Hasil untuk "Special situations and conditions"

Ozge Ece Gunaydin, Sercan Onal Aykar, Esin Ergin et al.

Abstract Objective Thoracic mobility significantly enhances athletic ability and performance. The objective of this study was to examine the impact of thoracic mobility exercises on the physical attributes of strength, endurance, flexibility, and the speed of serve and spike in female adolescent volleyball players. Method In this study, 36 adolescent female adolescent volleyball players participated. Participants were divided into 2 groups as mobility added training and only training program. In the mobility group, thoracic mobility exercises were applied in addition to the training program for 4 weeks. The athletes were evaluated in terms of internal and external rotation strength, endurance, thoracic mobility, spike and serve speeds. A 2 × 2 ANOVA was used to compare the differences between the groups. Results In this study, significant increases were observed in strength, scapular endurance, thoracic rotation angles, smash and serve speed in both the thoracic mobility group and the control group (p < 0.05). However, it was determined that changes in some parameters differed between groups; right internal rotation strength increased only in the control group, while hyperextension increased only in the thoracic mobility group (p < 0.05). However, no group was found to be superior to the other in terms of any parameter in the intergroup comparisons (p > 0.05). Conclusion The results indicate that thoracic mobility exercises added to training programs yield similar results to the control group in terms of strength, endurance, flexibility, spike and serve speed. Future studies with longer-term interventions, dose-response design, and different sports disciplines may further contribute to the literature. Trial registration ClinicalTrials.gov NCT07203209, 24.09.2025. Retrospectively registered.

Li Chen, Wei Liu, Renshan Cui

Abstract Background To investigate the hope level and identify its associated factors among widowed older adults residing in long-term care facilities. Methods A cross-sectional study was conducted using convenience sampling. 228 widowed older adults meeting inclusion criteria were recruited from several long-term care facilities in Liaoning Province for face-to-face questionnaire surveys. Results The hope level average score among widowed older adults in long-term care facilities was (31.73 ± 3.31). Multiple linear regression analysis revealed that nine factors were significantly associated with hope levels: educational level, duration of widowhood, frequency of children’s visits, pension income, number of chronic diseases, frequency of participation in recreational activities, medical payment method, evaluation of the long-term care facility, and total perceived social support score. These factors collectively explained 81.4% of the variance in hope levels (Adjusted R² = 0.814, F = 96.027, P < 0.001). Conclusion Hope levels among widowed older adults in long-term care facilities were at a moderate-low level. Nursing staff and facility administrators should pay attention to the hope levels of these residents and implement targeted interventions based on the identified associated factors to enhance hope levels and consequently improve their quality of life.

Bhargav Teja Nallapu, Ali Ezzati, Helena M. Blumen et al.

ABSTRACT INTRODUCTION Understanding the heterogeneity of brain structure in individuals with the Motoric Cognitive Risk Syndrome (MCR) may improve the current risk assessments of dementia. METHODS We used data from six cohorts from the MCR consortium (N = 1987). A weakly‐supervised clustering algorithm called HYDRA (Heterogeneity through Discriminative Analysis) was applied to volumetric magnetic resonance imaging (MRI) measures to identify distinct subgroups in the population with gait speeds lower than one standard deviation (1SD) above mean. RESULTS Three subgroups (Groups A, B, and C) were identified through MRI‐based clustering with significant differences in regional brain volumes, gait speeds, and performance on Trail Making (Part‐B) and Free and Cued Selective Reminding Tests. DISCUSSION Based on structural MRI, our results reflect heterogeneity in the population with moderate and slow gait, including those with MCR. Such a data‐driven approach could help pave new pathways toward dementia at‐risk stratification and have implications for precision health for patients. Highlights Different patterns of brain atrophy were observed among the people with moderate and slow gait speeds Slower gait speeds were associated with substantial cortical atrophy, higher rates of Motoric Cognitive Risk Syndrome (MCR), and worse cognitive performance This approach can aid patient stratification at early asymptomatic stages and have implications for precision health.

Lin Hu, Haixia Feng, Jing Han et al.

