Sex education, relationships, and sexuality in young adults with spina bifida

OBJECTIVES: To assess the adequacy of sex education and to determine the incidence of various difficulties encountered in relationships and sexual contact by young adults who have spina bifida (SB) with and without hydrocephalus (HC) in the Netherlands. DESIGN: Cross-sectional. SETTING: Community. PARTICIPANTS: Patients with SB occulta or aperta (N=157; 41% male; mean age, 20.8 y; age range, 16-25 y). Interventions Not applicable. MAIN OUTCOME MEASURES: Structured interview on sex education, relationships, sexual activities, and sexual functioning. RESULTS: Although sex education had been provided to almost all patients, fewer than a quarter received information specific to people with SB. Of all patients, 25% had a partner, 70% desired sexual contact, 47% had had sexual contact, and 22% had had sexual intercourse during the last year. Only 52% were satisfied with their present sex life. Incontinence and lack of self-confidence were important obstacles. Compared with patients without HC (HC-), patients with HC (HC+) less often had a partner, were sexually less active, and more often had problems with sexual functioning. Predictors of not having sexual contact were having HC and being male. CONCLUSIONS: Relationships and sexuality are important for young adults with SB. HC+ patients are less active and perceive more problems than HC- patients. Counseling in relationships and sexuality should be part of the regular care for this group.     

Triad of physical activity, aerobic fitness and obesity in adolescents and young adults with myelomeningocele.

OBJECTIVE: Comprehensively and objectively assess physical activity, aerobic fitness and body fat in adolescents and young adults with myelomeningocele and to investigate their relationships. DESIGN: Cross-sectional study. SUBJECTS: Fifty-one persons (26 males) with myelomeningocele aged 21.1 (standard deviation) 4.5) years. METHODS: Physical activity was measured with an accelerometry-based activity monitor. Aerobic fitness was defined as the maximum oxygen uptake during the last minute of a maximal exercise test. Body fat was assessed using sum of 4 skin-folds and body mass index. Correlations were studied using multiple regression analyses. RESULTS: Thirty-nine percent of the participants were inactive and another 37% were extremely inactive. Aerobic fitness was 42% lower than normative values and 35% were obese. Ambulatory status was related to daily physical activity (beta = 0.541), aerobic fitness (beta = 0.397) and body fat (beta = -0.243). Gender was related to aerobic fitness (beta = -0.529) and body fat (beta = 0.610). Physical activity was related to aerobic fitness in non-ambulatory persons with myelomeningocele (beta = 0.398), but not in ambulatory persons. CONCLUSION: Adolescents and young adults with myelomeningocele were physically inactive, had poor aerobic fitness and high body fat. Differences exist between subgroups regarding gender and ambulatory status.     

Sexual functioning in adolescents and young adults with spina bifida

Cardenas DD, Topolski TD, White CJ, McLaughlin JF, Walker WO. Sexual functioning in adolescents and young adults with spina bifida.

Objective

To assess sexual education and sexual functioning in adolescents and young adults with spina bifida.

Design

Survey, inception cohort.

Setting

The community.

Participants

A cohort of adolescents and young adults (N=121; range, 15-35y; 58% women) enrolled in a longitudinal pediatric database.

Interventions

Not applicable.

Main Outcome Measures

Questions on sexual function, reproductive function, bladder and bowel continence, the Perceived Quality of Life Scale, and the Satisfaction With Life Scale.

Results

Almost all adolescents and young adults with spina bifida in our study received sexual education at school, less at home, or by physicians. Twenty-five percent of men and 68% of women were informed about reproductive function by their physicians. Participants who reported that they smoked were 10 times more likely to report being sexually active and women were 2.3 times more likely to be sexually active than men. Hydrocephalus was a significant predictor of sexual activity among women but not men. Participants with urinary incontinence were less likely to be sexually active. Women without hydrocephalus were significantly more satisfied with life than women with hydrocephalus.

