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Liu X, Zhu H, Peng Y, Liu Y, Shi X. Twenty-Four week Taichi training improves pulmonary diffusion capacity and glycemic control in patients with Type 2 diabetes mellitus. PLoS One 2024; 19:e0299495. [PMID: 38635535 PMCID: PMC11025805 DOI: 10.1371/journal.pone.0299495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 02/11/2024] [Indexed: 04/20/2024] Open
Abstract
This study evaluated the effect of 24-week Taichi training and Taichi plus resistance band training on pulmonary diffusion capacity and glycemic control in patients with Type 2 diabetes mellitus (T2DM). Forty-eight patients with T2DM were randomly divided into three groups: Group A-Taichi training: practiced Taichi 60 min/day, 6 days/week for 24 weeks; Group B-Taichi plus resistance band training: practiced 60-min Taichi 4 days/week plus 60-min resistance band training 2 days/week for 24 weeks; and Group C-controls: maintaining their daily lifestyles. Stepwise multiple regression analysis was applied to predict diffusion capacity of the lungs for carbon monoxide (DLCO) by fasting blood glucose, insulin, glycosylated hemoglobin (HbA1c), tumour necrosis factor alpha (TNF-α), von Willebrand Factor (vWF), interleukin-6 (IL-6), intercellular adhesion molecule 1 (ICAM-1), endothelial nitric oxide synthase (eNOS), nitric oxide (NO), endothelin-1 (ET-1), vascular endothelial growth factor, and prostaglandin I-2. Taichi with or without resistance band training significantly improved DLCO, increased insulin sensitivity, eNOS and NO, and reduced fasting blood glucose, insulin, HbA1c, TNF-α, vWF, IL-6, ICAM-1, and ET-1. There was no change in any of these variables in the control group. DLCO was significantly predicted (R2 = 0.82) by insulin sensitivity (standard-β = 0.415, P<0.001), eNOS (standard-β = 0.128, P = 0.017), TNF-α (standard-β = -0.259, P = 0.001), vWF (standard-β = -0.201, P = 0.007), and IL-6 (standard-β = -0.175, P = 0.032) in patients with T2DM. The impact of insulin sensitivity was the most important predictor for the variation of DLCO based on the multiple regression modeling. This study demonstrates that 24-week Taichi training and Taichi plus resistance band training effectively improve pulmonary diffusion capacity and blood glycemic control in patients with T2DM. Variation of DLCO is explained by improved insulin sensitivity and endothelial function, and reduced inflammatory markers, including TNF-α, vWF, and IL-6.
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Affiliation(s)
- Xiaoli Liu
- Department of Physical Education, Xihua University, Chengdu, Sichuan, China
- Department of Physical Education, Hubei Minzu University, Enshi, Hubei, China
- University of North Texas Health Science Center, Fort Worth, Texas, United States of America
| | - Huan Zhu
- Department of Physical Education, Hubei Minzu University, Enshi, Hubei, China
| | - Yong Peng
- Department of Physical Education, Hubei Minzu University, Enshi, Hubei, China
| | - Yaofeng Liu
- Department of Physical Education, Hubei Minzu University, Enshi, Hubei, China
| | - Xiangrong Shi
- University of North Texas Health Science Center, Fort Worth, Texas, United States of America
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Chan A, De Simoni A, Wileman V, Holliday L, Newby CJ, Chisari C, Ali S, Zhu N, Padakanti P, Pinprachanan V, Ting V, Griffiths CJ. Digital interventions to improve adherence to maintenance medication in asthma. Cochrane Database Syst Rev 2022; 6:CD013030. [PMID: 35691614 PMCID: PMC9188849 DOI: 10.1002/14651858.cd013030.pub2] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Asthma is the most common chronic lung condition worldwide, affecting 334 million adults and children globally. Despite the availability of effective treatment, such as inhaled corticosteroids (ICS), adherence to maintenance medication remains suboptimal. Poor ICS adherence leads to increased asthma symptoms, exacerbations, hospitalisations, and healthcare utilisation. Importantly, suboptimal use of asthma medication is a key contributor to asthma deaths. The impact of digital interventions on adherence and asthma outcomes is unknown. OBJECTIVES To determine the effectiveness of digital interventions for improving adherence to maintenance treatments in asthma. SEARCH METHODS We identified trials from the Cochrane Airways Trials Register, which contains studies identified through multiple electronic searches and handsearches of other sources. We also searched trial registries and reference lists of primary studies. We conducted the most recent searches on 1 June 2020, with no restrictions on language of publication. A further search was run in October 2021, but