Pilates-based exercise in the reduction of the low back pain: an overview of reviews

OBJECTIVE

Pilates is a popular system of exercise that is recommended for healthy individuals and patients with low back pain (LBP). The restoration of muscle function in lumbopelvic stability and pelvic floor muscles has been fostered by practices based on this strategy. Restoring or sustaining the motor control of the lumbar spine and proper body posture during each exercise is very important. The aim of this umbrella review (UR) of systematic reviews and narrative reviews is to detect the effects of exercise on patients with chronic low back pain (CLBP).

MATERIALS AND METHODS

Records were published in December 2019 and identified from Web of Science, PubMed, and Scopus. Studies that addressed this topic were included. The protocol was registered on PROSPERO (246510).

RESULTS

The Pilates method, using functional exercises, improves muscular strength and endurance. Eleven studies were included in the UR. Nine reviews for chronic LBP concluded that there were pain relief and functional progression from the Pilates-based exercise intervention in the short-term. There was strong evidence that Pilates exercise improved flexibility and dynamic balance and enhanced muscular endurance among healthy people in the short-term.

CONCLUSIONS

Pilates exercise improved dynamic balance and flexibility also raised muscular endurance in people in the short time. There was some evidence that admits this exercise as effective in body fat reduction and increasing fat-free mass in the short-term.

Underascertainment of COVID-19 cases among first responders: a seroepidemiological study

Background

Providing frontline support places first responders at a high risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Aims

This study was aimed to determine the anti-SARS-CoV-2 seroprevalence in a cohort of first responders (i.e. firefighters/paramedics), to detect the underascertainment rate and to assess risk factors associated with seropositivity.

Methods

We conducted a serological survey among 745 first responders in Germany during 27 November and 4 December 2020 to determine the anti-SARS-CoV-2 seroprevalence using Elecsys® Anti-SARS-CoV-2 immunoassay (Roche Diagnostics, Mannheim, Germany). As part of the examination, participants were asked to provide information on coronavirus disease 2019 (COVID-19)-like-symptoms, information on sociodemographic characteristics and workplace risk factors for a SARS-CoV-2 infection and any prior COVID-19 infection. Descriptive statistics and logistic regression analysis were performed and seroprevalence estimates were adjusted for test sensitivity and specificity.

Results

The test-adjusted seroprevalence was 4% (95% CI 3.1–6.2) and the underascertainment rate was 2.3. Of those tested SARS-CoV-2 antibody positive, 41% were aware that they had been infected in the past. Seropositivity was elevated among paramedics who worked in the emergency rescue team providing first level of pre-hospital emergency care (6% [95% CI 3.4–8.6]) and those directly exposed to a COVID-19 case (5% [95% CI 3.5–8.1]). Overall, the seroprevalence and the underascertainment rate were higher among first responders than among the general population.

Conclusions

The high seroprevalence and underascertainment rate highlight the need to mitigate potential transmission within and between first responders and patients. Workplace control measures such as increased and regular COVID-19-testing and the prompt vaccination of all personnel are necessary.

Results of the Italian project 'GiochiAMO' to improve nutrition and PA among children

BACKGROUND

Prevalence of overweight and obesity during childhood is still elevated in high-income countries. GiochiAMO is a health promotion program that uses knowledge-based education and games to teach healthy nutrition and physical activity among children (6-8 years old).

METHODS

This study was a single arm field trial. Second and third grade classes of primary school attended an oral presentation about nutrition and physical activity and then were involved in three game sessions. Two multiple-choice questionnaires were administered at the beginning and at the end of the trail. The following scores were measured: nutrition behavior score (NTs), physical activity behavior score (PAs) and delta score (Ds). Wilcoxon, T-test and Mann Whitney were used to perform the univariate analysis.

RESULTS

A total number of 74 and 76 children participated in the physical activity and nutrition interventions. NTs was 4.17 (SD: 2.23) before and 5.03 (SD: 2.79) after the intervention (P = 0.005). PAs was 27.4 (SD: 9.6) before and 30.5 (SD: 10.7) after the intervention (P = 0.003). No significant differences were obtained comparing males and females for all scores. Ds was 0.86 for nutrition and 3.1 for physical activity. Univariate analysis of Delta scores obtained no significant differences.

