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Effect of voluntary breathing exercises on stable coronary artery disease in heart rate variability and rate-pressure product: a study protocol for a single-blind, prospective, randomized controlled trial.
Wu, Q, Liu, L, Jiang, X, Hu, YY, Liang, QS, He, ZS, Xue, Y, Zhu, W, Tang, ZX, Hou, YY, et al
Trials. 2020;(1):602
Abstract
BACKGROUND At present, China has more than 11 million patients with stable coronary heart disease and this is becoming a major public health problem. The pathological changes of coronary heart disease can lead to dysfunction of the cardiac autonomic nervous system, which increases the risk of complications such as malignant arrhythmia (ventricular flutter, ventricular fibrillation, etc.), heart rate, systolic blood pressure, and rate-pressure product (RPP), which is highly correlated with myocardial oxygen consumption and indirectly reflects myocardial blood supply and oxygen consumption. Although the guidelines recommend that such patients take drugs to reduce heart rate and myocardial oxygen consumption, the clinical control of heart rate is still not ideal. Thus, in this trial, we will use voluntary breathing exercises as the strategy of exercise rehabilitation for patients with stable coronary artery disease (SCAD), in order to increase the vagus nerve activity and/or reduce the sympathetic nervous activity, help maintain or rebuild the balance of plant nerve system, improve the time-domain index of heart rate variability, reduce the burden on the heart, and relieve patients' anxiety and other negative emotions. METHODS This is a 6-month single-blind, randomized controlled clinical trial that will be conducted in the First Affiliated Hospital of Soochow University. A total of 140 patients who fill out the Informed Consent Form are registered and randomized 1:1 into the Voluntary Breathing Exercises (VBE)-based clinical trial monitoring group (n = 70) or the Routine follow-up group (n = 70). The VBE-based clinical trial monitoring group is given VBE training on the basis of conventional treatment and health education, while the control group received conventional health education and follow-up. The primary outcomes will be measured heart rate variability and RPP. Secondary outcomes will include changes in Self-rating Anxiety Scale, total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, weight, and body mass index. DISCUSSION This trial will carry out scientific respiratory exercise for patients with SCAD, which belongs to the category of active secondary prevention for patients, and changes from remedial to pre-protective. VBE is easy to operate and is not limited by time and place. It is important and meaningful to carry out VBE for patients with SCAD. This study will provide considerable evidence for further large-scale trials and alternative strategies for the rehabilitation nursing of patients with SCAD. TRIAL REGISTRATION Chinese Clinical Trials Registry, 1900024043 . Registered on 23 June 2019.
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Beyond survival: Practical wellness tips during the 2019 coronavirus disease pandemic.
Maniuk, T, Mok, G, Schouela, N, Thurgur, L, Ho, M, Fischer, L, Syed, S
CJEM. 2020;(5):579-583
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Influence of two different methods of nutrition education on the quality of life in children and adolescents with type 1 diabetes mellitus - a randomized study.
Dłużniak-Gołaska, K, Panczyk, M, Szypowska, A, Sińska, B, Szostak-Węgierek, D
Roczniki Panstwowego Zakladu Higieny. 2020;(2):197-206
Abstract
Background. Nutrition education is one of the most important factors determining the effectiveness of treatment and maintaining an adequate quality of life (QoL) in children and adolescents with type 1 diabetes. Material and Methods. A randomized single-blind study was conducted between October 2017 and April 2019 at the Children's Clinical Hospital in Warsaw. The study included 170 patients (aged 8-17) with at least 1-year history of type 1 diabetes, treated with insulin pumps. The participants were randomly divided into two groups: a control group (C) - traditional/ informative education methods, and an experimental group (E) - modern/interactive methods. PedsQL Diabetes Module 3.0 questionnaire was used in the assessment of the QoL. Total PedsQL score was the primary outcome. The secondary outcomes included the results obtained in five subscales of the questionnaire. The relationships between selected variables and changes in scores were also verified. Results. Data obtained from 136 patients were analyzed. In both groups no significant changes regarding total PedsQL were noted 6 months after the intervention. However, a significant reduction occurred as regards the scores of 'Communication' subscale in group C. Analyzing other determinants of the QoL, significant dependencies were observed between: the level of physical activity and a change in 'Diabetes symptoms' subscale, and the level of parents' education and a change in 'Treatment barriers' subscale. Conclusions. Both methods of nutrition education exerted a comparable influence on the total QoL. However, modern methods were more effective in terms of the improvement in the aspect of communication. Additionally, moderate physical activity and parents' tertiary education constituted valid determinants of various aspects of the QoL in children and adolescents with type 1 diabetes.