studies were not fully incorporated. SELECTION CRITERIA We included randomised controlled trials (RCTs) including cluster- and quasi-randomised trials of any duration in any setting, comparing a digital adherence intervention with a non-digital adherence intervention or usual care. We included adults and children with a clinical diagnosis of asthma, receiving maintenance treatment. DATA COLLECTION AND ANALYSIS We used standard methodological procedures for data collection. We used GRADE to assess quantitative outcomes where data were available. MAIN RESULTS We included 40 parallel randomised controlled trials (RCTs) involving adults and children with asthma (n = 15,207), of which eight are ongoing studies. Of the included studies, 30 contributed data to at least one meta-analysis. The total number of participants ranged from 18 to 8517 (median 339). Intervention length ranged from two to 104 weeks. Most studies (n = 29) reported adherence to maintenance medication as their primary outcome; other outcomes such as asthma control and quality of life were also commonly reported. Studies had low or unclear risk of selection bias but high risk of performance and detection biases due to inability to blind the participants, personnel, or outcome assessors. A quarter of the studies had high risk of attrition bias and selective outcome reporting. We examined the effect of digital interventions using meta-analysis for the following outcomes: adherence (16 studies); asthma control (16 studies); asthma exacerbations (six studies); unscheduled healthcare utilisation (four studies); lung function (seven studies); and quality of life (10 studies). Pooled results showed that patients receiving digital interventions may have increased adherence (mean difference of 14.66 percentage points, 95% confidence interval (CI) 7.74 to 21.57; low-certainty evidence); this is likely to be clinically significant in those with poor baseline medication adherence. Subgroup analysis by type of intervention was significant (P = 0.001), with better adherence shown with electronic monitoring devices (EMDs) (23 percentage points over control, 95% CI 10.84 to 34.16; seven studies), and with short message services (SMS) (12 percentage points over control, 95% CI 6.22 to 18.03; four studies). No significant subgroup differences were seen for interventions having an in-person component versus fully digital interventions, adherence feedback, one or multiple digital components to the intervention, or participant age. Digital interventions were likely to improve asthma control (standardised mean difference (SMD) 0.31 higher, 95% CI 0.17 to 0.44; moderate-certainty evidence) - a small but likely clinically significant effect. They may reduce asthma exacerbations (risk ratio 0.53, 95% CI 0.32 to 0.91; low-certainty evidence). Digital interventions may result in a slight change in unscheduled healthcare utilisation, although some studies reported no or a worsened effect. School or work absence data could not be included for meta-analysis due to the heterogeneity in reporting and the low number of studies. They may result in little or no difference in lung function (forced expiratory volume in one second (FEV1)): there was an improvement of 3.58% predicted FEV1, 95% CI 1.00% to 6.17%; moderate-certainty evidence); however, this is unlikely to be clinically significant as the FEV1 change is below 12%. Digital interventions likely increase quality of life (SMD 0.26 higher, 95% CI 0.07 to 0.45; moderate-certainty evidence); however, this is a small effect that may not be clinically significant. Acceptability data showed positive attitudes towards digital interventions. There were no data on cost-effectiveness or adverse events. Our confidence in the evidence was reduced by risk of bias and inconsistency. AUTHORS' CONCLUSIONS Overall, digital interventions may result in a large increase in adherence (low-certainty evidence). There is moderate-certainty evidence that digital adherence interventions likely improve asthma control to a degree that is clinically significant, and likely increase quality of life, but there is little or no improvement in lung function. The review found low-certainty evidence that digital interventions may reduce asthma exacerbations. Subgroup analyses show that EMDs may improve adherence by 23% and SMS interventions by 12%, and interventions with an in-person element and adherence feedback may have greater benefits for asthma control and adherence, respectively. Future studies should include percentage adherence as a routine outcome measure to enable comparison between studies and meta-analysis, and use validated questionnaires to assess adherence and outcomes.
