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1.
Impact of Lifestyle Modification on Atrial Fibrillation.
Wingerter, R, Steiger, N, Burrows, A, Estes, NAM
The American journal of cardiology. 2020;(2):289-297
Abstract
Atrial Fibrillation (AF) is the most common arrhythmia in adults, and the rapid increase in AF prevalence has been classified by experts as an epidemic. The mechanisms of AF are complex and incompletely understood. While many aspects of management are now based on high quality evidence, other clinical decisions are based on experience and judgment. This article provides an up to date review relating to lifestyle modification and its effect on AF to inform clinical treatment. This comprehensive review used PubMed and Google Scholar to perform keyword searches of articles published between 1998 and the present, with the exception of the 1978 "Holiday Heart" article. Robust data has emerged identifying multiple risk factors for development of AF, including age, sex, hypertension, diabetes mellitus, obesity, alcohol consumption, exercise, and obstructive sleep apnea. Recent evidence indicates that lifestyle modification has a significant role in mitigating the risk and burden of AF. In conclusion, based on the available evidence, an interdisciplinary approach to lifestyle modification will likely reduce risk and/or symptom burden of AF.
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2.
Conceptualizing Health Behaviors as Acute Mood-Altering Agents: Implications for Cancer Control.
Dunton, GF, Kaplan, JT, Monterosso, J, Pang, RD, Mason, TB, Kirkpatrick, MG, Eckel, SP, Leventhal, AM
Cancer prevention research (Philadelphia, Pa.). 2020;(4):343-350
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Abstract
A massive portion of cancer burden is accounted for by a small collection of highly prevalent cancer risk behaviors (e.g., low physical activity, unhealthy diet, and tobacco use). Why people engage in numerous types of cancer risk behaviors and fail to adopt various cancer prevention behaviors has been poorly understood. In this commentary, we propose a novel scientific framework, which argues that a common affective (i.e., emotion based) mechanism underpins a diversity of such cancer risk and prevention behaviors. The scientific premise is that cancer risk and prevention behaviors produce immediate and robust changes in affective states that are translated into motivations and drives, which promote further pursuit of risk behaviors or avoidance of prevention behaviors. After describing the conceptual and scientific basis for this framework, we then propose central research questions that can address the validity and utility of the framework. Next, we selectively review and integrate findings on the mood-altering effects of various cancer risk and prevention behaviors from the addiction science, exercise science, and behavioral nutrition literatures, focusing on the nature and phenomenology of behavior-elicited mood changes and their value for predicting future behavior change. We conclude by discussing how this framework can be applied to address critical scientific questions in cancer control.
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Supporting women of childbearing age in the prevention and treatment of overweight and obesity: a scoping review of randomized control trials of behavioral interventions.
Hutchesson, MJ, de Jonge Mulock Houwer, M, Brown, HM, Lim, S, Moran, LJ, Vincze, L, Rollo, ME, Hollis, JL
BMC women's health. 2020;(1):14
Abstract
BACKGROUND Women of childbearing age are vulnerable to weight gain. This scoping review examines the extent and range of research undertaken to evaluate behavioral interventions to support women of childbearing age to prevent and treat overweight and obesity. METHODS Eight electronic databases were searched for randomized controlled trials (RCT) or systematic reviews of RCTs until 31st January 2018. Eligible studies included women of childbearing age (aged 15-44 years), evaluated interventions promoting behavior change related to diet or physical activity to achieve weight gain prevention, weight loss or maintenance and reported weight-related outcomes. RESULTS Ninety studies met the inclusion criteria (87 RCTs, 3 systematic reviews). Included studies were published from 1998 to 2018. The studies primarily focused on preventing excessive gestational weight gain (n = 46 RCTs, n = 2 systematic reviews), preventing postpartum weight retention (n = 18 RCTs) or a combination of the two (n = 14 RCTs, n = 1 systematic review). The RCTs predominantly evaluated interventions that aimed to change both diet and physical activity behaviors (n = 84) and were delivered in-person (n = 85). CONCLUSIONS This scoping review identified an increasing volume of research over time undertaken to support women of childbearing age to prevent and treat overweight and obesity. It highlights, however, that little research is being undertaken to support the young adult female population unrelated to pregnancy or preconception.
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Identifying contexts and mechanisms in multiple behavior change interventions affecting smoking cessation success: a rapid realist review.