Conclusions

Adolescents and young adults with spina bifida in this sample were only slightly satisfied with life and sexual activity was only associated with life satisfaction among women. Dissatisfaction with life often leads to engagement in health-risk behaviors, which may, in part, account for the association between sexual activity and smoking behavior observed in these data. Further studies of health risk behaviors among youth with spina bifida are warranted and interventions aimed at reducing health risk behaviors among adolescents and young adults should specifically include spina bifida as a target group.     

Muscle strength,aerobic capacity and physical activity in independent ambulating children with lumbosacral spina bifida

Purpose. This cross-sectional study investigates deficits and associations in muscle strength, 6-minute walking distance (6MWD), aerobic capacity (VO_2peak), and physical activity (PA) in independent ambulatory children with lumbosacral spina bifida.

Method. Twenty-tree children participated (13 boys, 10 girls). Mean age (SD): 10.4 (±3.1) years. Muscle strength (manual muscle testing and hand-held dynamometry), 6MWD, VO_2peak (maximal exercise test on a treadmill), and PA (quantity and energy expenditure [EE]), were measured and compared with aged-matched reference values.

Results. Strength of upper and lower extremity muscles, and VO_2peak were significantly lower compared to reference values. Mean Z-scores ranged from ?1.2 to ?2.9 for muscle strength, and from ?1.7 to ?4.1 for VO2peak. EE ranged from 73 – 84% of predicted EE. 6MWD was significantly associated with muscle strength of hip abductors and foot dorsal flexors. VO_2peak was significantly associated with strength of hip flexors, hip abductors, knee extensors, foot dorsal flexors, and calf muscles.

Conclusions. These children have significantly reduced muscle strength, 6MWD, VO_2peak and lower levels of PA, compared to reference values. VO_2peak and 6MWD were significantly associated with muscle strength, especially with hip abductor and ankle muscles. Therefore, even in independent ambulating children training on endurance and muscle strength seems indicated.     

体检人群中骨密度与心血管疾病危险因素的关系初探

目的探讨骨质疏松与心血管疾病之间的关系。方法对774例体检者进行骨量检测并按检测结果分为三组,记录体质量指数(BMI)、空腹血糖(FPG)、收缩压(SBP)、舒张压(DBP)以及血脂[总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]等指标。结果在体检人群中骨量减少有较高的发生率(32.69%),骨质疏松的发生率约为2.07%。男性与女性在三个骨量分组中的分布差异有统计学意义(χ2值为27.070,P<0.01)。骨量减少与年龄、HDL-C的增加及体质量指数有关,差异有统计学意义(χ2值分别为14.467,6.060,4.586;P<0.05)。结论 BMD是人群中需要监测的指标,骨量的变化与心血管疾病危险因素之间有一定的关系。     

精神分裂症患者代谢性心血管疾病相关危险因素分析

目的探讨影响精神分裂症患者代谢性心血管疾病的相关危险因素。 方法采用回顾资料收集分析1 706例精神分裂症患者(研究组)基本信息以及体质量指数(BMI)、血糖、血脂检测水平,并与81例正常健康人(对照组)进行比较。对研究组年龄、性别、职业、婚姻、吸烟、饮酒、病程、心电图(ECG)、脑电地形图(BEAM)与收缩压(SBP)、舒张压(DBP),BMI,空腹血糖(FBG)、甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白(HDL-C)进行Person相关分析。 结果研究组代谢性心血管疾病危险因素：FBG[(4.43±0.98)mmol/L]、TC[(3.88±0.82)mmol/L]、HDL-C[(1.21±0.34)mmol/L)]与对照组[FBG(5.38±0.50)mmol/L,TC(4.16±0.63)mmol/L,HDL-C(1.41±0.22)mmol/L]比较,差异有统计学意义(t＝53.93,12.49,29.09;P<0.05);研究组不同性别患者组内比较差异无统计学意义(P>0.05),研究组不同病程组、不同年龄组患者组内比较,FBG差异有统计学意义(F＝38.37,0.27;P<0.05);首发患者与对照组比较,FBG、TC、HDL-C差异有统计学意义(t＝5.69,2.84,4.38;P<0.05);将代谢性心血管因素SBP、DBP、BMI、FBG、TG、TC、HDL-C与性别、年龄、地域、职业、婚姻、病程、发病形式、饮酒、吸烟、ECG、BEAM进行相关分析发现,BMI与发病形式、吸烟正相关(r＝0.082,0.104,P<0.05);SBP与发病形式正相关(r＝0.082,P<0.05);DBP与发病形式、ECG呈正相关(r＝0.049,0.069,P<0.05);FBG与年龄、婚姻、总病程、吸烟呈负相关,(r＝－0.056,－0.050,－0.126,－0.054,P<0.05);TG与年龄、婚姻成正相关(r＝0.056,0.055,P<0.05),与地域、吸烟负相关(r＝－0.053,－0.062,P<0.05);总TC与吸烟负相关(r＝－0.054,P<0.05);HDL-C与饮酒呈负相关(r＝－0.051,P<0.05)。 结论精神分裂症患者FBG、TC、HDL-C等代谢性心血管疾病危险因素较普通人群更突出,与区域、吸烟、饮酒、婚姻、病程相关,患者不良的生活方式是引起代谢危险因素突出的重要原因。     

