Comparison of health-related quality of life (HRQoL) between ileal conduit diversion and orthotopic neobladder based on validated questionnaires: a systematic review and meta-analysis

Purpose

The question of whether orthotopic neobladder (ONB) reconstruction is superior to ileal conduit diversion (ICD) with respect to health-related quality of life (HRQoL) remains controversial. The goal of this study is to perform a meta-analysis to compare post-ICD and post-ONB HRQoL in patients with bladder cancer.

Methods

A systematic search of Medline, Embase, the Cochrane Central Register of Controlled Trials, and the annual congress abstracts of the European Association of Urology (EAU), the American Urological Association (AUA) and the Société Internationale d’Urologie (SIU) up to June 2017 was conducted to identify all relevant clinical trials using validated questionnaires to assess HRQoL. A systematic review and meta-analysis were then performed.

Results

A total of 2507 patients from 26 eligible studies were included. Meta-analyses showed significant differences favouring ONB patients in global health status (WMD?+?9.13, p?=?0.004), physical functioning (WMD?+?11.57, p?=?0.0001), role functioning (WMD?+?9.64, p?=?0.002), and social functioning (WMD?+?6.81, p?=?0.03) based on the EORTC-QLQ-C30 questionnaire and in the total score of FACT questionnaire (WMD?+?6.80, p?=?0.001). However, ONB patients were more likely to have postoperative urinary symptoms than ICD patients (WMD ??22.19, p?=?0.0001).

Conclusions

ONB patients are more likely to have a better global health status than ICD patients. Regardless of the type of urinary diversion (UD) surgery, a gradual improvement in HRQoL over preoperative status tended to stabilise after 12 months postoperatively.

     

Consumption of vitamin D-fortified yogurt drink increased leptin and ghrelin levels but reduced leptin to ghrelin ratio in type 2 diabetes patients: a single blind randomized controlled trial

Purpose

This study aimed to evaluate the effect of daily consumption of vitamin D-fortified yogurt drink (doogh) in comparison with plain doogh on appetite-regulating hormones including leptin and ghrelin in type 2 diabetes (T2D) patients.

Methods

In a single blind randomized clinical trial, subjects with T2D were randomly allocated to one of the two groups and received either vitamin D3-fortified doogh (FD; containing 170 mg calcium and 500 IU/250 mL, n ₂?=?50) or plain doogh (PD; containing 170 mg calcium and no vitamin D/250 mL, n ₁?=?50) twice a day for 12 weeks. Leptin and ghrelin were evaluated at the beginning and after 12 weeks of intervention.

Results

The intervention resulted in a significant improvement of circulating 25(OH)D, fasting glucose, Quantitative Insulin Check Index (QUICKI), hs-CRP, in FD compared with PD group. A significant rise in both serum leptin (+1.3?±?7.2 mg/L; p?=?0.013) and ghrelin (10.1?±?26.1 ng/L; p?=?0.012) was observed in FD group. A between-group difference for ghrelin changes (p?=?0.029) remained significant after adjusting for changes QUICKI (p?=?0.039), body mass index (p?=?0.034) and hs-CRP (p?=?0.022). Despite an increase in both leptin and ghrelin, leptin to ghrelin (L/G) ratio actually decreased in FD. Changes of L/G ratio showed a significant between-group difference (p?=?0.036), which remained significant even after adjusting for changes of hs-CRP (p?=?0.028) and fat mass (p?=?0.047) but disappeared after adjusting for changes of QUICKI (p?=?0.42).

Conclusions

Daily intake of vitamin D-fortified doogh may increase circulating leptin and ghrelin but L/G ratio may actually decrease. Our results suggest that improving vitamin D may result in an improvement in insulin sensitivity which may finally regulate beneficially appetite hormones. Further studies with adequate power are needed to confirm the results.

     

Effect of socio-demographic factors and obesity on blood pressure among adults based on health status in Gaza,Palestine

Aims

To identify risk factors of elevated blood pressure due to differences in socio-demographic factors, obesity, and health status.

Methods

Cross-sectional study. A total of 482 participants were chosen from Primary Healthcare Centers in Gaza City, Palestine, based on objective criteria.