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Positive Effects of Practical Nutrition Lessons in a Primary School Setting with a High Proportion of Migrant School Children.
Weber, KS, Eitner, J, Dauben, L, Spörkel, O, Strassburger, K, Sommer, J, Kaiser, B, Buyken, AE, Kronsbein, P, Müssig, K
Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association. 2020;(2):111-118
Abstract
BACKGROUND Children with migration background are at increased risk for overweight, partly due to less favorable dietary habits compared to their German counterparts. We examined the effects of practical nutrition lessons among children with a high proportion of migration background in a primary school setting. METHODS Ten 3rd and 4th grade classes (n=166 children, 73% with migration background) received the intervention and nine school classes (n=139 children, 76% with migration background) served as control. Before, shortly after (only among the intervention group) and three months after the three-day practical nutrition lessons, the nutrition-related skills, behavior, attitudes, and knowledge of the children were assessed using a questionnaire. Changes between baseline and 1st follow-up among children of the intervention group were calculated using linear mixed models. Differences between the two groups for changes between baseline and 2nd follow-up were tested using linear regression analyses. Models were adjusted for potential confounders. RESULTS Shortly after the practical nutrition lessons, the children of the intervention group had improved their knowledge (β=1.7; 95% CI: 1.0; 2.4, P<0.001) and skills (β=1.8; 95% CI: 1.4; 2.2, P<0.001). These changes were sustainable and larger in the intervention compared to the control group (knowledge: β=1.6; 95% CI: 0.7; 2.5, P<0.001; skills: β=1.3; 95% CI: 0.7; 1.9, P<0.001). Changes in nutrition-related behavior and attitudes did not differ between the groups. CONCLUSIONS Providing practical nutrition lessons in a primary school setting with a high proportion of children with immigrational background improved the children's nutrition-related knowledge and skills.
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The effect of education through mobile phone short message service on promoting self-care in pre-diabetic pregnant women: A randomized controlled trial.
Abbaspoor, Z, Amani, A, Afshari, P, Jafarirad, S
Journal of telemedicine and telecare. 2020;(4):200-206
Abstract
INTRODUCTION Gestational diabetes is increasing in developed and developing countries. This study aimed to evaluate the effect of SMS messaging on the self-care among pre-diabetic pregnant women. METHODS This randomized controlled trial conducted on 100 pre-diabetic pregnant women referred to Ahvaz Health Centers, Iran, Sep to Dec, 2016. Women were randomly assigned into the face to face education group and short message systems in addition to the face to face education group. Self-care variables were compared between the groups. Data was analyzed using chi-square, independent and paired t-tests. RESULTS There was no difference regard to FBG and OGTT, but there was a significant difference between groups in physical activity level (P<0.001) and in all food groups except bread and cereals after the intervention (P<0.05). CONCLUSION The education through a short text message system seem couldn't control the blood sugar, but it could promote physical activity and food additives of pre-diabetic pregnant women.
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Impact of a nutrition education programme on preschool children's willingness to consume fruits and vegetables.
Melnick, EM, Thomas, K, Farewell, C, Quinlan, J, LaFlamme, D, Brogden, D, Scarbro, S, Puma, JE
Public health nutrition. 2020;(10):1846-1853
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Abstract
OBJECTIVE To evaluate the impact of a preschool-based nutrition education programme consisting of twelve 'hands on' nutrition education lessons delivered during the school year on young children's willingness to consume fruits and vegetables. DESIGN Quasi-experimental, pre-post design including the collection of plate waste evaluation data at the start and end of the 2015-2016 school year within two groups: (1) randomly selected classrooms receiving the intervention and (2) within conveniently sampled preschool classrooms not receiving the intervention serving as a comparison group. SETTING Centre-based preschool programmes serving low-income families in the Denver metro area. PARTICIPANTS Three- to five-year-old children in preschool classrooms participating in the intervention during the 2015-2016 school year (n 308) and children enrolled in comparison classrooms (n 215). RESULTS Repeated-measures logit models assessed whether increases in the odds of consuming small samples of fruits and vegetables between Time 1 (pre-intervention) and Time 2 (post-intervention) were different for children within the intervention group compared with the comparison group. Analyses showed that the change over time in consumption of the three vegetable samples varied by intervention status with greater change occurring among children within the intervention group (edamame: P = 0·001; cauliflower: P ≤ 0·0001 and red pepper: P ≤ 0·0001). Unlike vegetables, the change over time in consumption of the two fruit samples was not different between children within the intervention and comparison groups. CONCLUSIONS An experiential-learning nutrition education programme can positively influence eating behaviours of low-income preschoolers in a centre-based setting by increasing willingness to consume vegetables.
