The more the better? A meta-analysis on effects of combined cognitive and physical intervention on cognition in healthy older adults

Both cognitive intervention and physical exercise benefit cognitive function in older adults. It has been suggested that combined cognitive and physical intervention may induce larger effects than cognitive or physical intervention alone, but existing literature has shown mixed results. This meta-analysis aimed at assessing the efficacy of combined intervention on cognition by comparing combined intervention to control group, cognitive intervention and physical exercise. Eligible studies were controlled trials examining the effects of combined intervention on cognition in older adults without known cognitive impairment. Twenty interventional studies comprising 2667 participants were included. Results showed that the overall effect size for combined intervention versus control group was 0.29 (random effects model, p = 0.001). Compared to physical exercise, combined intervention produced greater effects on overall effect size (0.22, p < 0.01), while no significant difference was found between combined intervention and cognitive intervention. Effects of combined intervention were moderated by age of participants, intervention frequency and setting. The findings suggest that combined intervention demonstrates advantages over control group and physical exercise, while evidence is still lacking for superiority when compared combined intervention to cognitive intervention. More well-designed studies with long follow-ups are needed to clarify the potential unique efficacy of combined intervention for older adults.     

Evaluation of exposure–response relationships for health effects of microbial bioaerosols – A systematic review

Studies suggest adverse health effects following exposure to bioaerosols in the environment and in particular at workplaces. However, there is still a lack of health-related exposure limits based on toxicological or epidemiological studies from environmental health or from the working environment. The aim of this study was to derive health-based exposure limits for bioaerosols that can protect the general population as group “at risk” via environmental exposure using analysis of peer-reviewed studies related to occupational medicine, indoor air and environmental health. The derivation of exposure limits should be conducted by the members of a bioaerosol expert panel according to established toxicological criteria. A systematic review was performed in Medline (PubMed) including studies containing both data on exposure measurements and observed health outcomes. In addition, literature recommended by the experts was considered. A comprehensive search strategy was generated and resulted in a total of n = 1569 studies in combination with the literature recommendations. Subsequently, abstracts were screened using defined exclusion criteria yielding a final number of n = 44 studies. A standardized extraction sheet was used to combine data on health effects and exposure to different bioaerosols. After full-text screening and extraction according to the defined exclusion criteria n = 20 studies were selected all related to occupational exposures comprising the working areas wood processing, farming, waste processing and others. These studies were analyzed in collaboration with the bioaerosol expert network in terms of suitability for derivation of health-related exposure limits. The bioaerosol expert network concluded that none of the analyzed studies provided suitable dose–response relationships for derivation of exposure limits. The main reasons were: (1) lack of studies with valid dose–response data; (2) diversity of employed measuring methods for microorganisms and bioaerosol-emitting facilities; (3) heterogeneity of health effects; (4) insufficient exposure assessment. However, several indicator parameters and exposure concentrations could be identified for different bioaerosol-emitting facilities. Nevertheless, health-related exposure limits are urgently needed especially in approval procedures of facilities like composting plants or livestock farms emitting bioaerosols in the neighbourhood of residents. In the regulatory toxicology framework, it is common to use animal experimental studies for derivation of general exposure limits if appropriate environmental epidemiological studies on harmful substances are lacking. This might be another possibility to obtain health-related exposure limits for specific bioaerosol parameters. Furthermore, we recommend to use suitable measurable outcome parameters related to bioaerosols; to measure bioaerosols according to a protocol representative for exposure pattern and duration at the particular work place; to develop standardized detection methods for indicator parameters; to combine different detection methods to compensate for the limitations of each method; to apply new analysis methods to identify the real risk potential.     

Radiotherapy for breast cancer: The predictable consequences of an unmet need

Radiotherapy has had a transformative impact on the treatment of breast cancer, but is unavailable to the majority of breast cancer patients in low- and middle-income countries. In these settings, where many women present with advanced disease at an age when they are often the primary caregiver for their families, the lack of access to radiotherapy is particularly devastating. Until recently, this disparity has been largely neglected in the medical literature and it had been difficult to convince governments, industry, and policymakers of the importance of investing in radiotherapy, as well as broader cancer control strategies, in low-resource settings. The Lancet Radiotherapy Commission report published in 2015 challenged many assumptions about the affordability of radiotherapy treatment. Data from the Commission is presented here to support radiotherapy investment for breast cancer and discuss how the morbidity and premature mortality among adult women caused by breast cancer has a huge detrimental effect on both the health sector and the economy.     