体质量指数与心血管的危险因素个体聚集性的关系

目的探讨体质量指数与心血管危险因素个体聚集性的关系。方法分析1560名(35～70岁)渔区自然人群中高血压、高血清胆固醇(高TC)、高血糖、高密度脂蛋白胆固醇过低(低HDL-C)与体质量指数(BM I)水平的关系。结果人群中高血压、高TC、高血糖及低HDL-C的患病率均随BM I上升而明显升高。4种高危因素中,具有至少1种和同时具有2种或以上的个体在人群中,所占百分比随BM I上升而显著升高。且后者的上升速度大于前者。结论超重和肥胖常伴多种心血管病的危险因素聚集。BM I对于心血管病一级预防具有重要价值。     

Cross-sectional associations between physical activity and selected coronary heart disease risk factors in young adults. The Cardiovascular Risk in Young Finns Study

Abstract

Objective. Physical activity (PA) may reduce the risk of coronary heart disease (CHD) by inducing beneficial changes in several risk factors. We studied the associations between PA and a range of risk markers of CHD in young adults.

Methods and results. We measured serum lipoproteins, oxidized LDL, adipokines, inflammatory markers, metabolic markers, and arginine metabolites in 2,268 individuals (age 24–39 y). Participants were asked frequency, duration, and intensity of PA in leisure time. In addition, commuting to work was assessed. In both sexes, PA was inversely associated with waist circumference (all P < 0.0001). After controlling for sex, age, and waist circumference, PA was directly associated with HDL-cholesterol and apolipoprotein A1, and inversely with heart rate, smoking, oxidized LDL, apolipoprotein B, insulin, glucose, C-reactive protein, leptin, L-arginine, and phospholipase A2 activity (all P < 0.05).

Conclusion. These population-based data are consistent with the idea that the beneficial effects of PA on CHD risk are mediated by favorable influences on several risk factors, as judged by independent relations to markers of lipoprotein metabolism, glucose metabolism, and inflammation. These associations reflect beneficial effects on cardiovascular health in both sexes and may offer mechanistic insights for the inverse association between PA and CHD.     

Association between knowledge and risk for cardiovascular disease among older adults: A cross-sectional study in China

ObjectivesThis study aimed to describe cardiovascular risk and cardiovascular disease (CVD) knowledge among older adults, and further explore the association between knowledge and risk.MethodsIn this cross-sectional study, we enrolled 1120 older adults who received physical examination in health centers. The participants were interviewed to obtain their behavioral risk factors related to CVD and clinical characteristics. A risk prediction chart was used to predict participants’ cardiovascular risk based on clinical characteristics and behavioral risk factors. Participants’ CVD knowledge was collected with a pretested knowledge questionnaire.ResultsAmong the 1120 participants, 240 (21.4%) had low cardiovascular risk, 353 (31.5%) had moderate cardiovascular risk, 527 (47%) had high and very high cardiovascular risk. The knowledge level about CVD among 0.8% of the 1120 participants was good while that of 56.9% was poor. Lower CVD knowledge level, older age, lower income, and lower educational level were the independent factors of higher cardiovascular risk level.ConclusionsThis study highlights the need to reduce the cardiovascular risk among older adults. CVD knowledge should be considered when developing health interventions.     