Results

Systolic and diastolic blood pressure (SBP and DBP) showed significant differences according to different educational, menopausal, obesity, and health statuses, but no significant differences due to sex, marital status, and family size. Correlations of SBP with age, waist circumference, and weight were significant at P?=?0.001 (r _s?=?0.444, r _s?=?0.434, and r _s?=?0.323, respectively). Correlations of DBP with age, waist circumference, and weight were also significant at P?=?0.001 (r _s?=?0.170, r _s?=?0.374, and r _s?=?0.362, respectively). A total of 169 subjects out of 482 have SBP?≥130 mmHg and DBP?≥85 mmHg. By the multivariate logistic regression model, the odds ratio (OR) for obesity equaled 2.768 (95% CI: 1.183 to 6.475, P?=?0.019), OR for having a mother with one or more chronic diseases equaled 1.886 (95% CI: 1.185 to 3.003, P?=?0.007), and OR for a medium-sized family (6–10 members) equaled 0.611 (95% CI: 0.376 to 0.994, P?=?0.013).

Conclusion

Blood pressure increased by elevated body mass index and waist circumference; participants who have a mother with hypertension and/or diabetes are most likely to have higher blood pressure.

     

The association between post-diagnosis health behaviors and long-term quality of life in survivors of ductal carcinoma in situ: a population-based longitudinal cohort study

Purpose

Women diagnosed with ductal carcinoma in situ (DCIS) often experience adverse changes in health-related behaviors following diagnosis. The impact of health behaviors on long-term quality of life (QoL) in DCIS survivors has not been investigated.

Methods

We examined the association of post-diagnosis body mass index (BMI), physical activity, alcohol, and smoking with QoL among 1448 DCIS survivors aged 20–74 enrolled in the population-based Wisconsin in situ Cohort from 1997 to 2006. Health behaviors and QoL were self-reported during biennial post-diagnosis interviews. Physical and mental QoL were measured using the validated SF-36 questionnaire. Generalized linear regression was used to determine the association between behaviors and QoL with adjustment for confounders. Lagged behavior variables were used to predict QoL during follow-up and avoid reverse causation.

Results

Women reported 3,536 QoL observations over an average 7.9 years of follow-up. Women maintaining a healthy BMI had on average a significantly higher summary measure score of physical QoL than obese women (normal versus obese: β?=?3.02; 2.18, 3.85). Physical QoL scores were also elevated among those who were physically active (5?+?h/week vs. none: β?=?1.96; 0.72, 3.20), those consuming at least seven drinks/week of alcohol (vs. none; β?=?1.40; 0.39, 2.41), and nonsmokers (vs. current smokers: β?=?1.80; 0.89, 2.71). Summary measures of mental QoL were significantly higher among women who were moderately physically active (up to 2 h/week vs. none: β?=?1.11; 0.30, 1.92) and nonsmokers (vs. current smokers: β?=?1.49;0.45, 2.53).

Conclusions

Our results demonstrate that maintaining healthy behaviors following DCIS treatment is associated with modest improvements in long-term QoL. These results inform interventions aimed at promoting healthy behaviors and optimizing QoL in DCIS survivors.

     

Iodine nutrition and thyroid nodules among children and adolescents in a coastal area of China

Aim

This study aims to assess iodine nutritional status and investigate the prevalence of thyroid nodules in children and adolescents in Ningbo city, China.

Subject and methods

A cross-sectional survey was conducted in Ningbo, China, in 2011. Salt iodine, urine iodine concentration (UIC) and thyroid nodules (by ultrasonography) were measured in 329 participants aged 6–17 years.

Results

The median UIC of all participants was 167.23 μg/L. No significant differences in UICs were observed between boys and girls (Z?=??1.06, P?=?0.29), children and adolescents (Z?=??1.88, P?=?0.06), iodized salt users and noniodized salt users (Z?=??0.10, P?=?0.92). A total of 114 nodules with maximum diameters between 1.5 and 12 mm were found among 51 (15.50 %) participants, the prevalence of thyroid nodules between children and adolescents has no significant difference (χ ²?=?0.29, P?=?0.59), and there were no significant differences in age (t?=?1.56, P?=?0.12), gender (χ ²?=?0.13, P?=?0.72), type of salt (χ ²?=?0.14, P?=?0.71), family history of thyroid diseases (P?=?0.46, Fisher’s exact test) and UICs (Z?=??1.12, P?=?0.26) between the participants with thyroid nodules and those without.