Abstract Background Frailty is a syndrome as with aging in the population of type 2 diabetes mellitus (T2DM) and exercise has become an essential non-pharmacological tool especially in the pre-frail stage. Notably, the form of supervised home-based exercise program has been strongly recommended in recent years. This study aimed to verify the potential effects of the supervised home-based elastic band exercise in pre-frail older T2DM patients in China. Methods A total of 100 participants were included and randomly divided into intervention group (IG) (n = 50) and control group (CG) (n = 50). The CG received a routine care, while the IG received an extra home-based elastic band training under online and offline supervisions sustaining 12-weeks. The glycosylated hemoglobin (HbA1c), blood lipids, body composition, physical function, scales of Diabetes specificity quality of life scale (DSQL), Pittsburgh sleep quality index (PSQI) and short form geriatric depression scale (GDS-15) of the participants were evaluated before and after intervention. Results The average age of the participants were 66.01 ± 4.76 with 55% male and average BMI 24.75 ± 3.51 kg/m2. The clinical characteristics of the two groups were comparable. After 12 weeks’ training, muscle mass of the limbs (P < 0.05), physical function indicators including grip strength, chair stands (both P < 0.05), walking time (P < 0.01), HbA1c (P < 0.05), frailty score (P < 0.05), subjective sleep quality (P < 0.05), total DSQL scores (P < 0.01) and the depressive status (P < 0.01) improved significantly in IG when compared with CG. Conclusion Supervised home-based elastic band exercise could improve limb muscle mass, physical fitness, glucose and lipid control and quality of life in pre-frail older T2DM patients. Trial registration number ChiCTR2300070726; Registration date: 21/04/2023.

Izabela Hądzlik, Klaudia Wojtyła, Marta Barg

Behavioural addictions, also known as non-substance-related addictions, encompass a range of compulsive behaviours that closely mirror substance use disorders in their effects on the brain's reward system and the individual's daily life. These addictions include, but are not limited to, gambling disorder, internet gaming disorder, compulsive shopping, and the focus of this review - exercise addiction. Exercise addiction is characterized by an intense, uncontrollable urge to engage in physical activity, despite potential negative consequences. Unlike substance use disorders, exercise addiction often remains underrecognized, overshadowed by the widespread promotion of regular physical activity as a healthy lifestyle choice. This review aims to offer a comprehensive overview of exercise addiction, covering its psychological origin and characteristics, diagnostic criteria, co-occurrence with other psychiatric disorders, epidemiology among athletes and management strategies.

Quan Wang, Yanmin Cao, Xinyu Liu et al.

Ethan R. Roy, Sanming Li, Sepideh Saroukhani et al.

Abstract Background Aging significantly elevates the risk of developing neurodegenerative diseases. Neuroinflammation is a universal hallmark of neurodegeneration as well as normal brain aging. Which branches of age-related neuroinflammation, and how they precondition the brain toward pathological progression, remain ill-understood. The presence of elevated type I interferon (IFN-I) has been documented in the aged brain, but its role in promoting degenerative processes, such as the loss of neurons in vulnerable regions, has not been studied in depth. Methods To comprehend the scope of IFN-I activity in the aging brain, we surveyed IFN-I-responsive reporter mice at multiple ages. We also examined 5- and 24-month-old mice harboring selective ablation of Ifnar1 in microglia to observe the effects of manipulating this pathway during the aging process using bulk RNA sequencing and histological parameters. Results We detected age-dependent IFN-I signal escalation in multiple brain cell types from various regions, especially in microglia. Selective ablation of Ifnar1 from microglia in aged mice significantly reduced overall brain IFN-I signature, dampened microglial reactivity, lessened neuronal loss, restored expression of key neuronal genes and pathways, and diminished the accumulation of lipofuscin, a core hallmark of cellular aging in the brain. Conclusions Overall, our study demonstrates pervasive IFN-I activity during normal mouse brain aging and reveals a pathogenic, pro-degenerative role played by microglial IFN-I signaling in perpetuating neuroinflammation, neuronal dysfunction, and molecular aggregation. These findings extend the understanding of a principal axis of age-related inflammation in the brain, one likely shared with multiple neurological disorders, and provide a rationale to modulate aberrant immune activation to mitigate neurodegenerative process at all stages.

Vaneza Tique-Salleg, Jairo Chevel-Mejia, Jorge Miranda et al.

Christantie Efendy, Jony Francisco Dos Santos Silva, Retna Siwi Padmawati

Bruno Gonçalves Galdino da Costa, Jean-Philippe Chaput, Marcus Vinicius Veber Lopes et al.