A guideline-driven assessment of need for cardiovascular disease risk intervention in persons with chronic paraplegia

OBJECTIVE: To examine percentages of persons with chronic paraplegia who qualify for lipid-lowering therapeutic lifestyle intervention (TLI) as assessed by authoritative guidelines. DESIGN: Cross-sectional. SETTING: Academic medical center. PARTICIPANTS: Forty-one subjects (mean age +/- standard deviation, 34+/-11 y) with motor-complete paraplegia (American Spinal Injury Association grade A or B) at T6-L1 levels for greater than 2 years. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Percentages of subjects qualifying for TLI were independently assessed and then compared using National Cholesterol Education Project Adult Treatment Panel (ATP) II (1994) and ATP III (2002) Guidelines. RESULTS: A total of 34.1% of subjects qualified for intervention based on the ATP II Guidelines and 63.4% based on ATP III (chi1(2) test=4.53; 2-tailed, P=.003). Seventy-six percent (31/41) of study participants had high-density lipoprotein cholesterol levels below the high-risk criterion of 40 mg/dL established by ATP III. Almost one third of subjects had hypertension, and 34.1% satisfied criteria for diagnosis of the metabolic syndrome. CONCLUSIONS: A high percentage of young, apparently healthy people with chronic paraplegia are at risk for cardiovascular disease and qualify for lipid-lowering TLI. Updated guidelines of the ATP III have increased the urgency for early risk assessment and intervention.     

Manorah training alleviates median neural tension and improves physical fitness in sedentary young adults: A randomized control trial

IntroductionMost young adults do not achieve the recommended physical activity, and physical inactivity thus is a worldwide public health problem contributing to premature death. Although Thai dance has been reported to increase physical activity, a small number of studies have reported on the impact of Manorah. Herein Manorah is a signature traditional dramatic art of Southern Thailand. The present study aimed to reveal the effects of Manorah training on health-related variables.MethodsThirty-four young females were divided into two groups, where one group underwent Manorah training and the other represented the control. Manorah training was performed for 45 min/day, 3 days/week for 4 weeks. Median neural tension, balance, flexibility, and muscle endurance were determined.ResultsManorah significantly decreased nerve tension (p < 0.001). Physical fitness was also markedly improved after the training.ConclusionsThis Manorah program may be recommended as an exercise and an intervention for symptoms related to positive tension.     

Patients with musculoskeletal conditions do less vigorous physical activity and have poorer physical fitness than population controls: a cross-sectional study

Objectives

To compare physical activity and physical fitness in patients with various musculoskeletal conditions receiving physiotherapy in primary care with population controls.

Design

Cross-sectional.

Participants

One hundred and sixty-seven patients with musculoskeletal conditions receiving physiotherapy in primary care and 313 population controls from various settings and geographical areas.

Main outcome measures

Physical activity was measured with the International Physical Activity Questionnaire short-form (IPAQ-sf) and reported in metabolic equivalents (METs). The 6-minute walk test and 30-second sit-to-stand test reflected cardiorespiratory endurance and muscular strength, respectively.

Results

Differences in physical activity between the groups were explored using the Mann–Whitney U-test. The patient group reported significantly less vigorous activity compared with the control group {median 0 [interquartile range (IQR) 0 to 960] vs median 240 [IQR 0 to 1440] MET minutes/week, respectively)} (P = 0.001). A similar proportion of patients (68%) and controls (75%) reached the recommended level of health-enhancing physical activity (P = 0.11). Linear regression analyses adjusted for age, body mass index and gender showed significantly poorer fitness in the patient group compared with the control group, reflected by the 6-minute walk test and the 30-second sit-to-stand test {mean difference 69 m [95% confidence interval (CI) 52 to 85; P ≤ 0.001] and six repetitions [95% CI 5 to 7; P ≤ 0.001], respectively}.

Conclusions

Patients with various long-term musculoskeletal conditions receiving physiotherapy in primary care had significantly poorer physical fitness and reported less vigorous physical activity compared with population controls.     