Conclusion

The iodine nutrition was adequate in children and adolescents in Ningbo city, but the prevalence of thyroid nodules among children and adolescents was high.

     

The association between maternal nutrition and lifestyle during pregnancy and 2-year-old offspring adiposity: analysis from the ROLO study

Aim

To examine the association between maternal nutrition and lifestyle factors and offspring adiposity, using baseline and 2-year postpartum follow-up data from a randomised control trial of low glycaemic index diet.

Subject and methods

Food diaries and lifestyle questionnaires were completed during pregnancy and infant feeding and maternal lifestyle questionnaires 2 years postpartum for 281 mother and infant pairs from the ROLO study. Maternal anthropometry was measured throughout pregnancy and infant and maternal anthropometry was measured 2 years postpartum.

Results

Maternal 2 year postpartum body mass index (BMI) was positively associated with offspring BMI-for-age z-score (B?=?0.105, p?=?0.015). Trimester 2 saturated fat intake was positively associated with offspring subscapular:triceps skinfold ratio (B?=?0.018, p?=?0.001). Trimester 1 glycaemic index was also positively associated with offspring sum of subscapular and triceps skinfolds (B?=?0.009, p?=?0.029).

Conclusions

Maternal BMI 2 years postpartum was positively associated with offspring BMI. Pregnancy saturated fat intake was positively and polyunsaturated fat negatively associated with offspring adiposity. While further research is necessary, pregnancy and the postpartum period may be early opportunities to combat childhood obesity.

     

Impact of orthodontic treatment on adolescents’ quality of life: a longitudinal evaluation of treated and untreated individuals

Purpose

To assess the impact of fixed appliance therapy on the quality of life of a cohort of Brazilian adolescents.

Methods

The treatment group was composed of individuals who started orthodontic treatment. The control group was composed of individuals not selected for immediate treatment. Adolescents answered the Brazilian short form of the Child Perceptions Questionnaire (CPQ_11–14). Higher scores indicate a greater negative impact on quality of life. Adolescents in the treatment group completed four sets of interviews: prior to appliances’ bonding (T1), 1 month (T2), 6 months (T3) and 12 months (T4) after appliances’ placement. Adolescents in the control group were assigned to a comparable schedule. Statistics included inter-group comparisons, Friedman and Wilcoxon tests, and mixed-effects models.

Results

In the treatment group, the functional limitation score was higher at T1 (p?=?0.004) and T2 (p?=?0.007) compared to T4. The emotional well-being score was higher at T1 compared to T2 (p?<?0.001), T3 (p?<?0.001) and T4 (p?<?0.001). The overall CPQ_11–14 score was higher at T1 compared to T2 (p?=?0.005), T3 (p?<?0.001) and T4 (p?<?0.001). The overall CPQ_11–14 score was also higher at T2 compared to T3 (p?=?0.001). No significant change was found in the control group. In the mixed-effects models, the interaction between group (treatment) and time was significant for functional limitations (p?<?0.001), emotional well-being (p?<?0.001), social well-being (p?=?0.004) and the overall CPQ_11–14 score (p?<?0.001).

Conclusion

Quality of life improved among adolescents undergoing orthodontic treatment. Orthodontists should inform patients what they might expect regarding the physical and the psychosocial repercussions of appliance therapy.

     

Health and well-being benefits of spending time in forests: systematic review

Background

Numerous studies have reported that spending time in nature is associated with the improvement of various health outcomes and well-being. This review evaluated the physical and psychological benefits of a specific type of exposure to nature, forest therapy.

Method

A literature search was carried out using MEDLINE, PubMed, ScienceDirect, EMBASE, and ProQuest databases and manual searches from inception up to December 2016. Key words: “Forest” or “Shinrin -Yoku” or “Forest bath” AND “Health” or “Wellbeing”. The methodological quality of each randomized controlled trials (RCTs) was assessed according to the Cochrane risk of bias (ROB) tool.

Results

Six RCTs met the inclusion criteria. Participants’ ages ranged from 20 to 79 years. Sample size ranged from 18 to 99. Populations studied varied from young healthy university students to elderly people with chronic disease. Studies reported the positive impact of forest therapy on hypertension (n?=?2), cardiac and pulmonary function (n?=?1), immune function (n?=?2), inflammation (n?=?3), oxidative stress (n?=?1), stress (n?=?1), stress hormone (n?=?1), anxiety (n?=?1), depression (n?=?2), and emotional response (n?=?3). The quality of all studies included in this review had a high ROB.

