect was observed of technology-enabled MBPs on stress (Hedges g = − 0.47, 95% CI − 1.02 to 0.21, p

Objective The objective of this study was to evaluate the effect of skipping breakfast on body composition and cardiometabolic risk factors. Methods This study conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating breakfast skipping compared with breakfast consumption. Inclusion criteria included age ≥ 18, intervention duration ≥ 4 weeks, ≥ 7 participants per group, and ≥ 1 body composition measure. Random-effects meta-analyses of the effect of breakfast skipping on body composition and cardiometabolic risk factors were performed. Results Seven RCTs (n = 425 participants) with an average duration of 8.6 weeks were included. Compared with breakfast consumption, breakfast skipping significantly reduced body weight (weighted mean difference [WMD] = -0.54 kg [95% CI: -1.05 to -0.03], P = 0.04, I2 = 21.4%). Percent body fat was reported in 5 studies and was not significantly different between breakfast skippers and consumers. Three studies reported on low-density lipoprotein cholesterol (LDL), which was increased in breakfast skippers as compared with breakfast consumers (WMD = 9.24 mg/dL [95% CI: 2.18 to 16.30], P = 0.01). Breakfast skipping did not lead to significant differences in blood pressure, total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, C-reactive protein, insulin, fasting glucose, leptin, homeostatic model assessment of insulin resistance, or ghrelin. Conclusions Breakfast skipping may have a modest impact on weight loss and may increase LDL in the short term. Further studies are needed to provide additional insight into the effects of breakfast skipping.

Purpose This study aimed to summarize earlier studies on the effects of RS consumption on the serum levels of inflammatory biomarkers. Methods A comprehensive search was done in the electronic databases that published from 1988 up to May 2019. Two reviewers independently performed screening, data extraction, and risk-of-bias assessment. We used from the effect size, as estimated by the mean difference to perform the fixed method meta-analysis. Results Overall, 13 studies with 14 effect sizes met the inclusion criteria and were included in the final analysis. Sample size of these studies ranged from 15 to 75 and intervention duration ranged from 4 to 14 weeks. Meta-analysis revealed that higher consumption of resistant starch caused a significant reduction in the interleukin 6 (weighted mean difference = − 1.11 pg/mL; 95% CI: − 1.72, − 0.5 pg/mL; P = P = 0.001) levels. However, no significant changes were found in C-reactive protein concentration (weighted mean difference = − 0.21 mg/L; 95% CI: − 1.06, 0.63 mg/L; P = 0.61). Moreover, the changes in interleukin 6 concentration was dependent on study quality and intervention duration. Conclusion The current meta-analysis indicated that RS intake can improve some inflammatory biomarkers. More research, with a large sample sizes and accurate design is recommended.

Introduction: Ventilator-associated pneumonia (VAP) is a nosocomial infection that develops 48 h after the initiation of mechanical ventilatory support. Current evidence-based guidelines demonstrate that VAP prevention is feasible through the implementation of certain VAP prevention bundle of interventions simultaneously. We aimed in this study to investigate the effect of VAP prevention pre- and post- implementation. Methods: This is a single-center, cohort study that took place at the Pediatric Intensive Care Unit (PICU) of King Abdulaziz Medical City (KAMC), Jeddah, Saudi Arabia from January 2015 to March 2018 and assessed the rate of VAP before and after implementation of the bundle. Results: The study included 141 children, 95 were included from the pre-bundle group and 36 from the bundle group. VAP developed in 35% of the pre-bundle group compared to 31% of the bundle group (p = 0.651) with incidence rates equaled to 18 and 12 per 1000 ventilator days, respectively. Conclusion: This study found that VAP bundle did not significantly reduce VAP rate in the PICU. Further large prospective multi-center studies with longer intervention duration are indicated to investigate the benefits of using VAP prevention bundle. Keywords: Ventilator-associated pneumonia, VAP, VAP Bundle, PICU