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Affiliation(s)
- Amy Chan
- Centre for Behavioural Medicine, Department of Practice and Policy, UCL School of Pharmacy, University College London, London, UK
- School of Pharmacy, The University of Auckland, Auckland, New Zealand
- Asthma UK Centre for Applied Research, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Anna De Simoni
- Wolfson Institute of Population Health, Centre for Primary Care Asthma UK Centre for Applied Research, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Vari Wileman
- Centre for Behavioural Medicine, Department of Practice and Policy, UCL School of Pharmacy, University College London, London, UK
| | - Lois Holliday
- Wolfson Institute of Population Health, Centre for Primary Care Asthma UK Centre for Applied Research, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Chris J Newby
- Research Design Service, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Claudia Chisari
- Centre for Behavioural Medicine, Department of Practice and Policy, UCL School of Pharmacy, University College London, London, UK
| | - Sana Ali
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Natalee Zhu
- School of Pharmacy, The University of Auckland, Auckland, New Zealand
| | | | | | - Victoria Ting
- School of Pharmacy, The University of Auckland, Auckland, New Zealand
| | - Chris J Griffiths
- Asthma UK Centre for Applied Research, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Miller TT, Maurer SH, Felker JT. Searching for a cure on Facebook: Patterns of social media use amongst caregivers of children with brain tumors. Cancer Med 2022; 11:3323-3331. [PMID: 35343641 PMCID: PMC9468429 DOI: 10.1002/cam4.4693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/28/2022] [Accepted: 03/09/2022] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Social media (SM) is ubiquitous in modern society. How SM provides information, advice, and community to families coping with childhood brain tumors is poorly understood. We sought to understand how caregivers of children with brain tumors use and are affected by SM. METHODS A survey was administered to caregivers of children who were receiving or within the last 5 years received chemotherapy for pediatric brain tumors. Differences in variables across groups were evaluated using nonparametric tests and chi-square tests. RESULTS Thirty-five of 36 caregivers acknowledged use of SM. Facebook was the most used platform (86%). Fifty-eight percent and 47% used SM to read and share information about their child's cancer, respectively. Thirty-four percent were comforted while 40% were bothered by cancer-related information on SM. Eleven participants (31%) sought a second opinion based on information from SM. Caregivers of children with a poor prognosis were more likely to use a treatment from SM that was not initially recommended by their oncologist (p = 0.043). CONCLUSION SM is commonly used by caregivers to obtain and share care-related information. Many noted positive and negative effects of SM on emotional wellness. SM influenced treatment decisions, and this effect was stronger with poorer prognosis. Our results demonstrate the dichotomous impact of SM in medicine-it is a source of both solace and anxiety, a place to confirm treatment decisions and to create doubt in the treatment decisions of the oncologist. This illustrates the importance of discussing SM with caregivers of children with brain tumors.
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Affiliation(s)
- Tyler T Miller
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Scott H Maurer
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.,Department of Pediatrics, Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Division of Palliative Medicine and Supportive Care, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - James T Felker
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.,Department of Pediatrics, Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Krusnauskas R, Eimantas N, Baranauskiene N, Venckunas T, Snieckus A, Brazaitis M, Westerblad H, Kamandulis S. Response to Three Weeks of Sprint Interval Training Cannot Be Explained by the Exertional Level. ACTA ACUST UNITED AC 2020; 56:medicina56080395. [PMID: 32784754 PMCID: PMC7466197 DOI: 10.3390/medicina56080395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 08/04/2020] [Indexed: 01/13/2023]
Abstract
Background and Objectives: The all-out mode of sprint interval training (SIT) has been shown to be an efficient method for improving sports performance, exercise capacity, and aerobic fitness. Although the benefits of SIT are well described, the mechanisms underlying the different degrees of response remain largely unexplored. We aimed to assess the effects of exertion on the responsiveness to SIT. Materials and Methods: The participants were 28 young untrained men (mean ± SD age 25.7 ± 6.03 years) who exhibited either a large or small increase in Wingate test average power in response to nine SIT sessions performed over three weeks. Each training session comprised four-six bouts of 30 s all-out cycling interspaced with 4 min of rest. Individual responses were assessed using heart rate (HR) during exercise for all nine sessions, as well as blood lactate concentration up to 1 h, and the decrement in maximal voluntary knee extension torque (MVC) up to 24 h after the first and last training sessions. Peak oxygen uptake (VO2peak) and maximum HR were measured before and after training during an incremental cycling test to exhaustion. Results: Although all participants showed benefits of SIT such as increased VO2peak, the increase in anaerobic cycling power varied between participants. We identified 17 high responders and nine low responders, whose average power outputs were 0.80 ± 0.22 and 0.22 ± 0.19 W/kg, respectively. The HR achieved during any of the training sessions did not differ between high and low responders. The lactate kinetics did not differ between groups before and after the intervention. Training resulted in a more rapid recovery of MVC without any discernible differences between the high and low responders. Conclusion: The differences in the responses to SIT are not dependent on the exertion level during training.