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Effect of an educational intervention on public knowledge, attitudes, and intended practices towards diabetes mellitus: A quasi-experimental study.
Alsous, MM, Odeh, M, Abdel Jalil, M
International journal of clinical practice. 2020;(9):e13565
Abstract
AIM: To assess the impact of educational workshops on the knowledge, attitudes, and intended practices (KAP) of the general public towards diabetes in Jordan in terms of symptoms, risk factors, complications, and prevention. METHODS A pharmacist led educational intervention and Propensity score matching was carried out for a convenience sample to assess Jordanians pre- and post-knowledge, attitudes, and practices towards diabetes mellitus (DM) using a validated questionnaire. RESULTS Among the 357 invited participants, 335 attended the educational workshops (response rate 93.8%). Prior to intervention, participants showed an overall knowledge score of 16.03 ± 4.88. About half of the participants knew that a sedentary lifestyle is a risk factor for getting DM (n = 172, 51.3%). Following educational intervention, knowledge scores significantly improved to be 21.36 ± 2.11 (P value < .001). A similar finding was obtained for attitude scores, where mean attitude scores significantly improved from 2.74 ± 1.94 before intervention to 4.40 ± 1.87 following the workshop (P value < .001). As for the intended practices, the educational intervention improved the participants' intent to exercise, eat healthy foods, and do annual screening. CONCLUSIONS Participants' knowledge, attitudes, and intended practices improved following a trained pharmacy led educational intervention. These encouraging results highlight the need for continuous national educational interventions about diabetes provided by trained health care professionals such as pharmacists. Future studies are needed to evaluate the impact of improved knowledge and perceptions on actual long-term practice.
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Effects of school-based physical activity and multi-micronutrient supplementation intervention on growth, health and well-being of schoolchildren in three African countries: the KaziAfya cluster randomised controlled trial protocol with a 2 × 2 factorial design.
Gerber, M, Ayekoé, SA, Beckmann, J, Bonfoh, B, Coulibaly, JT, Daouda, D, du Randt, R, Finda, L, Gall, S, Mollel, GJ, et al
Trials. 2020;(1):22
Abstract
BACKGROUND In low- and middle-income countries, infectious diseases remain a key public health issue. Additionally, non-communicable diseases are a rapidly growing public health problem that impose a considerable burden on population health. One way to address this dual disease burden, is to incorporate (lifestyle) health promotion measures within the education sector. In the planned study, we will (i) assess and compare physical activity, physical fitness, micronutrient status, body composition, infections with soil-transmitted helminths, Schistosoma mansoni, malaria, inflammatory and cardiovascular health risk markers, cognitive function, health-related quality of life, and sleep in schoolchildren in Côte d'Ivoire, South Africa and Tanzania. We will (ii) determine the bi- and multivariate associations between these variables and (iii) examine the effects of a school-based health intervention that consists of physical activity, multi-micronutrient supplementation, or both. METHODS Assuming that no interaction occurs between the two interventions (physical activity and multi-micronutrient supplementation), the study is designed as a cluster-randomised, placebo-controlled trial with a 2 × 2 factorial design. Data will be obtained at three time points: at baseline and at 9 months and 21 months after the baseline assessment. In each country, 1320 primary schoolchildren from grades 1-4 will be recruited. In each school, classes will be randomly assigned to one of four interventions: (i) physical activity; (ii) multi-micronutrient supplementation; (iii) physical activity plus multi-micronutrient supplementation; and (iv) no intervention, which will serve as the control. A placebo product will be given to all children who do not receive multi-micronutrient supplementation. After obtaining written informed consent from the parents/guardians, the children will be subjected to anthropometric, clinical, parasitological and physiological assessments. Additionally, fitness tests will be performed, and children will be invited to wear an accelerometer device for 7 days to objectively assess their physical activity. Children infected with S. mansoni and soil-transmitted helminths will receive deworming drugs according to national policies. Health and nutrition education will be provided to the whole study population independently of the study arm allocation. DISCUSSION The study builds on the experience and lessons of a previous study conducted in South Africa. It involves three African countries with different social-ecological contexts to investigate whether results are generalisable across the continent. TRIAL REGISTRATION The study was registered on August 9, 2018, with ISRCTN. https://doi.org/10.1186/ISRCTN29534081.