Conclusion

Forest therapy may play an important role in health promotion and disease prevention. However, the lack of high-quality studies limits the strength of results, rendering the evidence insufficient to establish clinical practice guidelines for its use. More robust RCTs are warranted.

     

Effects of 12-week supplementation of <Emphasis Type="Italic">Citrus bergamia</Emphasis> extracts-based formulation CitriCholess on cholesterol and body weight in older adults with dyslipidemia: a randomized,double-blind,placebo-controlled trial

Backgrounds

Recent experiments suggest that Citrus bergamia extracts could benefit people with dyslipidemia and obesity but this needs to be further validated.

Methods

A total of 98 people age-matched older adults (65 years) with elevated blood lipids were enrolled to receive 12-week supplementation of a Citrus bergamia extracts-based formulation (CitriCholess)(n?=?48) and placebo (n?=?50).

Results

No group differences were found in baseline bodyweight, body mass index (BMI), blood cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C) and glucose levels. CitriCholess supplementation resulted in lower levels than placebo in TG (1.83?±?0.92 vs. 1.95?±?1.34 mmol/L, P?=?0.612), TC (5.14?±?0.98 vs. 5.44?±?0.77 mmol/L, P?=?0.097), and LDL-C (3.13?±?0.74 vs. 3.43?±?0.62 mmol/L, P?=?0.032). Compared to placebo, CitriCholess also resulted in greater reductions in body weight (?0.604?±?0.939 vs. 0.06?±?0.74 kg, P?<?0.01), waist circumferences (?0.60?±?1.349 cm vs. -0.16?±?1.503 cm, P?<?0.01) and BMI (?0.207?±?0.357 vs. 0.025?±?0.274, P?<?0.01). Additionally, females had a significantly higher level of HDL-C than males. TC was significantly correlated with LDL-C, and to a less degree, with TG. TG was inversely correlated with HDL-C. Body weight and waist circumference were negatively correlated with HDL-C and positively correlated with glucose.

Conclusion

12-week supplementation of CitriCholess could benefit lipid metabolism and weight management in old adults with dyslipidemia.

     

Body mass index and physical activity and the risk of diverticular disease: a systematic review and meta-analysis of prospective studies

Purpose

We conducted a systematic review and meta-analysis of prospective studies of the association between body mass index (BMI) and physical activity and diverticular disease risk.

Methods

PubMed and Embase databases were searched up to February 7, 2017. Summary relative risks and 95% confidence intervals (95% CIs) were calculated using a random effects model and nonlinear associations were modeled using fractional polynomial models.

Results

Six cohort studies of BMI and diverticular disease risk (28,915 cases, 1,636,777 participants) and five cohort studies of physical activity and diverticular disease risk (2080 cases, 147,869 participants) were included. The summary relative risk (RR) of incident diverticular disease for a 5 unit BMI increment was 1.28 (95% CI: 1.18–1.40, I ²?=?77%, n?=?6) for diverticular disease, 1.31 (95% CI: 1.09–1.56, I ²?=?74%, n?=?2) for diverticulitis, and 1.20 (95% CI: 1.04–1.40, I ²?=?56%, n?=?3) for diverticular disease complications. There was no evidence of a nonlinear association between BMI and diverticular disease risk (p _nonlinearity?=?0.22), and risk increased even within the normal weight range. Compared to a BMI of 20, the summary RR for a BMI of 22.5, 25.0, 27.5, 30.0, 32.5, 35.0, 37.5, and 40.0 was 1.15 (1.07–1.23), 1.31 (1.17–1.47), 1.50 (1.31–1.71), 1.71 (1.52–1.94), 1.96 (1.77–2.18), 2.26 (2.00–2.54), 2.60 (2.11–3.21), and 3.01 (2.06–4.39), respectively. The summary RR was 0.76 (95% CI: 0.63–0.93, I ²?=?54%, n?=?5) for high vs. low physical activity and 0.74 (95% CI: 0.57–0.97, I ²?=?39.5%, p _{heterogeneity}?=?0.20, n = 2) for high vs. low vigorous physical activity.