The effect of supplementation with zinc on levels of IGF-1 remains relatively unexplored, and many of previous studies have reported equivocal findings. Thus, the aim of this study was to elucidate the influence of zinc on IGF-1. A complete systematic search was executed in Scopus, Web of Science, Embase, and PubMed/MEDLINE, by reviewers, from database inception until June 2019. Weighted mean difference (WMD) with the 95% CI was used for assessing the effects of zinc on IGF-1. We evaluated between study heterogeneity using the I-squared and the Q-test statistic. Ten studies reported changes in plasma levels of IGF-1. Combined results ascertained an increase in IGF-1 levels following zinc administration (WMD: 8.620 ng/ml, 95% CI: 1.126, 16.113, I2 = 97.3%). Subgroup analyses demonstrated that zinc intake dosage ≤10 mg/day (WMD: 9.50 ng/ml, 95% CI: 1.47, 17.53) and intervention length ˃8 weeks (WMD: 10.08 ng/ml, 95% CI: 0.67, 19.48) significantly greater increased IGF-1 levels. The present study demonstrated that zinc supplementation can elicit significant increases in IGF-1 in humans. In addition, greater increments were observed when zinc intake dosage was ≤10 mg/day and intervention duration ˃8 weeks. Keywords: Zinc, IGF-1, Humans, Meta-analysis

Randomized controlled trials, being published in English and investigating the associations of at least 4 weeks intervention of citrus and/or its extracts on weight loss among adults, were searched from PubMed, Web of Science, Scopus, and Cochrane by June 2019 to conduct a meta-analysis. Thirteen articles, including 921 participants, were selected and evaluated by modified Jadad scale. Pooled results by the random-effects model showed that citrus and/or its extracts administration significantly reduced 1.280 kg body weight (95% CI: -1.818 to -0.741, p = 0.000, I2 = 81.4%), 0.322 kg/m2 BMI (95% CI: -0.599 to -0.046, p = 0.022, I2 = 87.0%), 2.185 cm WC (95% CI: -3.804 to -0.566, p = 0.008, I2 = 98.3%), and 2.137 cm HC (95% CI: -3.775 to -0.500, p = 0.011, I2 = 96.2%), respectively, but no significantly decreased effects on WHR and body fat were observed. Subgroup analysis deduced the different effects of study location, intervention duration on body weight associated indices. No publication bias was observed. Our meta-analysis supported the beneficial effects of citrus and/or its extracts supplement on body weight control, and future well-designed studies are required to firmly establish the clinical efficacy of citrus and/or its extracts intervention on body weight.

Background and aims Sustained psychosocial support via online social groups may help former tobacco users maintain abstinence. This study aims to examine the effectiveness of participating in a WhatsApp social group for long-term smoking cessation. Design Two-arm, open-labelled, pragmatic, individually randomized controlled trial. Setting All participants are service users of smoking cessation clinics, and all interventions are delivered via mobile phones. Participants Participants included 1008 adult quitters who self-report no tobacco use in the past 3-30 days. Interventions The intervention group (n = 504) will join a WhatsApp social group to receive standardized and theory-based reminders of smoking relapse prevention and participate in discussion with other WhatsApp group members using their own mobile phones. All social groups will be led by counselors or specialist nurse practitioners. The control group (n = 504) will receive similar reminders via short messages to their own mobile phones but will not interact with other participants. The intervention duration for both groups is 8 weeks. Both groups will receive a booklet at baseline about how to prevent smoking relapse. Measurements The primary outcome is biochemically validated tobacco abstinence at 12 months after consent. Comments The findings will provide evidence concerning the utility of operating online social group discussion for prevention of smoking relapse and sustaining long-term abstinence.