Regular aerobic exercise increases dispositional mindfulness in men: A randomized controlled trial

Dispositional mindfulness is a construct described as the propensity to be aware of one's actions in everyday life. Although high dispositional mindfulness has been demonstrated to be beneficial for improved mental and physical health, little is known about ways to improve dispositional mindfulness for individuals not practicing meditation or mindful exercises. The study aimed at investigating (1) whether dispositional mindfulness can also be trained by regular aerobic exercise and (2) whether changes in dispositional mindfulness are associated with changes in mental and physical health. 149 healthy men were randomly allocated to one of two 12-week interventions (aerobic exercise or relaxation training) or a waitlist control condition. Dispositional mindfulness and mental and physical health were assessed before and after the intervention by self-report questionnaires. Over the course of the intervention, increases in dispositional mindfulness occurred in the aerobic exercise group but not in the relaxation or waitlist control conditions (p = .018). Increases in dispositional mindfulness were moderately correlated with improvements in mental health. For the first time, this study shows that dispositional mindfulness can be increased through regular aerobic exercise. Future research is needed to identify how the mindfulness-enhancing potential of aerobic exercise can be used most effectively.     

老年2型糖尿病患者教育和管理领域护理问题的现状及对策探讨

通过对某医院2008-2013年间收治的768例老年2型糖尿病住院患者进行回顾性资料分析,探求近年来老年2型糖尿病患者健康教育和自我管理领域存在的护理问题现状,并针对问题采用以循证为基础的方法结合临床经验及患者实际情况探讨行之有效的健康教育对策,以期为老年2型糖尿病患者健康教育体系的进一步完善和科学发展提供参考。     

Differences in Response to a Dietary Intervention Between the General Population and First-Degree Relatives of Colorectal Cancer Patients

ObjectiveTo determine whether response to a dietary intervention is greater among people with family history of colorectal cancer (CRC) compared with a general population.DesignCohort study examining participants from 2 related studies.SettingRural Virginia.ParticipantsSeventy people with first-degree relatives with CRC and 113 participants from the intervention arm of a trial in the general population.InterventionBoth studies implemented a low-intensity intervention delivered via telephone and mail, including low-literacy self-help booklets and personalized dietary feedback.Main Outcome MeasuresFat, fiber, and fruit and vegetable behavior.AnalysisPropensity score matching controlled for confounders. Mixed-model ANOVAs compared samples; mediation by perceived cancer risk was assessed.ResultsParticipants in both groups significantly improved fat, fiber, and fruit and vegetable behavior at 1-month follow-up; there was significantly greater improvement in the general population sample. Cancer risk perception did not mediate the relationship between study sample and dietary change.Conclusions and ImplicationsContrary to expectations, first-degree relatives of CRC patients did not respond better to a dietary intervention than the general population, nor was risk perception related to dietary change. Given the role of diet in CRC risk, additional research should investigate targeted strategies to improve dietary intakes of people at higher cancer risk.     

影响卵巢癌患者持续性化疗的相关因素及对策

目的探讨影响卵巢癌患者持续性化疗的相关因素及应采取的相应对策。方法对十堰市人民医院2009年6月～2010年6月妇科收治的30例不愿持续性化疗的卵巢癌患者,通过交谈法、倾听法、电话随访方式进行调查,分析其不愿持续性化疗的原因,进行有针对性的心理疏导、相关知识宣教,并采取经济支持、健康教育、社会支持等措施。结果 30例患者都愉快地接受持续性化疗。结论实施有效的伦理干预、健康教育、社会支持等措施,可以促进卵巢癌患者坚持化疗,以延长其生命并提高其生活质量。     

团体心理干预对大学生自我效能、自我接纳影响的研究

目的:探讨团体心理干预对大学生自我接纳、自我效能水平的影响。方法:将某院校94名1-2年级本科生随机分为实验组(n=47)和对照组(n=47)。实验组实施团体心理干预,每周1次,共10周。结果:①干预前实验组、对照组GSES总分、SAQ总分及因子分无显著差异;②实验组干预后与对照组后测时GSES总分,SAQ总分及自我评价因子分差异显著;③实验组干预前后GSES总分、SAQ总分及自我接纳、自我评价因子分差异显著。结论:团体心理干预能有效提升大学生自我效能、自我接纳水平。