Conclusions

These results suggest that even moderate increases in BMI may increase the risk of diverticular disease as well as diverticular disease complications and that a higher level of physical activity may reduce the risk.

     

Cytological evaluation of breast lesions in symptomatic patients presenting to Kenyatta National Hospital,Kenya: a retrospective study

Background

Palpable breast lump, breast pain, and nipple discharge are common symptoms of breast disease. Breast cytology (fine-needle aspiration, nipple discharge smear, and touch preparation) accurately identifies benign, atypical, and malignant pathological changes in breast specimens. This study aims to determine the types of breast lesions diagnosed by breast cytology and assess the clinical adequacy of narrative reporting of breast cytology results.

Methods

Medical records of 390 patients presenting to breast or general surgery clinics in Kenyatta National Hospital, Nairobi, Kenya, between January 2010 and March 2014 were evaluated retrospectively.

Results

Of the 390 diagnosed breast lesions, 89.7 % (n?=?350) occurred in females, while 10.3 % (n?=?40) occurred in males, giving rise to a female-to-male ratio of 8.8:1. Neoplastic breast lesions (n?=?296) comprised 75.9 %, while non-neoplastic breast lesions (n?=?94) comprised 24.1 % of all diagnosed breast lesions. The neoplastic lesions were classified as 72.3 % (n?=?214) benign and 27.7 % (n?=?82) malignant, resulting in a benign-to-malignant ratio of 2.6:1. Fibroadenoma (n?=?136) and gynecomastia (n?=?33) were the most frequently diagnosed breast lesions for women and men, respectively.

Conclusions

Breast cytology effectively diagnosed neoplastic and non-neoplastic breast lesions. Neoplastic breast lesions occurred more frequently in women whereas non-neoplastic lesions occurred more frequently in men. To address the limitations associated with narrative reporting of breast cytology results, a synoptic reporting format incorporating the United Kingdom’s National Health Service Breast Screening Programme’s diagnostic categories (C1 to C5) is recommended for adoption by this hospital.

     

Effect of probiotics and synbiotics consumption on serum concentrations of liver function test enzymes: a systematic review and meta-analysis

Purpose

The gut–liver interaction suggests that modification of gut bacterial flora using probiotics and synbiotics may improve liver function. This systematic review and meta-analysis aimed to clarify the effect of probiotics and synbiotics consumption on the serum concentration of liver function enzymes.

Methods

PubMed (MEDLINE), Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library (Central) were searched from 1980 to August 2017 for studies where adults consumed probiotics and/or synbiotics in controlled trials and changes in liver function enzymes were examined.

Results

A total of 17 studies (19 trials) were included in the meta-analysis. Random effects meta-analyses were applied. Probiotics and synbiotics significantly reduced serum alanine aminotransferase [? 8.05 IU/L, 95% confidence interval (CI) ? 13.07 to ? 3.04; p?=?0.002]; aspartate aminotransferase (? 7.79 IU/L, 95% CI: ? 13.93 to ? 1.65; p?=?0.02) and gamma-glutamyl transpeptidase (? 8.40 IU/L, 95% CI ? 12.61 to ? 4.20; p?<?0.001). Changes in the serum concentration of alkaline phosphatase and albumin did not reach a statistically significant level. Changes to bilirubin levels were in favour of the control group (0.95 μmol/L, 95% CI 0.48–1.42; p?<?0.001). Subgroup analysis suggested the existence of liver disease at baseline, synbiotics supplementation and duration of supplementation?≥?8 weeks resulted in more pronounced improvement in liver function enzymes than their counterparts.

Conclusions

Probiotics and synbiotics may be suggested as supplements to improve serum concentration of liver enzymes, especially when synbiotics administered for a period?≥?8 weeks and in individuals with liver disease.

     

Armed conflict,alcohol misuse,decision-making,and intimate partner violence among women in Northeastern Uganda: a population level study

Background

Relations among and interactions between exposure to armed conflict, alcohol misuse, low socioeconomic status, gender (in)equitable decision-making, and intimate partner violence (IPV) represent serious global health concerns. Our objective was to determine extent of exposure to these variables and test pathways between these indicators of interest.