Minian, N, Corrin, T, Lingam, M, deRuiter, WK, Rodak, T, Taylor, VH, Manson, H, Dragonetti, R, Zawertailo, L, Melamed, OC, et al
BMC public health. 2020;(1):918
Abstract
BACKGROUND Smoking continues to be a leading cause of preventable chronic disease-related morbidity and mortality, excess healthcare expenditure, and lost work productivity. Tobacco users are disproportionately more likely to be engaging in other modifiable risk behaviours such as excess alcohol consumption, physical inactivity, and poor diet. While hundreds of interventions addressing the clustering of smoking and other modifiable risk behaviours have been conducted worldwide, there is insufficient information available about the context and mechanisms in these interventions that promote successful smoking cessation. The aim of this rapid realist review was to identify possible contexts and mechanisms used in multiple health behaviour change interventions (targeting tobacco and two or more additional risk behaviours) that are associated with improving smoking cessation outcome. METHODS This realist review method incorporated the following steps: (1) clarifying the scope, (2) searching for relevant evidence, (3) relevance confirmation, data extraction, and quality assessment, (4) data analysis and synthesis. RESULTS Of the 20,423 articles screened, 138 articles were included in this realist review. Following Michie et al.'s behavior change model (the COM-B model), capability, opportunity, and motivation were used to identify the mechanisms of behaviour change. Universally, increasing opportunities (i.e. factors that lie outside the individual that prompt the behaviour or make it possible) for participants to engage in healthy behaviours was associated with smoking cessation success. However, increasing participant's capability or motivation to make a behaviour change was only successful within certain contexts. CONCLUSION In order to address multiple health behaviours and assist individuals in quitting smoking, public health promotion interventions need to shift away from 'individualistic epidemiology' and invest resources into modifying factors that are external from the individual (i.e. creating a supportive environment). TRIAL REGISTRATION PROSPERO registration number: CRD42017064430.
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Extended Reality Technologies in Nutrition Education and Behavior: Comprehensive Scoping Review and Future Directions.
McGuirt, JT, Cooke, NK, Burgermaster, M, Enahora, B, Huebner, G, Meng, Y, Tripicchio, G, Dyson, O, Stage, VC, Wong, SS
Nutrients. 2020;(9)
Abstract
The use of Extended Reality (XR) (i.e. Virtual and Augmented Reality) for nutrition education and behavior change has not been comprehensively reviewed. This paper presents findings from a scoping review of current published research. Articles (n = 92) were extracted from PubMed and Scopus using a structured search strategy and selection approach. Pertinent study information was extracted using a standardized data collection form. Each article was independently reviewed and coded by two members of the research team, who then met to resolve any coding discrepancies. There is an increasing trend in publication in this area, mostly regarding Virtual Reality. Most studies used developmental testing in a lab setting, employed descriptive or observational methods, and focused on momentary behavior change like food selection rather than education. The growth and diversity of XR studies suggest the potential of this approach. There is a need and opportunity for more XR technology focused on children and other foundational theoretical determinants of behavior change to be addressed within nutrition education. Our findings suggest that XR technology is a burgeoning approach in the field of nutrition, but important gaps remain, including inadequate methodological rigor, community application, and assessment of the impact on dietary behaviors.
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Behavioral Approaches to Weight Management for Health and Wellness.
Normand, MP, Gibson, JL
Pediatric clinics of North America. 2020;(3):537-546
Abstract
Obesity has become a public health crisis associated with serious health problems. It is a problem that is, by and large, remarkably simple: you gain weight as a result of consuming more calories than you burn. Applied behavior analysis and behavior therapy have produced a range of methods and technologies well-suited to address the problems of overeating and physical inactivity. These methods and technologies, and the conceptual foundations underpinning them, are the focus of this article.
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Nutrition-related interventions targeting childhood overweight and obesity: A narrative review.
Kerr, JA, Loughman, A, Knox, A, Koplin, JJ, Allen, KJ, Wake, M
Obesity reviews : an official journal of the International Association for the Study of Obesity. 2019;:45-60
Abstract
Systematic reviews of nutritional interventions indicate limited efficacy in reducing childhood obesity, but their blanket conclusions could obscure promising components. This narrative review sought more detail on effective components within nutrition-related interventions involving children aged 2 to 11 years. In May 2016, the World Health Organization (WHO) searched the Cochrane Library and PubMed for relevant reviews. From 36 reviews, we screened 182 nutrition-related randomized trials for inclusion. We then reviewed those that reported at least 1 statistically significant (P < 0.05) treatment benefit on body weight and/or composition outcomes at their longest follow-up assessment. Fourteen trials met inclusion criteria (median n = 554; mean intervention duration = 10.8 mo; follow-up = 4.4 mo). "Effective" approaches included environmental changes such as school water fountain installations and cafeteria menu changes and possibly less sustainable strategies such as health education lessons. However, effect sizes even of these selected significant treatment benefits were modest-significant body mass index z-score effects range from -0.1 to -0.2. Each trial was associated with very small improvements in body composition. Because this is a "best-case" scenario (reflecting our design), trialists should rigorously test these strategies alone and possibly together; be open to novel strategies; and ensure that each strategy is culturally relevant and self-sustainable.