CONCLUSIONS

The present results confirm the effectiveness of 'GiochiAMO' to change nutrition and physical activity behavior.

Compliance with the school smoking ban: A cross-sectional study from Italy

BACKGROUND

In 2015, 37% of Italian adolescents reported to have smoked in the past month. The study aimed to evaluate smoking beha-viour on the school premises and to study the influence of the school environment on student smoking.

METHODS

Around 900 junior high-school students, aged 11-13 years old completed an online survey in November 2016 and May 2017. Descriptive statistics, univariate analyses and binary logistic regression were performed to analyse data.

RESULTS

Between 40 - 50% of students indicated that students and staff smoke on the school premises. Students who witnessed students (OR: 3.48 (2.20 - 5.50)) and school employees (OR: 3.17 (1.97 - 5.10)) smoking were more likely to be a smoker.

CONCLUSION

Although laws making it illegal to smoke on the school ground are in place, in Italy, its enforcement is sloppy. To tackle adolescent smoking effectively, policymakers are advised to enforce smoking restrictions and to verify these are respected.

Sexual assault, sense of belonging, depression and suicidality among LGBQ college students

Background

There has been growing concern about the poor mental health of college student of gay, lesbian, bisexual, or questioning/queer (LGBQ) sexual orientation. Factors believed to negatively influence LGBQ student's health include discrimination and victimization such as sexual assault, whereas factors believed to positively influence mental health include cohesiveness and a sense of belonging. Little is known about how these might interact with each other. Therefore, the objective of this study was to compare the effect of sexual orientation, history of sexual assault and sense of belonging on depression and suicidality among LGBQ and heterosexual students.

Methods

This is a secondary data analysis using a subset of available data from the 2017-2018 Healthy Minds Study dataset. The dataset was encompassed of self-report data from about 60,200 college students across 60 campuses in the United States. Descriptive statistics and three-way interaction analysis using PROCESS macro models in SPSS were performed.

Results

Students identifying as LGBQ reported more frequently to have experienced sexual assault, to suffer from depressive symptoms and to have suicidal thoughts than heterosexual students. Significant three-way interaction effects were found for sexual orientation, sexual assault and sense of belonging predicting depressive symptoms (b= -.06, p= .042, CI: -.12; -.00), and suicidality (b= -.10, p= .004, CI: -.01; -.003). The effect of sexual assault on mental health differed depending on sexual orientation and sense of belonging. Particularly among LGBQ students, high sense of belonging was protective in the presence of sexual assault, and its absence had a deleterious effect on mental health.

Conclusions

There is a need to reduce mental health problems and sexual assault on college campuses and to foster a sense of belonging. Enhancing sense of belonging may represent a strategy to mitigate depression and suicidality, particularly among LGBQ students.

Key messages

Mental health problems such as depression and suicidal ideation among sexual minority students remain highly prevalent in the United States. Increasing sense of belonging may moderate symptoms such as depressiveness and suicidal ideation.

The use of quality indicators (QIs) to evaluate the oncologic care in CCCN: a systematic review

Key messages

The CCCN has been recognized as an ideal model for structuring the process of care that guarantees a complete and integrated approach for the management of oncological patients. Quality Indicators represent valid and reliable tools that should be used to perform a standardized comparison among different healthcare systems and to guarantee a homogeneous quality of care.

Social capital and students’ health: results of the splash study

Background

Universities around the world are challenged with rising rates of mental health problems among their students. Cumulative evidence demonstrated that aspects of the social environment, including social capital, play an important role in mental health. This study aimed to determine the prevalence of depressive symptoms among university students from across the globe and to investigate whether social capital was associated with depressive symptoms in university students.

Methods

A cross-sectional study was conducted in Albania, Brazil, Germany, Italy, Malaysia Oman, South Korea, Switzerland, Taiwan and the USA in 2018/2019. Data were obtained through self-administered questionnaire, including questions on sociodemographic characteristics and depressive symptoms. The BDI-S was used to assess the presence of depressive symptoms. Multilevel analyses were conducted to assess the relationship between social capital and depressive, adjusting for individual covariates (e.g. perceived stress and health behaviours) and country-level characteristics (e.g. democracy type).