Methods

We surveyed 605 women aged 13 to 49 who were randomly selected via multistage sampling across three districts in Northeastern Uganda in 2016. We used Mplus 7.4 to estimate a moderated structural equation model of indirect pathways between armed conflict and intimate partner violence for currently partnered women (n?=?558) to evaluate the strength of the relationships between the latent factors and determine the goodness-of-fit of the proposed model with the population data.

Results

Most respondents (88.8%) experienced conflict-related violence. The lifetime/ past 12 month prevalence of experiencing intimate partner violence was 65.3%/ 50.9% (psychological) and 59.9%/ 43.8% (physical). One-third (30.7%) of women’s partners reportedly consumed alcohol daily. The relative fit of the structural model was superior (CFI?=?0.989; TLI?=?0.989). The absolute fit (RMSEA?=?0.029) closely matched the population data. The partner and joint decision-making groups significantly differed on the indirect effect through partner alcohol use (a₁b₁?=?0.209 [0.017: 0.467]).

Conclusions

This study demonstrates that male partner alcohol misuse is associated with exposure to armed conflict and intimate partner violence—a relationship moderated by healthcare decision-making. These findings encourage the extension of integrated alcohol misuse and intimate partner violence policy and emergency humanitarian programming to include exposure to armed conflict and gendered decision-making practices.

     

The effectiveness of an NaF rinse containing fTCP on eroded enamel remineralization

Objective

The authors investigated the effectiveness of a functionalized tricalcium phosphate (fTCP) combined with a low fluoride level in a mouthrinse to reharden eroded enamel lesions.

Methods

Ninety enamel slabs attached in pairs to removable appliances were randomly assigned to three treatment groups (n?=?30/group): (T1) NaF rinse (225 ppm F?+?40 ppm fTCP), (T2) NaF rinse (225 ppm F; ACT^®), and (T3) no mouthrinse (saliva). While wearing the in situ appliance for 14 days, subjects brushed their teeth with 1100 ppm F toothpaste (Crest©) for 2 min, rinsed with 15 ml of water for 10s, and then rinsed with 15 ml of their assigned treatment mouthrinse. Treatment efficacy was evaluated using surface microhardness (SMH) and transverse microradiography (TMR). Intra- and intergroup comparisons (α?=?0.05) were performed using the t-test and ANOVA followed by the Tukey test (HSD).

Results

With SMH, intragroup comparison (t-test) indicated significant rehardening of the eroded lesion with exposure to T1 (p?<?0.001) and T2 (p?<?0.01) but not with T3 However, with TMR, remineralization was only significant (p?=?0.01) with T1, but not with T2 and T3. In the intergroup comparison with percentage change in SMH, T1 was significantly different from T3 (p?<?0.01; Tukey HSD) but not from T2, and T2 was significantly different from T3. Intergroup comparison based on percentage mineral gain showed that T2 (p?=?0.02) and T3 (p?=?0.01) differed significantly from fTCP, but not between each other.

Conclusion

Addition of low level fluoride to functionalized β-tricalcium phosphate promoted rehardening of eroded enamel lesions.

     

When Fear of Childbirth is Pathological: The Fear Continuum

Objectives

Given that prepartum psychiatric symptoms have been reported to be associated with postpartum disorders, focusing on the prepartum period appears of prime importance. The aim of the current study was threefold: (a) to identify the prevalence rates of women suffering from fear of childbirth (FOC) and tokophobia (b) to explore the association between FOC, obstetrical and psychopathological variables and (c) to identify the independent predictors of the intensity of FOC symptoms, FOC and tokophobia.

Methods

at 36 weeks’ gestation, 98 women completed questionnaires assessing FOC, pretraumatic stress, fear of pain, depressive and anxiety symptomatology as well as perceived social support. Socio-demographic and gynecological data were also gathered.

Results

22.45% of women reported a probable FOC and 20.41% suffered from a potential tokophobia. Epidural anesthesia (ß = 5.62, p?<?0.05), and the intensity of pretraumatic stress symptoms (ß= 0.69, p?<?0.05), were independently associated with the intensity of FOC symptoms. Planning a c-section was significantly related to FOC (β?=?0.09, p?=?0.03). Planning an epidural anesthesia was also an independent predictor of both FOC and tokophobia (β?=?1.33, p?=?0.03; β?=?1.26, p?=?0.04, respectively).