Background: Physical activity, sleep, and sedentary behaviors compose 24-h movement behaviors and have been independently associated with depressive symptoms. However, it is not clear whether it is the movement behavior itself or other contextual factors that are related to depressive symptoms. The objective of the present study was to examine the associations between self-reported and accelerometer-measured movement behaviors and depressive symptoms in adolescents. Methods: Cross-sectional data from 610 adolescents (14–18 years old) were used. Adolescents answered questions from the Center for Epidemiological Studies Depression scale and reported time spent watching videos, playing videogames, using social media, time spent in various physical activities, and daytime sleepiness. Wrist-worn accelerometers were used to measure sleep duration, sleep efficiency, sedentary time, and physical activity. Mixed-effects logistic regressions were used. Results: Almost half of the adolescents (48%) were classified as being at high risk for depression (score ≥20). No significant associations were found between depressive symptoms and accelerometer-measured movement behaviors, self-reported non-sport physical activity, watching videos, and playing videogames. However, higher levels of self-reported total physical activity (odd ratio (OR) = 0.92, 95% confidence interval (95%CI): 0.86–0.98) and volume of sports (OR = 0.88, 95%CI: 0.79–0.97), in minutes, were associated with a lower risk of depression, while using social media for either 2.0–3.9 h/day (OR = 1.77, 95%CI: 1.58–2.70) or >3.9 h/day (OR = 1.67, 95%CI: 1.10–2.54), as well as higher levels of daytime sleepiness (OR = 1.17, 95%CI: 1.12–1.22), were associated with a higher risk of depression. Conclusion: What adolescents do when they are active or sedentary may be more important than the time spent in the movement behaviors because it relates to depressive symptoms. Targeting daytime sleepiness, promoting sports, and limiting social media use may benefit adolescents.

S. M. O’Neill, B. Clyne, M. Bell et al.

Abstract Background Early warning systems (EWSs) are used to assist clinical judgment in the detection of acute deterioration to avoid or reduce adverse events including unanticipated cardiopulmonary arrest, admission to the intensive care unit and death. Sometimes healthcare professionals (HCPs) do not trigger the alarm and escalate for help according to the EWS protocol and it is unclear why this is the case. The aim of this qualitative evidence synthesis was to answer the question ‘why do HCPs fail to escalate care according to EWS protocols?’ The findings will inform the update of the National Clinical Effectiveness Committee (NCEC) National Clinical Guideline No. 1 Irish National Early Warning System (INEWS). Methods A systematic search of the published and grey literature was conducted (until February 2018). Data extraction and quality appraisal were conducted by two reviewers independently using standardised data extraction forms and quality appraisal tools. A thematic synthesis was conducted by two reviewers of the qualitative studies included and categorised into the barriers and facilitators of escalation. GRADE CERQual was used to assess the certainty of the evidence. Results Eighteen studies incorporating a variety of HCPs across seven countries were included. The barriers and facilitators to the escalation of care according to EWS protocols were developed into five overarching themes: Governance, Rapid Response Team (RRT) Response, Professional Boundaries, Clinical Experience, and EWS parameters. Barriers to escalation included: Lack of Standardisation, Resources, Lack of accountability, RRT behaviours, Fear, Hierarchy, Increased Conflict, Over confidence, Lack of confidence, and Patient variability. Facilitators included: Accountability, Standardisation, Resources, RRT behaviours, Expertise, Additional support, License to escalate, Bridge across boundaries, Clinical confidence, empowerment, Clinical judgment, and a tool for detecting deterioration. These are all individual yet inter-related barriers and facilitators to escalation. Conclusions The findings of this qualitative evidence synthesis provide insight into the real world experience of HCPs when using EWSs. This in turn has the potential to inform policy-makers and HCPs as well as hospital management about emergency response system-related issues in practice and the changes needed to address barriers and facilitators and improve patient safety and quality of care.

Sung-Jin Lee PhD, Kathleen Rose Parrott PhD, Minyong Lee PhD et al.