Coronary artery disease and risk factors in people with posttraumatic vision loss

OBJECTIVE: To examine the prevalence of coronary artery disease (CAD) and its risk factors in people with posttraumatic vision loss (PTVL). DESIGN: Cross-sectional, controlled study. SETTING: The general community. PARTICIPANTS: Study groups included 82 subjects with PTVL, 49 siblings, 58 blind subjects with retinitis pigmentosa (RP), and the general population in Israel. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Sociodemographic and biomedical data collected by using a structured questionnaire and medical records. RESULTS: The prevalence of CAD among subjects with PTVL (24%) was 2 to 3 times higher than the control groups ( P <.001). However, the prevalence of the CAD risk factors in these subjects was similar to or lower than those in the control groups. For example, significantly fewer subjects with PTVL were physically inactive (16%) than patients with RP (55%, P <.01). The only variable that was significantly associated with CAD prevalence was the cause of blindness-that is, trauma versus disease; the odds of having CAD after traumatic vision loss was 3.75 times higher than after RP. CONCLUSIONS: People with PTVL exhibit elevated rates of risk for CAD similar to those of other groups with physical disability. The traumatic injury that caused vision loss might be an important factor underlying that risk.     

老年2型糖尿病患者健康体适能的影响因素分析

目的：分析老年2型糖尿病（T2DM）健康体适能的影响因素及与有氧运动的关系,为老年T2DM运动疗法提供参考。方法：选择2021年1月至2022年6月在我院参加体检的老年T2DM患者125例为调查对象,分析有氧运动（方法、等级）、健康体适能评分,采用单多重线性回归分析老年T2DM患者健康体适能的影响因素。结果：125例老年T2DM患者器官功能、活动功能、躯体调适能力、健康体适能评分分别为（54.43±8.35）、（51.54±7.26）、（57.36±8.42）、（54.42±8.26）分。不同性别、年龄、病程、家庭经济状况、运动时间、运动频率、运动强度老年T2DM患者健康体适能评分比较,差异有统计学意义（P＜0.05）。影响老年T2DM患者器官功能的因素为年龄、经济状况、运动时间、运动频率（P＜0.05）;活动功能的影响因素为性别、年龄、运动时间、运动频率、运动强度（P＜0.05）;躯体调适功能的影响因素为年龄、病程、经济状况、运动时间、运动频率（P＜0.05）;健康体适能的影响因素为性别、年龄、经济状况、运动时间、运动频率（P＜0.05）。结论：老年T2DM患者健康体适能影响因素包括有氧运动时间与运动频率。开展运动时间＞60 min/d、运动频率＞5次/周、中等强度运动疗法有利于提高老年T2DM患者健康体适能。     

Relationship between physical activity,disability, and physical fitness profile in sedentary Latina breast cancer survivors

Objective: To report baseline data from a physical activity (PA) intervention for Latina breast cancer survivors, and assess the relationship between PA, fitness, and disability. Methods: Eighty-nine Latina breast cancer survivors from San Juan, PR and Houston, TX (age: 55.4 ± 9.9 years; BMI: 29.87 ± 5.62 kg/m²; ≥ 3 months post-treatment) participated in this study. At baseline participants completed fitness testing (six-minute walk test [6MWT], 30-second sit-stand; grip strength, lower and upper extremity and low back strength, shoulder range of motion, balance testing), and assessment of physical activity (PA) and disability. PA was assessed using the International Physical Activity Questionnaire (IPAQ). A subsample (n = 27) received an accelerometer to compare objective versus self-reported PA. Results: Participants exhibited low PA (M = 76.5 MET·minutes/week; SD = 183.4), poor fitness (6MWT M = 436.4 meters, SD = 99.1; 30s sit-stand, M = 11.6 stands, SD = 3.1), and no detectable disability. In an adjusted model lower extremity fitness was associated with PA, with a one repetition increase in sit-to-stand associated with 49 additional minutes of self-reported PA plus walking per week. The correlation between IPAQ moderate-vigorous PA and accelerometer was 0.38 (p = 0.047). Conclusion: Latina breast cancer survivors have low physical activity and fitness levels that increase their risk of disability, cardiometabolic comorbidities, and potential cancer recurrence.     