Conclusions

Given the high rates of FOC and tokophobia highlighted, developing an appropriate preparation to childbirth is of great relevance. Longitudinal studies should be developed in order to provide an in-depth examination of the course of prepartum psychiatric disorders, maintenance of symptoms and their impact on subsequent infant development.

     

Effects of long-term multicomponent exercise on health-related quality of life in older adults with type 2 diabetes: evidence from a cohort study

Purpose

To establish the effect of a long-term multicomponent exercise (LTMEX) intervention (24 months) on health-related quality of life (HRQoL), in older adults with type 2 diabetes (T2D).

Methods

This longitudinal retrospective cohort study analyzes the effects of a supervised LTMEX program on HRQoL in older adults with T2D (n?=?279). Participants underwent one of two conditions: LTMEX (n?=?241) trained three times per week; and unchanged lifestyle—the control group (CO; n?=?38). Participants completed baseline, and 2-year follow-up evaluations including the Short Form Health Survey 36 (SF-36), anthropometric, hemodynamic components, and cardiorespiratory fitness (VO₂ peak).

Results

LTMEX improves HRQoL, specifically physical functioning (P?<?0.001), general health (P?<?0.05), vitality (P?<?0.001), mental health (MH; P?<?0.05), physical component score (P?<?0.001), mental component score (P?<?0.001), and total SF-36 (P?<?0.001). LTMEX group also decreased body weight (BW; P?<?0.005), waist circumference (WC; P?<?0.001), waist-to-hip ratio (WHR; P?<?0.001), and systolic blood pressure (SBP; P?<?0.001), and increased VO₂ peak (P?<?0.001). CO group increased WC (P?=?0.012), BMI (P?=?0.024), waist-to-hip ratio (WHR; P?=?0.003) and SBP (P?<?0.001), and decreased vitality (P?<?0.001) and MH (P?<?0.05).

Conclusions

A LTMEX intervention improves physical and mental HRQoL in older adults with T2D, and also anthropometric, hemodynamic profile, and cardiorespiratory fitness.

     

Tissue distribution of oral vitamin B12 is influenced by B12 status and B12 form: an experimental study in rats

Purpose

Hydroxocobalamin (HOCbl) is the dominating Cbl form in food, whereas cyanocobalamin (CNCbl) is common in vitamin pills and oral supplements. This study compares single-dose absorption and distribution of oral HO[⁵⁷Co]Cbl and CN[⁵⁷Co]Cbl in Cbl-deficient and normal rats.

Methods

Male Wistar rats (7 weeks) were fed a 14-day diet with (n?=?15) or without (n?=?15) Cbl. We compared the uptakes of HO[⁵⁷Co]Cbl (free or bound to bovine transcobalamin) and free CN[⁵⁷Co]Cbl administered by gastric gavage (n?=?5 in each diet group). Rats were sacrificed after 24 h. Blood, liver, kidney, brain, heart, spleen, intestines, skeletal muscle, 24-h urine and faeces were collected, and the content of [⁵⁷Co]Cbl was measured. Endogenous Cbl in tissues and plasma was analysed by routine methods.

Results

Mean endogenous plasma-Cbl was sevenfold lower in deficient vs. normal rats (190 vs. 1330 pmol/L, p?<?0.0001). Cbl depletion increased endogenous Cbl ratios (tissue/plasma?=?k_in/k_out) in all organs except for the kidney, where the ratio decreased considerably. Twenty-four-hour accumulation of labelled Cbl showed that HOCbl?>?CNCbl (liver) and CNCbl?>?HOCbl (brain, muscle and plasma).

Conclusions

The Cbl status of rats and the administered Cbl form influence 24-h Cbl accumulation in tissues and plasma.

     

Correlates of health-related quality of life in young-old and old–old community-dwelling older adults

Purpose

This study aimed (1) to examine the role of potential correlates of HRQoL in a large representative sample of older adults, and (2) to investigate whether the relationships between HRQoL and potential factors differ as a function of HRQoL component (physical vs. mental) and/or age cohort (young-old vs. old–old).

Methods

This cross-sectional study included 802 older adults aged 60–79 years old. HRQoL was assessed using the SF-36 questionnaire. Functional fitness was assessed using the Senior Fitness Test. Physical activity was measured via the Baecke questionnaire. Demographic information, mental and health features were obtained through questionnaires.