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Education Research: Online Alzheimer education for high school and college students: A randomized controlled trial.
Saif, N, Niotis, K, Dominguez, M, Hodes, JF, Woodbury, M, Amini, Y, Sadek, G, Scheyer, O, Caesar, E, Hristov, H, et al
Neurology. 2020;(16):e2305-e2313
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OBJECTIVE Alzheimer disease (AD) risk factors are present throughout the lifespan. This randomized controlled trial evaluated the effectiveness of various online education strategies concerning AD risk reduction and brain health in younger populations. METHOD High school and college students were recruited via social media (Facebook and Instagram) to join AlzU.org, an evidence-based education portal, and were randomized to 1 of 4 courses: highly interactive webinar lessons narrated by actor Seth Rogen (celebrity webinar) or a physician (doctor webinar), minimally interactive video lessons with Seth Rogen (celebrity video), or minimally interactive video lessons (control). Surveys were administered at baseline and postcourse. The primary outcome was change in knowledge of AD risk reduction assessed by pre vs post lesson quiz scores. Secondary outcomes included change in awareness of AD research, hopefulness about AD, interest in pursuing health care, willingness to volunteer, and likelihood of recommending AlzU.org. RESULT A total of 721 participants joined. A total of 281 (38.9%) completed the course. Among college students, quiz score improvements were greater in celebrity webinar and celebrity video vs doctor webinar and control. Among high school students, no differences were found in quiz scores. In both groups, celebrity webinar, celebrity video, and doctor webinar resulted in greater improvements in awareness that nutrition and exercise may reduce AD risk vs controls. Among college students, celebrity webinar and celebrity video group participants felt more hopeful about the future of AD and more likely to recommend AlzU.org vs doctor webinar and control participants. Among college students, celebrity webinar, celebrity video, and doctor webinar participants were more willing to volunteer for AD causes and pursue health care careers vs controls. CONCLUSION Online education involving a celebrity may be an effective strategy for educating college students about AD risk reduction strategies. Further studies are warranted in high school students.
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A scoping review of evaluation frameworks and their applicability to real-world physical activity and dietary change programme evaluation.
Fynn, JF, Hardeman, W, Milton, K, Jones, AP
BMC public health. 2020;(1):1000
Abstract
BACKGROUND Physical activity and dietary change programmes play a central role in addressing public health priorities. Programme evaluation contributes to the evidence-base about these programmes; and helps justify and inform policy, programme and funding decisions. A range of evaluation frameworks have been published, but there is uncertainty about their usability and applicability to different programmes and evaluation objectives, and the extent to which they are appropriate for practitioner-led or researcher-led evaluation. This review appraises the frameworks that may be applicable to evaluation of physical activity and/or dietary change programmes, and develops a typology of the frameworks to help guide decision making by practitioners, commissioners and evaluators. METHODS A scoping review approach was used. This included a systematic search and consultation with evaluation experts to identify evaluation frameworks and to develop a set of evaluation components to appraise them. Data related to each framework's general characteristics and components were extracted. This was used to construct a typology of the frameworks based on their intended programme type, evaluation objective and format. Each framework was then mapped against the evaluation components to generate an overview of the guidance included within each framework. RESULTS The review identified 71 frameworks. These were described variously in terms of purpose, content, or applicability to different programme contexts. The mapping of frameworks highlighted areas of overlap and strengths and limitations in the available guidance. Gaps within the frameworks which may warrant further development included guidance on participatory approaches, non-health and unanticipated outcomes, wider contextual and implementation factors, and sustainability. CONCLUSIONS Our typology and mapping signpost to frameworks where guidance on specific components can be found, where there is overlap, and where there are gaps in the guidance. Practitioners and evaluators can use these to identify, agree upon and apply appropriate frameworks. Researchers can use them to identify evaluation components where there is already guidance available and where further development may be useful. This should help focus research efforts where it is most needed and promote the uptake and use of evaluation frameworks in practice to improve the quality of evaluation and reporting.