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Affiliation(s)
- Raulas Krusnauskas
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (N.E.); (N.B.); (T.V.); (A.S.); (M.B.); (H.W.); (S.K.)
- Correspondence:
| | - Nerijus Eimantas
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (N.E.); (N.B.); (T.V.); (A.S.); (M.B.); (H.W.); (S.K.)
| | - Neringa Baranauskiene
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (N.E.); (N.B.); (T.V.); (A.S.); (M.B.); (H.W.); (S.K.)
| | - Tomas Venckunas
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (N.E.); (N.B.); (T.V.); (A.S.); (M.B.); (H.W.); (S.K.)
| | - Audrius Snieckus
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (N.E.); (N.B.); (T.V.); (A.S.); (M.B.); (H.W.); (S.K.)
| | - Marius Brazaitis
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (N.E.); (N.B.); (T.V.); (A.S.); (M.B.); (H.W.); (S.K.)
| | - Hakan Westerblad
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (N.E.); (N.B.); (T.V.); (A.S.); (M.B.); (H.W.); (S.K.)
- Department of Physiology and Pharmacology, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Sigitas Kamandulis
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (N.E.); (N.B.); (T.V.); (A.S.); (M.B.); (H.W.); (S.K.)
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Zainuddin Z, Perera CJ, Haruna H, Habiburrahim H. Literacy in the new norm: stay-home game plan for parents. INFORMATION AND LEARNING SCIENCES 2020. [DOI: 10.1108/ils-04-2020-0069] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this study is twofold. Firstly, this research aims at helping countries implement an equitable, innovative and context-appropriate stay-home game plan for the millions of disadvantaged and under-privileged students severely affected by the forfeiture of school closures; and secondly, this study proclaims that the burgeoning popularity of gamification has the potential to lay the bedrock foundation for ‘Literacy in the New Norm’.
Design/methodology/approach
The temporal closure of schools around the world to limit the spread of the COVID-19 has resulted in massive educational disruptions triggering adverse effects and bringing much of education under grave threat. Through a review of the current empirical and conceptual literature, this study proposes a new gamification concept in a non-technology environment.
Findings
Well underway are global dialogues that hold conversations on implementing mitigation strategies to counter the looming global health crisis. This has generated the impetus for a more concerted effort by concerned governments and international organizations to identify appropriate solutions for the continuity of learning so that the learning never stops. While educators and learners plunge further into the core of reconstructing education, the authors recognize that the fundamentals of technology and virtual connectivity have all along contributed to the multi-faceted e-learning stage set. However, concerns regarding the paradigm shift to remote online learning would certainly exacerbate inequalities cardinally felt across disadvantaged communities around the globe.
Originality/value
As the world is currently bound by strict isolation measures, learners of all ages have been relegated to the confines of their homes. For the most part, the stark realities of technological mishaps that have befallen underprivileged school children, serve as a reminder to help target children all over the world who are in most peril of losing ground in terms of continued education. It is on these grounds that the criterion set out in this article elucidates the nature and scope of a supplementary stay-home game plan detailing the use of game affordances that bear intelligently in the creation of home-based activities for parents to give it their best effort in fostering a collaborative and meaningful parent-child relationship that spawns the new language of literacy in the new norm.
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