Results

A multiple regression analysis showed that BMI (β = ?0.15, p?=?0.001), body strength (β =?0.21, p?<?0.001), aerobic endurance (β =?0.29, p?<?0.001), physical activity (β =?0.11, p?=?0.007), depressive symptoms (β = ?0.19, p?<?0.001), falls (β = ?0.19, p?<?0.001), and living alone (β = ?0.16, p?<?0.001) were all significantly related to HRQoL-SF-36 total score. The positive relation with aerobic endurance was significantly higher for the physical component of HRQoL, while the negative relation with living alone was significantly higher for the mental component. The positive relation of HRQoL with physical activity was significantly higher in old–old compared to young-old adults.

Conclusion

This data suggest that body composition, functional fitness, psycho-social factors, and falls are important correlates of HRQoL in old age. There are HRQoL-component and age-cohort differences regarding these correlates, underlying the need for specific strategies at the community level to promote HRQoL in older adults.

     

Bibliometric analysis of peer-reviewed literature on Syrian refugees and displaced people (2011–2017)

Background

The Syrian conflict has created the worst humanitarian crisis of our time with approximately half of Syria’s pre-war population killed or forced to flee their homes. The current study aimed to analyze peer-reviewed literature published on Syrian refugees and displaced people.

Methods

A bibliometric methodology was implemented using Scopus database after retrieving documents relevant to Syrian refugees and displaced people.

Findings

In total, 323 documents were retrieved. Research articles constituted 71.2% (n?=?230) of the retrieved documents. The bulk (61.6%; n?=?199) of the retrieved documents were in health-related fields. Research domains of the retrieved health-related documents were mainly in the field of mental and psychosocial (17.3%; n?=?56), infectious diseases (15.2%; n?=?49), health policy and systems (16.4%; n?=?53), maternal and reproductive health (15.2%; n?=?49), and non-communicable diseases (NCD) (7.4%; n?=?24). Authors from research institutions in the United States produced the highest number of publications (24.5%; n?=?79), followed by Turkey (21.4%; n?=?69) and Lebanon (10.2%; n?=?33). The American University of Beirut was the most active (5.6%; n?=?18) research institution. Aside from Lebanon and Jordan, there was very little contribution from other Arab states. Conflict and Health was the most active journal (5.3%; n?=?17) in publishing on Syrian refugees and displaced people.

Conclusion

The study highlighted some particular research gaps – most notably the limited research on NCDs. There was also modest international research collaboration and engagement from Arab countries aside from Lebanon and Jordan.

     

Adaptation and testing of an assessment for mental health and alcohol use problems among conflict-affected adults in Ukraine

Background

In Ukraine, a large number of internally displaced persons (IDPs) and veterans experience social and psychological problems as a result of the ongoing conflict between Ukraine and Russia. Our purpose was to develop reliable and valid instruments to screen for common mental health and alcohol use problems in these populations.

Methods

We used a three-step process of instrument adaptation and testing. The instrument—the Mental Health Assessment Inventory (MHAI)—combines adapted standard screeners with items derived locally in Ukraine. A validity study was conducted using a sample of 153 adults (54% male) ages 18 years and older. All participants in the sample were IDPs or veterans living in or near the major urban areas of Kyiv and Zaporizhia. Reliability testing (internal consistency, test-retest) and validity testing (construct, criterion) of the MHAI were conducted using classical test theory. After initial testing, we used Item Response Theory (IRT) to shorten and further refine the instrument.

Results

The MHAI showed good internal consistency and test-retest reliability for the main outcomes: depression (α?=?0.94; r?=?.84), post-traumatic stress (PTS; α?=?0.97; r?=?0.87), anxiety (α?=?0.90; r?=?0.80), and alcohol use (α?=?0.86; r?=?0.91). There was good evidence of convergent construct validity among the scales for depression, PTS, and anxiety, but not for alcohol use. Item Response Theory (IRT) analysis supported use of shortened versions of the scales for depression, PTS, and anxiety, as they retained comparable psychometric properties to the full scales of the MHAI.

Conclusion

The findings support the reliability and validity of the assessment—the MHAI—for screening of common mental health problems among Ukrainian IDPs and veterans. Use of IRT shortened the instrument to improve practicality and potential sustainability.