Observational studies provide strong evidence for the health benefits of dietary fiber (DF) intake; however, human intervention studies that supplement isolated and synthetic DFs have shown inconsistent results. Therefore, we conducted a systematic review to summarize the effects of DF supplementation on immunometabolic disease markers in intervention studies in healthy adults, and considered the role of DF dose, DF physicochemical properties, intervention duration, and the placebo used. Five databases were searched for studies published from 1990 to 2018 that assessed the effect of DF on immunometabolic markers. Eligible studies were those that supplemented isolated or synthetic DFs for ≥2 wk and reported baseline data to assess the effect of the placebo. In total, 77 publications were included. DF supplementation reduced total cholesterol (TC), LDL cholesterol, HOMA-IR, and insulin AUC in 36–49% of interventions. In contrast, 50%), and longer intervention durations for CRP and glucose (50%). Half of the placebo-controlled studies used digestible carbohydrates as the placebo, which confounded findings for IL-6, glucose AUC, and insulin AUC. In conclusion, interventions with isolated and synthetic DFs resulted mainly in improved cholesterol concentrations and an attenuation of insulin resistance, whereas markers of dysglycemia and inflammation were largely unaffected. Although more research is needed to make reliable recommendations, a more targeted supplementation of DF with specific physicochemical properties at higher doses and for longer durations shows promise in enhancing several of its health effects.

To evaluate the effect of iron-fortified formula with different concentrations of bovine lactoferrin (bLF) on improvement of anemic status in term infants who were previously breast-fed. A randomized, controlled, open, and post-market intervention study. A total of 108 infants aged 6-9 mo who were previously breast-fed and weaned were selected. The subjects were divided into three groups with the sequence of outpatient: fortified group 1 (FG1) with a bLF concentration of 38 mg/100 g, FG2 with 76 mg/100 g bLF, FG0 with no bLF. The intervention duration was 3 mo. Weight, height, head circumference and the concentration of hemoglobin (Hb), serum ferritin (SF), serum transferring receptor (sTfR) were measured and sTfR-SF index (TFR-F index) and total body iron content (TBIC) were computed before and after intervention. The primary outcome measures were obtained from 96 infants (35, 33 and 28 for FG0, FG1 and FG2, respectively). After 1 mo of intervention, the changes of Hb level showed no significant difference (p>0.05) among the three groups, however, the Hb level of infants in FG2 were significantly higher than those of infants in the other two groups after 3 mo of intervention (p

To evaluate the efficacy of exercise-based interventions and mind-body therapies on quality of life, menopausal symptoms, and depression among Asian perimenopausal women.A systematic review, meta-analysis, and synthesis without meta-analysis (SWiM).Six electronic databases were systematically searched: PubMed, CINAHL, Embase, PsycINFO, Scopus, and ProQuest.The point of inception of each database to 15 November 2018 were systematically searched. A meta-analysis and SWiM were used to present the results. Review Manager 5.3 and The Cochrane Risk of Bias tool were used for meta-analyses and assessing of risk of bias, respectively.In all, 23 studies were reviewed. Significant effects in exercise-based interventions and mind-body therapies were found for quality of life, menopausal symptoms, and depression but not for hot flashes. Limitations of this review include insufficient blinding of participants and/or researchers found in most of the included studies and high levels of heterogeneity in the meta-analyses. Evidence found in this review is to be interpreted with caution.Healthcare professionals can consider exercise-based interventions or mind-body therapies to manage menopausal symptoms. Future trials of good quality can examine the cost-effectiveness and optimal intervention duration. Intervention effects on specific menopausal symptoms such as sleeplessness in Asia can be examined in future.Exercise-based interventions and mind-body therapies suggest effectiveness on quality of life, menopausal symptoms, and depression among Asian perimenopausal women. Exercise-based interventions and mind-body therapies improve quality of life, menopausal symptoms, and depression but not hot flashes. Long-term exercise-based interventions is effective in managing depression. Due to varied limitations in the review and included studies, firm conclusions cannot be reached. Healthcare professionals in Asia can consider implementing exercise-based interventions and mind-body therapies for symptomatic perimenopausal Asian women.目的: 评价运动干预和身心疗法对亚洲围绝经期妇女生活质量、更年期症状和抑郁情绪的影响。 设计: 开展系统评估、荟萃分析以及不包括荟萃分析的综合汇总(SWiM)。 数据来源: 通过6大电子数据库:PubMed、CINAHL、Embase、PsycINFO、Scopus和ProQuest展开系统性检索。 评估方法: 对各个数据库自建立之初到2018年11月15日期间所发表的文献进行系统性检索。采用荟萃分析和SWiM方法来展示检索结果。使用Review Manager 5.3和Cochrane偏倚风险工具分别进行荟萃分析和偏倚风险评估。 结果: 共对23项研究进行了评估。结果显示,运动干预和身心疗法对生活质量、更年期症状和抑郁情绪具有显著影响,但对热潮红并无效果。本项评估的局限性包括在大多数纳入研究中发现参与者和/或研究人员的盲法试验不够充分,以及荟萃分析中存在高度异质性。因此,在解释本项评估中所发现的证据时需格外谨慎。 结论: 医疗服务人员可考虑采用运动干预或身心疗法来控制更年期症状。对于成本效益和最佳干预时间,未来可通过开展更多高质量试验予以检验确定。针对亚洲妇女特定更年期症状(如失眠)的干预效果将在未来得到检验。 影响: 运动干预和身心疗法对亚洲围绝经期妇女的生活质量、更年期症状和抑郁情绪具有显著影响。运动干预和身心疗法有助于改善生活质量、更年期症状和抑郁情绪,但对热潮红并无效果。长期运动干预可有效治疗抑郁症。由于评估和纳入研究存在各种局限性,目前无法得出明确的结论。亚洲地区的医疗服务人员可考虑对有症状的围绝经期妇女实施运动干预和身心疗法。.

