Lifestyle medicine (Hoboken, N.J.)最新文献

{"title":"Diverse research designs are needed for population health: Lessons from Maslow","authors":"Marcus Schmitt-Egenolf,&nbsp;Fraser Birrell","doi":"10.1002/lim2.55","DOIUrl":"10.1002/lim2.55","url":null,"abstract":"<p>It has been repeatedly shown that randomized controlled trials (RCTs) do not represent real-world patient populations; a recent systematic review showed that more than 70% of trials are not broadly representative, limiting external validity.<span>¹</span> Consequently, RCT-based conclusions can be true (high internal validity) but many are irrelevant for the real-world setting due to low external validity and generalizability. Evidence-based medicine has given pre-eminence to RCTs, and meta-analyses of RCTs graded as the highest evidence in medicine. Although RCTs are superior in certain situations, mainly for pharmacological intervention aiming to treat a single disease in an otherwise healthy patient population, their inherent reductionist setting can miss much of what is valuable in health—things that can only be captured in a more patient-centred approach.<span>²</span> This over-reliance on a familiar tool, known as the law of the instrument or ‘Maslow's hammer’, has already been described in 1966: ‘I suppose it is tempting, if the only tool you have is a hammer, to treat everything as if it were a nail’.<span>³</span> RCTs should consequently be used appropriately, as necessary evidence before acquiring real-world evidence in pharmacological interventions.<span>⁴</span></p><p>As we realize that societal determinants and individual lifestyle choices—which are not easily evaluated in RCTs—will be the major determinants of health and well-being in the future, over-reliance on the RCT instrument holds the danger of limiting medical progress through ‘by design’ prioritization of pharmacological interventions. Virtual group consultations, able to utilise limited resources (health professionals) maximally and deliver efficient care<span>⁵</span>, are an example of an innovative intervention that cannot be evaluated in a classic RCT. But observational designs have well-recognised limitations, so modern intervention and trial types now available to us should be more widely used and further developed. These include stepped wedge designs, just-in-time adaptive interventions (JITAIs, sometimes referred to as ‘jedis’), (sequential) multi-randomisation trials, and ‘small data’ approaches.<span>^5-7</span> As innovative interventions spread at scale, we believe embedded evaluation should be prioritized through novel health technology assessment (HTA) or health service funding schemes, as they and other complex interventions are best studied in real-world conditions, despite a paucity of RCT data.<span>⁹</span> New—and preferably collaborative to address global inequality—funding streams are needed like the recent initiative from the United Kingdom's National Institute for Health Research (NIHR) for varied research approaches in diverse populations.<span>¹⁰</span> Only then can true variety be delivered to facilitate the robust healthcare system changes the syndemic h","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.55","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46927591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maladaptive or misunderstood? Dopamine fasting as a potential intervention for behavioral addiction","authors":"Yi Yang Fei,&nbsp;Peter Anto Johnson,&nbsp;Noor A.L. Omran,&nbsp;Austin Mardon,&nbsp;John Christy Johnson","doi":"10.1002/lim2.54","DOIUrl":"10.1002/lim2.54","url":null,"abstract":"<p>In this commentary, we strive to illustrate common misconceptions of the dopamine fasting fad that has become popular among wellness enthusiasts and purported by health gurus. Here, we review the proposed Dopamine fasting technique for managing behavioral addictions as proposed by California psychiatrist Dr. Cameron Sepah. We first summarize correct and incorrect interpretations of what Dopamine fasting involves. Next, we contextualize the role of dopamine as it relates to behavioral modification interventions for addiction. Particularly, we discuss the role of dopamine in behavioral addiction and the effectiveness of cognitive behavioral therapy (CBT) techniques for various addictions which are the basis of the proposed dopamine fasting technique. While we see potential for dopamine fasting to offer significant benefits to individuals, we highlight the limitation of the self-guided aspect of dopamine fasting, which could pose physical and emotional harm to individuals if the guideline is misinterpreted or misused as the sole treatment for severe disorders which require clinician input. Future studies should aim to assess not only the scientific efficacy of dopamine fasting as a potential treatment approach for behavioral addiction, but also the needs and well-being of individuals who seek self-directed treatment from popular media trends.