Results

A total 3894 students participated. Out of all participants almost 47% presented clinically relevant depressive symptoms. The prevalence of depressive symptoms was highest among students identifying as other than male or female (48.7%), among students with low socioeconomic status (59.5%) and among students with low levels of cognitive (65.3%) and behavioural social capital (57.0%). Even after adjustment in multilevel logistic regression analyses, depressive symptoms remained significantly associated with low levels of cognitive social capital (OR = 1.49, 95% CI: 1.06 to 2.10) and low level of behavioural social capital (OR = 1.36, 95% CI: 1.08 to 1.71).

Conclusions

Social capital may play an important role in mental health problems in the university setting. The study identified significant opportunities for future research and health promotion strategies among students.

Key messages

Key factors associated with depressive symptoms among university students were low levels of behavioural and cognitive social capital. Health promotion programs targeting young persons with depressive symptoms should include effective components of social epidemiology such as social capital.

Right-wing populism and self-rated health in Europe: a multilevel analysis

Background

Individuals who hew to a conservative political ideology have been previously reported to have better self-rated health compared to liberals. No studies have examined whether the correlation between right-wing ideology and health also holds for populism, a brand of politics that is gaining momentum throughout the world. We tested whether the association still holds for right-wing populists.

Methods

We analysed data from 24617 respondents nested within 18 European countries included in the 2016 European Social Survey. Multilevel analyses were conducted to assess the relationship between political ideology and self-rated health, adjusting for other individual covariates (happiness and social capital) and country-level characteristics (democracy type).

Results

Individuals who voted for right-wing populist parties were 43% more likely to report fair/poor health compared to traditional conservatives (OR = 1.43, 95% confidence interval 1.23 to 1.67). The association was attenuated after controlling for individual-level variables, including happiness and access to social capital (OR = 1.21, confidence interval 1.03 to 1.42). Higher levels of social capital (informal networks, OR = 0.40, 95% confidence interval 0.29 to 0.56; trust, OR = 0.82, 95% confidence interval 0.74 to 0.92) and happiness (OR = 0.18, 95% confidence interval 0.15 to 0.22) were protectively correlated with fair/poor self-rated health.

Conclusions

Individuals voting for right-wing populist parties report worse health compared to conservatives. It remains unclear whether ideology is just a marker for health-related practices, or whether the values and beliefs associated with a particular brand of ideology leads to worse health.

Key messages

There is a significant association between voting for right-wing populist parties and self-rated poor health. Social capital was protectively correlated with self-rated health calling for renewed attention on the effects of social capital on political ideology and health.

"GiochiAMO": a school-based smoking and alcohol prevention program for children - a pilot randomized field trial. Part 2

BACKGROUND

Young people who begin to smoke at an early age are at a higher risk of becoming occasional or regular smokers and establishing a premature dependence. It is fundamental to act as soon as possible, from very early childhood, to prevent harmful behaviors for health such as smoking and drinking alcohol. Young people must be encouraged to adopt healthy lifestyles.

OBJECTIVES

The aim of the study is two-fold. First, increasing the knowledge about the negative health effects of cigarette smoking and alcohol consumption among children aged 9-10 years; and second, to introduce and reinforce life skills in order to learn how to tackle social influences that encourage children to smoke and to drink alcohol.

METHODS

A pilot randomized field trial was conducted in May-June 2017. Four primary school classes in Rome were randomized to either the intervention or the control group. Both groups participated in an oral presentation about the risks and consequences of smoking and alcohol consumption, and the concept of life skills. The intervention group participated in two gaming sessions, each lasting 1.5 hours. Children were involved in six games aiming to deliver and reinforce knowledge about the target themes of the study. A 21 multi-response questions questionnaire was handed out to both groups at the beginning and at the end of the study. Eleven questions were about smoking; five questions about alcohol; five questions about life skills. Each question item included one correct answer. For each domain, a score was computed (total; smoking; alcohol; life skills).

RESULTS

67 children participated in the study (34 in the intervention and 33 in the control group). Univariate analyses showed significant differences among the intervention group before and after the intervention for total score (p<0.001), smoke score (p<0.001), and life skills score (p=0.003). No significant differences among the intervention group before and after the intervention were reported for alcohol score (p=0.076). Regarding the control group univariate analysis showed significant differences in total score (p=0,001) and life skills score (p=0.005). Multivariate analysis revealed that enrollment in the intervention was the only variable that had a significant positive influence on smoking knowledge score (beta=1.070, p=0.05).