BACKGROUND Parents of adolescents and young adults (AYAs) with cancer offer primary support to their children and often experience their own high levels of distress, affecting parent-AYA communication and quality of life. OBJECTIVE To reduce parent distress and improve communication during high-risk cancer treatment, we examined efficacy of a self-care and communication intervention for parents and indirect benefit for AYAs receiving a therapeutic music video (TMV) intervention. METHODS In this study, we conducted a multisite, randomized controlled trial with AYAs and parents enrolled as dyads (n = 110). Parents were randomized to intervention or low-dose control; all AYAs received TMV. Data collection occurred at baseline, 2 weeks post intervention (T2), and 90 days post intervention (T3). RESULTS There were no significant between-group differences on primary outcomes for parents or AYAs. We did find significant differences favoring the parent intervention group on parenting confidence at T2 and marginally better outcomes for family adaptability/cohesion at T3. Both groups exhibited significant within-group improvement for parent distress (state anxiety, T3; perceived stress, T2 and T3; mood, T3), state anxiety (T2) intervention only, and family strengths control group only. Qualitative data demonstrate the parent intervention raised self-awareness and parent confidence in the short term. CONCLUSION Parents found their intervention helpful. Absence of significant results may be due to short intervention duration, need for tailored content, underpowered sample, and potential indirect parent benefit from AYA participation in TMV. The parent intervention did not provide an indirect benefit for AYAs. IMPLICATIONS FOR NURSING Parents identified their own need for communication and support from nurses. Nurses can optimize AYA care by attending to parent needs through supportive listening and encouraging self-care.

Introduction: The recommendation of exercise programs in the senior population may benefit inactive and sedentary individuals and improve and help to treat specific health conditions. The purpose of this review is to summarize the published evidence from RCT studies of aerobic exercise interventions for mental health in older adults over the last 20 years.Methods: A literature search was conducted using electronic databases including Web of Science, PubMed/Medline, and ProQuest.Results: A total of 15 studies met the inclusion criteria. The subjects of these studies were aged 60 years or older and had various physical health statuses. In 15 studies, the mean effect size for the experimental outcome was 0.56 ± 0.39 (95%CI: 0.36–0.76). One-way ANOVA indicated no significant differences in the intervention duration [F(2,15) = 0.919, p = 0.420], subject category [F(2,15) = 0.046, p = 0.955], or measurement category [F(3,14) = 0.967, p = 0.436]. However, there were significant differences in exercise frequencies [F(2,15) = 6.03, p = 0.012].Conclusion: The available evidence suggests that aerobic exercise is beneficial for improving the mental health of adults aged 60 years and older. The intervention effect can be achieved regardless of the type of subject and the duration of the intervention. Further, the present study indicates that low-frequency, long-term and regular aerobic exercise is more effective for older adults. Therefore, we recommend that older adults to exercise at a low frequency depending on their physical condition.