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Possible Solutions as a Concept in Behavior Change Interventions.
Mahoney, DE
International journal of nursing knowledge. 2019;(2):93-98
Abstract
PROBLEM Nurses are uniquely positioned to implement behavior change interventions. Yet, nursing interventions have traditionally resulted from nurses problem-solving rather than allowing the patient to self-generate possible solutions for attaining specific health outcomes. PURPOSE The purpose of this review is to clarify the meaning of possible solutions in behavior change interventions. METHODS Walker and Avant's method on concept analysis serves as the framework for examination of the possible solutions. CONCLUSION Possible solutions can be defined as continuous strategies initiated by patients and families to overcome existing health problems. IMPLICATIONS FOR NURSING PRACTICE As nurses engage in behavior change interventions, supporting patients and families in problem-solving will optimize health outcomes and transform clinical practice.
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HISTORICAL PERSPECTIVE OF GASTROESOPHAGEAL REFLUX DISEASE CLINICAL TREATMENT.
Zaterka, S, Marion, SB, Roveda, F, Perrotti, MA, Chinzon, D
Arquivos de gastroenterologia. 2019;(2):202-208
Abstract
BACKGROUND Gastroesophageal reflux disease (GERD) is one of the most prevalent gastrointestinal diseases. GERD generates significant impairment in patients' quality of life and it is associated to relevant medical resources utilization. A better understanding of GERD pathophysiology in the past five decades has favored the evolution of therapeutic strategies from non-drug interventions and antacids to more efficacious and safer alternatives. OBJECTIVE To summarize data about the historical evolution of GERD management in Brazil, focusing on medical therapy and addressing evidence on efficacy and safety of drug classes currently recommended. METHODS A narrative review was conducted by systematizing information about discoveries on GERD pathophysiology. We also addressed efficacy and safety of medications currently used to reduce symptoms and improve endoscopic healing of esophageal lesions. A structured search on Pubmed was performed to identify systematic reviews and meta-analysis investigating GERD outcomes positively impacted by proton pump inhibitors (PPIs), the first choice of pharmacotherapy for the disease. RESULTS The chronological development of therapeutic measures for GERD in Brazil evolved from lifestyle interventions with relative poor effect on symptoms related to esophageal acid exposure, particularly heartburn, to effective and safe pharmacological interventions such as histamine H2-receptor antagonists and PPIs. In the present days, some drug classes play a minor role in disease management, namely prokinetics and antacids, due to their reduced efficacy and relevant safety concerns (particularly with prokinetics). The main challenge for prescribers and researchers seems to be finding long-acting acid suppressants strategies able to ameliorate patients' symptoms and quality of life, thereafter, reducing medical resource consumption. The dual delayed-release PPI dexlansoprazole seems to respond for some of the limitations other PPIs have. CONCLUSION Recognizing the historical evolution of GERD management can help care providers to better understand therapeutic options for their patients, as well as focus on unmet needs that deserve further attention. PPIs are still the first choice therapy, with good evidence in favor of their efficacy, despite some safety concerns. However, as with any medical intervention, it is recommended to prescribe PPIs for patients with clear indication, using adequate dosing and monitoring for adverse events.
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Final Consumer Options to Control and Prevent Foodborne Norovirus Infections.
Guix, S, Pintó, RM, Bosch, A
Viruses. 2019;(4)
Abstract
Norovirus (NoV) causes about one-fifth of all cases of foodborne diseases and is a foremost cause of domestically acquired foodborne acute gastroenteritis and outbreaks. NoV infections are often associated with the consumption of contaminated fresh and ready-to-eat produce, fresh and frozen berries, raw/undercooked bivalve mollusks and products which become contaminated during handling. Despite many industrial efforts to control and prevent NoV contamination of foods, the prevalence of NoV in high-risk foodstuffs at retail is still significant. Although certain consumer behaviors may even increase the risk of virus transmission, interventions aiming at changing/implementing consumer habits may be considered as opportunities for risk mitigation. This review aims at providing an update on the progress made in characterizing the effect that consumer habits, which are most critical to prevent NoV transmission (food choice and hygiene, disinfection and cooking during food preparation), may have on reducing the risk of NoV infection. A better understanding of the options for NoV control and prevention may be translated into innovative educational, social or even technological tools targeting consumers with the objective of mitigating the risk of NoV transmission.