CONCLUSION

This pilot study shows that the intervention was effective among the intervention group for all the scores: total score, smoke score and life skills score, but ineffective for alcohol. Overall, the combination of a presentation and games was effective in increasing life skills knowledge.

Returning to work after breast cancer: A systematic review of reviews

BACKGROUND

Due to improvements in breast cancer diagnosis and treatment, the healthcare system faces a growing number of cancer survivors. Breast cancer survivors experience many difficulties when returning to work, including discrimination at work and lack of support by employers and colleagues.

OBJECTIVE

To point out the knowledge in literature up to date about return to work (RTW) after breast cancer, the factors influencing it and the interventions to facilitate it.

METHODS

A literature search was conducted in January 2017 using the databases Medline (PubMed) and Scopus. Studies were included if they analyzed the problem of RTW in women treated for breast cancer.

RESULTS

Twenty-six articles met the inclusion criteria. The studies were divided into four themes: factors facilitating or impeding RTW; interventions to enhance RTW; lived experiences of RTW; economic aspects related to cancer survivors and RTW.

CONCLUSIONS

The heterogeneity of the interventions suggests the need for a better definition of the concept of RTW. To compare interventions, studies should use a rigorous approach and better outcome measures should be identified to evaluate RTW.

Shift work, overweight and obesity in health professionals: a systematic review and meta-analysis

Shift work may have significant repercussions on the health of the worker, and has been linked to unhealthy lifestyles. The aim was to conduct a systematic review of the literature and to assess the relationship between night shift and overweight and obesity among health professionals. A literature search was performed using PubMed and Scopus. The keywords used included: "shift work", "night work", "obesity", "overweight", "nurses" "doctors" "physicians". The whole process of revision followed the PRISMA Statement. Two researchers independently, reviewed the search results, assessed the quality and extracted data. Six transversal and a cohort studies were found for the population of nurses. The meta-analysis did not produce significant results on the prevalence of obesity in the population of nurses (OR: 1.00; 95% CI 0.66-1.50). More high-quality studies and including a larger number of participants should be conducted, in order to assess whether there is real cause-effect relationship between the exposure to night shifts and weight gain as well as of obesity.

Link between perceived smoking behaviour at school and students smoking status: a large survey among Italian adolescents

OBJECTIVES

To investigate a possible link between sociodemographic factors, the perception of smoking habits at school and smoking status of Italian adolescents attending secondary school.

STUDY DESIGN

The study was a cross-sectional study.

METHODS

An anonymous online survey was employed to gather information on age, gender, smoking status and to examine the perception of smoking behaviour on the school premises. Chi-squared and Kruskal-Wallis tests were performed for the univariate analysis and logistic and multinomial regressions for the multivariate analysis.

RESULTS

The statistical analyses included 1889 students. Univariate analysis showed significant differences concerning knowledge between smoker and non-smoker concerning the harmfulness of smoking (P < 0.001). According to the multivariate analysis smokers had a higher perception of teacher, principal or janitor smoking at school (odds ratio: 1.54 [95% confidence interval 1.26-1.89]). Students older than 19 years most often begin smoking because their friends smoke compared with younger students (adjusted odds ratio: 1.18 [95% confidence interval 0.48-2.89]).

CONCLUSION

School environment and behaviour of role models play a crucial part in student smoking. To prevent and reduce youth tobacco smoking, not merely the presence of preventive measures is important but greater attention needs to be placed on the enforcement of smoking policies.

Smoking as a risk factor for developing Multiple Sclerosis: A meta-analysis of observational studies

OBJECTIVE

The aim of this study was to improve and update the pool of available studies included in the previous meta-analyses, and to provide further evidence about smoking as a risk factor for MS.

MATERIAL AND METHODS

PubMed and Scopus searches were undertaken to identify studies investigating the association between cigarette smoking and MS. Odds ratio (OR), relative risk (RR) together with 95% confidence intervals (CIs) were calculated for case-control and cohort studies and prevalence rate for cross sectional.

RESULTS

33 studies were suitable for the meta-analysis. The summary OR for case control studies (ever versus never) was 1.40 (95% CI, 1.29 to 1.52) and 1.42 (1.26-1.60) for current vs. no-smokers.

CONCLUSIONS

Smoking is associated with MS risk. Research using animal models can help to fully understand the mechanisms behind the association.