This study explored residential (housing and town) satisfaction of rural older adults aging in place, relating to demographic and housing characteristics. We conducted a structured, face-to-face survey with 149 rural older adults. Regression results revealed that housing satisfaction for rural older adults were significantly related to demographic and housing characteristics, including personal health status, healthy home status, and structure size. Bivariate analysis revealed that satisfaction with a town feature, shopping location, was the most frequently related to demographic and housing variables, followed by cost of living in town; and that health status was most frequently associated with town feature satisfaction. The study results can enhance programs and/or services for older adults aging in rural communities.

Jong-Koo Lee

Brenda Eskenazi, David I. Levine, Stephen Rauch et al.

Abstract Background Indoor residual spraying (IRS), the coating of interior walls of houses with insecticides, is common in malaria-endemic areas. While important in malaria control, IRS potentially exposes residents to harmful insecticides. The World Health Organization recommends steps to minimize exposure; however, no programme has focused on educating populations. Methods A dramatic presentation and song were developed by study personnel and performed by lay performers in order to spread awareness of the importance of IRS and to minimize insecticide exposure. Performances were staged at 16 sprayed villages in the Vhembe District of Limpopo, South Africa, at which 592 attendees completed short questionnaires before and after the performance about behaviors that might limit insecticide exposure. Overall indices of the attendees’ change in knowledge of precautions to take prior to and after spraying to prevent insecticide exposure were analyzed using hierarchical mixed models to assess the effect of the performance on change in participants’ knowledge. Results Approximately half of attendees lived in homes that had been sprayed for malaria and 62% were female. Over 90% thought it better to allow IRS prior to the presentation, but knowledge of proper precautions to prevent exposure was low. The proportion answering correctly about proper distance from home during spraying increased from 49.4% pre-performance to 62.0% post-performance (RR = 1.26, 95% CI = 1.13, 1.41), and the proportion reporting correctly about home re-entry interval after spraying increased from 58.5 to 91.1% (RR = 1.54, 95% CI 1.35, 1.77). Attendees improved in their knowledge about precautions to take prior to and after spraying from mean of 57.9% correct to a mean of 69.7% (β = 12.1%, 95% CI 10.9, 13.4). Specifically, increased knowledge in closing cupboards, removing food and bedding from the home, covering immoveable items with plastic, and leading animals away from the home prior to spraying were observed, as was increased knowledge in sweeping the floors, proper disposal of dead insects, and discarding dirty washrags after spraying. Conclusions A dramatic presentation and song were able to increase the attendees’ knowledge of precautions to take prior to and after spraying in order to limit their insecticide exposure resulting from IRS. This approach to community education is promising and deserves additional study.

Shai Chordekar, Cahtia Adelman, Haim Sohmer et al.

Context: Damage to the auditory system by loud sounds can be avoided by hearing protection devices (HPDs) such as earmuffs, earplugs, or both for maximum attenuation. However, the attenuation can be limited by air conduction (AC) leakage around the earplugs and earmuffs by the occlusion effect (OE) and by skull vibrations initiating bone conduction (BC). Aims: To assess maximum attenuation by HPDs and possible flanking pathways to the inner ear. Subjects and Methods: AC attenuation and resulting thresholds were assessed using the real ear attenuation at threshold (REAT) procedure on 15 normal-hearing participants in four free-field conditions: (a) unprotected ears, (b) ears covered with earmuffs, (c) ears blocked with deeply inserted customized earplugs, and (d) ears blocked with both earplugs and earmuffs. BC thresholds were assessed with and without earplugs to assess the OE. Results: Addition of earmuffs to earplugs did not cause significantly greater attenuation than earplugs alone, confirming minimal AC leakage through the external meatus and the absence of the OE. Maximum REATs ranged between 40 and 46 dB, leading to thresholds of 46–54 dB HL. Furthermore, calculation of the acoustic impedance mismatch between air and bone predicted at least 60 dB attenuation of BC. Conclusion: Results do not support the notion that skull vibrations (BC) contributed to the limited attenuation provided by traditional HPDs. An alternative explanation, supported by experimental evidence, suggests transmission of sound to inner ear via non-osseous pathways such as skin, soft tissues, and fluid. Because the acoustic impedance mismatch between air and soft tissues is smaller than that between air and bone, air-borne sounds would be transmitted to soft tissues more effectively than to bone, and therefore less attenuation is expected through soft tissue sound conduction. This can contribute to the limited attenuation provided by traditional HPDs. The present study has practical implications for hearing conservation protocols.