Cardiovascular risk factor screening satisfaction in the Heart of New Ulm Project

Objective

Community-based cardiovascular disease (CVD) risk factor screening programs have been used successfully in rural health improvement initiatives. However, little is known about what consumers like or dislike about them, which is a barrier to the design of future process improvements. The objective of this study was to examine the degree to which health risks and participant characteristics predicted screening satisfaction.

Design

This study utilized a cross-sectional survey design.

Setting

Data was collected as part of the broader Heart of New Ulm Project, which is a community-based CVD prevention demonstration project based in rural Minnesota.

Participants

There were 126 randomly invited individuals from the CVD risk factor screenings, with 118 individuals who agreed to participate and had complete data available for analyses.

Methods

A multivariate logistic regression analysis was used to examine the association between demographics, lifestyle, and biometric risk factors and screening satisfaction.

Results

Twenty percent of respondents indicated some level of dissatisfaction with the screening process. Satisfied participants were more likely to be female (OR=4.15), not have an optimal lifestyle (OR=3.47), and have an intention to improve their lifestyle habits (OR=3.26). Age, education, and CVD risk level were not significant predictors in the final model.

Conclusion

Satisfaction was high in this screening program, with healthy males being least satisfied with their experience. This has implications for the design of future intervention efforts, as they may require specific programmatic features and more specialized, targeted marketing strategies to attract a broad spectrum of participants likely to benefit.     

Effects of arthritis exercise programs on functional fitness and perceived activities of daily living measures in older adults with arthritis

OBJECTIVE: To ascertain the effectiveness of the National Arthritis Foundation (NAF) aquatic and on-land exercise programs on functional fitness and perceived ability to perform activities of daily living (ADL) measures in older adults with arthritis. DESIGN: The effects of aquatic and on-land exercise intervention programs were analyzed by repeated-measures analysis of variance by using a planned comparison approach with an independent 3 x 2 (group by test) design. omega(2) analyses were used to ascertain the relative treatment magnitude of each dependent variable. SETTING: Testing in an indoor track facility; exercise programs conducted in community settings. PARTICIPANTS: A volunteer sample of 30 men and women with arthritis (osteoarthritis, n=22; rheumatoid arthritis, n=8), randomly assigned into either an aquatic exercise (n=10), on-land exercise (n=10), or control group (n=10). INTERVENTION: Eight-week on-land and aquatic exercise program. MAIN OUTCOME MEASURES: Functional fitness, ADLs, and hand-held dynamometry measures assessed on a 1-day pretest and posttest session, before and after an 8-week exercise program. RESULTS: Aquatic and on-land exercise subjects showed significant improvements on 9 of 12 functional fitness, 3 of 4 ADLs, and 7 of 8 hand-held isometric strength tests after their respective exercise programs. No significant changes were found in any of these measures for the control group. CONCLUSION: Both NAF exercise programs appear to be effective in improving functional physical fitness and perceived ability to perform ADL measures in older adults with arthritis.     

超重、运动、吸烟、饮酒与西藏人群胆囊结石患病风险的横断面调查研究

目的研究超重、运动、吸烟、饮酒与西藏拉萨地区行政干部人群胆囊结石患病风险的关系。方法对2006年1月至2010年5月在武警西藏总队医院体检的全区行政干部4000人进行了横断面问卷调查和分析体检结果。其中女1678人,年龄(42.3±13.1)岁;男2322人,年龄(42.5±12.9)岁。结果胆囊结石的患病率男、女性分别为11.0%和22.3%。体重指数≥25.0kg/m2,每日饮酒量>20g和每周运动时间<2h是胆囊结石的危险因素(P<0.05)。在有胆囊结石的人群中脂肪肝的患病率为46.4%,无胆囊结石人群中脂肪肝的患病率为29.8%,χ2=43.529,P<0.01。结论这一随机选择的人群脂肪肝、胆道疾病、肥胖的患病率很高,饮酒、脂肪肝、缺乏运动可以认为是这一人群患胆囊结石的危险因素。