</p>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.54","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42426930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 transmission flow through the stigmatization process in Bangladesh: A qualitative study","authors":"Md. Shahgahan Miah,&nbsp;Md. Razib Mamun,&nbsp;S. M. Murshid Hasan,&nbsp;Md. Golam Faruk Sarker,&nbsp;Muhammad Salim Miah,&nbsp;Md. Gias Uddin Khan,&nbsp;Ashraful Kabir,&nbsp;Mohammad Ainul Haque,&nbsp;N. M. Rabiul Awal Chowdhury","doi":"10.1002/lim2.52","DOIUrl":"10.1002/lim2.52","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Coronavirus disease (COVID-19) patients and survivors face stigma, discrimination, and negligence. The motives for and the different types and consequences of COVID-19-related stigmatization remain underexplored in Bangladesh. Therefore, this study examined how the COVID-19 stigmatization process is interlinked with transmission flow.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a qualitative research design, we conducted 20 in-depth interviews with infected and suspected caregivers and five key informant interviews with physicians, local media representatives, leaders, law enforcement officials, and local administrative officials in three divisional cities of Bangladesh. We performed thematic analysis to analyze the data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants expressed their experiences with multiple subthemes within three themes (stigma related to symptoms, stigma associated with isolation and quarantine, and stigma associated with health services). Participants reportedly faced stigma, for example, exclusion, hesitation to interact, avoidance, bullying, threat, and negligence caused by misinformation, rumors, and fear. Stigmatized individuals reportedly hid their symptoms and refrained from seeking healthcare services, contributing to COVID-19 transmission flow.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Revealed insights may contribute to effective prevention, control, and management of such an emerging pandemic. Further in-depth exploration of such stigmatization process will enrich unexpected outbreaks management effectively.</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9015364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10294645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved mood following a single immersion in cold water","authors":"John S. Kelly,&nbsp;Ellis Bird","doi":"10.1002/lim2.53","DOIUrl":"10.1002/lim2.53","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>An increasing volume of anecdotal and scientific evidence suggests that mood may be enhanced following swimming in cold water. The exact mechanisms responsible are largely unknown, but may include the effects of exercise from swimming and the effects of cold. This study examined the effect on mood following immersion in cold water, where swimming was not the primary activity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Profile of Mood States (POMS) questionnaire was completed by 64 undergraduate students. The following week, 42 participants completed up to 20-min immersion (18ʹ36ʺ ± 1ʹ48ʺ) in cold sea water (13.6°C). Twenty-two participants acted as controls. The POMS was completed immediately following the cold-water immersion by both groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cold-water immersion group showed a significant decrease, with a large effect size, of 15 points from 51 to 36, compared to 2 points in the control group, 42 to 40. Positive sub-scales increased significantly in the cold-water immersion group (Vigour by 1.1, and Esteem-Related Affect by 2.2 points) and negative sub-scales showed significant reductions (Tension by 2.5, Anger 1.25, Depression 2.1, Fatigue 2.2, and Confusion 2.8 points). The control showed no significant change except for depression, which was significantly higher after the period by 1.6 points.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Cold-water immersion is a well-tolerated therapy that is capable of significantly improving mood in young, fit, and healthy individuals. A key aim of this study was to control for the effects of swimming as a mechanism responsible for the improvement in mood which has been shown in previous studies. Thus, the change in mood evidenced in this study was not due to physical activity per se. Consequently, the hypothesis that cold in and of itself can improve mood is supported.</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.53","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42718706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and socioeconomic factors associated with overweight/obesity among three reproductive age groups of women in Nepal","authors":"Md. Shariful Islam,&nbsp;Oluwadara Ola,&nbsp;Joan Alaboson,&nbsp;Jeffrey Dadzie,&nbsp;Md. Hasan,&nbsp;Nazmul Islam,&nbsp;Shristi Mainali,&nbsp;KM Saif-Ur-Rahman","doi":"10.1002/lim2.51","DOIUrl":"10.1002/lim2.51","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Overweight/obesity represents a major and increasing burden in Nepal where women in reproductive-aged groups are highly affected. We aimed to explore the trends and association of overweight by socioeconomic position among the different reproductive-aged women in Nepal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used datasets from five nationally representative surveys, Nepal Demographic and Health Survey conducted between 1996 and 2016. A sample of 33,503 nonpregnant women aged 15–49 was included. Markers of socioeconomic position were education level, occupation, and household wealth. Descriptive analysis, crude and adjusted prevalence trends, and multiple logistic regression models were carried out.