Amparo Lopez-Bernus, Moncef Belhassen-García, Montserrat Alonso-Sardón et al.

BACKGROUND:Cystic echinococcosis (CE) is an important health problem in many areas of the world including the Mediterranean region. However, the real CE epidemiological situation is not well established. In fact, it is possible that CE is a re-emerging disease due to the weakness of current control programs. METHODOLOGY:We performed a retrospective observational study of inpatients diagnosed with CE from January 2000 to December 2012 in the Western Spain Public Health-Care System. PRINCIPAL FINDINGS:During the study period, 5510 cases of CE were diagnosed and 3161 (57.4%) of the cases were males. The age mean and standard deviation were 67.8 ± 16.98 years old, respectively, and 634 patients (11.5%) were younger than 45 years old. A total of 1568 patients (28.5%) had CE as the primary diagnosis, and it was most frequently described in patients <45 years old. Futhermore, a secondary diagnosis of CE was usually found in patients >70 year old associated with other causes of comorbidity. The period incidence rate was 17 cases per 105 person-years and was significantly higher when compared to the incidence declared through the Notifiable Disease System (1.88 cases per 105 person-years; p<0.001). CONCLUSIONS:CE in western Spain is an underestimated parasitic disease. It has an active transmission, with an occurrence in pediatric cases, but has decreased in the recent years. The systematic search of Hospital Discharge Records of the National Health System Register (HDR) may be a more accurate method than other methods for the estimation of the incidence of CE in endemic areas.

Kosynskyi E. О., Andriichuk Y.N., Hodinov V.N.

Approaches to definition of a level of state of health of students are shown. 94 students (48 girls and 46 youths) of basic medical group took part in an experiment. The state of the cardiovascular system was probed on indexes by frequencies of heart-throbs, arteriotony, index of Robinson, adaptation potential of circulation of blood. It is marked that at the beginning of school year students have a low level of functioning of the cardiovascular system. At 73,5 % girls and 62,2 % youth is expose tachycardia. At 8,2 % girls and 26,7 % youth is expose the enhanceable norm of systole arteriotony.

Paulo H. Yasuda, Elena E. Sakata, Maria Aparecida Shikanai-Yasuda et al.

Avaliou-se o desempenho da contraimunoeletroforese (CIE) no diagnóstico sorológico da leptospirose humana utilizando três tipos de antígenos derivados da L. interrogans sorovar icterohaemorrhagiae e do sorovar patoc da L. biflexa. Comparou-se os resultados obtidos na CIE com a prova de referência a soroaglutinação microscópica (SAM). Soros pareados de 135 pacientes com leptospirose foram subdivididos em 4 grupos de acordo com os resultados da SAM. Como controle coletou-se sangue de 69 indivíduos sadios. A concordância entre as duas técnicas variou de 92,64 a 94,11%. Os resultados obtidos pela CIE com os antígenos do sorovar icterohaemorrhagiae foram mais favoráveis do que aqueles derivados do patoc. Ressaltam-se as características de elevada sensibilidade detectando anticorpos antileptospiras mais precocemente do que a microaglutinação. As características encontradas no presente estudo credenciam o emprego da CIE como um método útil e prático para o diagnóstico da leptospirose humana na fase aguda da doença.<br>Counterimmunoelectrophoresis (CIE) was applied on paired sera from 135 pacients with leptospirosis and on 69 sera from a control group. The sera from pacients were subdivided in 4 groups according to the results obtained by the Microscopic Agglutination Test (MAT). The first samples sera from 58 pacientes were non reagent by MAT. Six monthly samples of sera were taken from 7 patients to follow-up and to determine the level of agglutinin and precipitin antibodies present using MAT and CIE. Serovars icterohaemorrhagie and patoc were used as antigens. Three types of antigens were compared, 1) Triton-X-100 extracted; 2) heat extacted and 3) a pool of them. The CIE using icterohaemorrhagiae derivated antigens types agreed with MAT in 92.64, 92.64 and 94.11% of the leptospirosis sera. The patoc antigens types reacted with the control group in 7.24, 86.95 and 84.05% of the samples, and consequently were eliminated from the present study. The icterohaemorrhagiae CIE reaction become positive earlier than MAT negative sera, and reverted to negative earlier in the follow-up samples from the pacients. The CIE was sensitive and specific, gave rapid results and was easy to perform.