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of overweight/obesity increased fivefold (7.5–35.2%) among women of reproductive age between 1996 and 2016 in Nepal. The prevalence increase of overweight was higher among women aged 25 to  &lt; 35 and 35–49. The overweight prevalence increased from 5.2% to 42.3% among women involved in manual work. Women aged 35–49 from the richest households were more likely overweight (adjusted odds ratio 5.68; 95% CI 4.62–6.99). Women with higher education had higher body weight irrespective of reproductive age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In Nepal, women aged 35–49 from the richest households and women with higher education were the highest risk groups for being overweight in Nepal. To improve the situation of overweight in Nepal, strategies prioritizing the vulnerable groups should be incorporated into the National Nutrition Policy and Strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lim2.51","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47851434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Median duration and factors that influence the duration of symptom resolution in COVID-19 patients in Ethiopia: A follow-up study involving symptomatic cases.","authors":"Saro Abdella Abrahim, Masresha Tessema, Eshetu Ejeta, Mahammed Ahmed, Atkure Defar, Alemayehu Hussen, Getachew Demoz, Eskindir Degu, Mulugeta Aseratie, Belay Merga, Enatenesh Dillnessa, Tegene Regassa, Dereje Duguma, Susan Whiting","doi":"10.1002/lim2.46","DOIUrl":"10.1002/lim2.46","url":null,"abstract":"<p><strong>Background: </strong>Understanding the clinical features of COVID-19 and duration for resolution of symptoms is crucial for isolation of patients and tailoring public health messaging, interventions and policy. Therefore, this study aims to assess the median duration of COVID-19 signs and symptoms' resolution and explore its predictors among symptomatic COVID-19 patients in Ethiopia.</p><p><strong>Methods: </strong>A hospital-based prospective cohort study involving 124 COVID-19 cases was conducted at Eka Kotebe General Hospital, COVID-19 Isolation and Treatment Center. The study participants were all symptomatic COVID-19 adult patients admitted to the hospital from 18 March to 20 August 2020. Physicians at the centre recorded the data using a log sheet. Cox proportional-hazards regression model was conducted. Statistical significance was defined at <i>P</i> < 0.05.</p><p><strong>Results: </strong>A total of 124 symptomatic COVID-19 patients with a mean age of 42 years (±17) were involved in the study. The median duration of symptom resolution of COVID-19 was seven days with a minimum of two and a maximum of sixty-eight days. Sex and body mass index (BMI) were statistically significant predictors of the symptom resolution. The hazard of having delayed sign or symptom resolution in males was 55% higher than in females (<i>P</i> = 0.039; CI: 0.22-0.96) and the hazard of delayed sign or symptom resolution in those with BMI ≥ 25 kg/m² was 35% higher than in those with BMI < 25 kg/m² (<i>P</i> = 0.041; CI: 0.44-0.98]).</p><p><strong>Conclusions: </strong>The median duration of COVID-19 symptom resolution was seven days. Being male and/or having a BMI ≥ 25 kg/m² were predictors of a delayed sign or symptom resolution time. Therefore, it is important to consider proportion of males and those with BMI ≥ 25 kg/m² when preparing isolation and treatment centres. Males and individuals with BMI ≥ 25 kg/m² shall also be given priority when shielding from the COVID-19.</p>","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":"2 1","pages":"e46"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8646405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44715256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assembling a ‘good’ and ‘bad’ night's sleep: A multifactorial proposition","authors":"R. Ogeil, Mai‐Tram Nguyen, M. Savic, D. Lubman","doi":"10.1002/lim2.48","DOIUrl":"https://doi.org/10.1002/lim2.48","url":null,"abstract":"","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46919959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educational collaboration can empower patients, support doctors in training and future‐proof medical education","authors":"F. Birrell, Ann Johnson, L. Scott, Alison Irvine, Robina Shah","doi":"10.1002/lim2.49","DOIUrl":"https://doi.org/10.1002/lim2.49","url":null,"abstract":"","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43420773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with low medication adherence in patients with Type 2 diabetes mellitus attending a tertiary hospital in Bangladesh","authors":"S. Islam, M. Islam, R. Uddin, Tania Tansi, S. Talukder, F. Sarker, K. Mamun, S. Adibi, L. Rawal","doi":"10.1002/lim2.47","DOIUrl":"https://doi.org/10.1002/lim2.47","url":null,"abstract":"","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/lim2.47","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44428555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Noncommunicable disease risk factors among the trainee doctors of a tertiary level diabetes hospital in Bangladesh","authors":"Tonima Sultana, M. Faruque, P. Banik, S. Sultana, Feroz Amin, M. M. Zaman","doi":"10.1002/lim2.45","DOIUrl":"https://doi.org/10.1002/lim2.45","url":null,"abstract":"","PeriodicalId":74076,"journal":{"name":"Lifestyle medicine (Hoboken, N.J.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/lim2.45","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48982161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}