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Ding Y, Zhang H, Hu Z, Sun Y, Wang Y, Ding B, Yue G, He Y. Perceived Social Support and Health-Related Quality of Life Among Hypertensive Patients: A Latent Profile Analysis and the Role of Delay Discounting and Living Alone. Risk Manag Healthc Policy 2024; 17:2125-2139. [PMID: 39246592 PMCID: PMC11380862 DOI: 10.2147/rmhp.s476633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Accepted: 08/27/2024] [Indexed: 09/10/2024] Open
Abstract
Background Improving health-related quality of life (HRQoL) among hypertensive individuals has emerged as a significant public health issue. However, current research has ignored the individual heterogeneity of perceived social support (PSS) among hypertensive patients. The potential mechanism of delay discounting (DD), living alone, and PSS on HRQoL remains unclear, and further exploration is required. Aim This study aimed to ascertain PSS profiles among hypertensive patients and examine the hypotheses that DD mediates the relationship between PSS and HRQoL and that this mediating process is moderated by living alone in hypertensive patients. Methods A cross-sectional study was carried out in Jiangsu, China. In total, 1815 hypertensive patients completed socio-demographic and HRQoL questionnaires, a PSS scale, and a DD task. Data analyses included a latent profile analysis, χ2-test, Spearman correlation analysis, and PROCESS macro for regression analysis. Results Four potential PSS profiles were identified: lowest (3.2%), moderate-low (26.6%), moderate-high (42.4%), and highest (27.8%). DD mediated the association between PSS and HRQoL. The first half of this mediating process was moderated by living alone. Conclusion Our findings indicated that PSS, DD, and living alone significantly influence the HRQoL of individuals with hypertension. Healthcare professionals should consider variations in PSS among hypertensive patients and implement interventions to reduce DD by enhancing PSS, in order to improve the HRQoL of this population.
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Affiliation(s)
- Yueming Ding
- Institute of Medical Humanities, School of Marxism, Nanjing Medical University, Nanjing, People's Republic of China
| | - Huiying Zhang
- Institute of Medical Humanities, School of Marxism, Nanjing Medical University, Nanjing, People's Republic of China
| | - Zhiqing Hu
- Institute of Medical Humanities, School of Marxism, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yanjun Sun
- Institute of Medical Humanities, School of Marxism, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yiping Wang
- School of Nursing, Nanjing Medical University, Nanjing, People's Republic of China
| | - Baolong Ding
- School of Pharmacy, Nanjing Medical University, Nanjing, People's Republic of China
| | - Guofeng Yue
- School of Health Policy and Management, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yuan He
- Institute of Medical Humanities, School of Marxism, Nanjing Medical University, Nanjing, People's Republic of China
- Research Center for Social Risk Management of Major Public Health Events (Key Research Base of Philosophy and Social Sciences of Universities in Jiangsu), Nanjing Medical University, Nanjing, People's Republic of China
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Yang Y, Gao Y, An R, Wan Q. Barriers and facilitators to exercise adherence in community-dwelling older adults: A mixed-methods systematic review using the COM-B model and Theoretical Domains Framework. Int J Nurs Stud 2024; 157:104808. [PMID: 38823146 DOI: 10.1016/j.ijnurstu.2024.104808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 04/26/2024] [Accepted: 05/10/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND Although the health benefits of exercise for older adults are widely recognized, physical inactivity is still common among older adults. Further clarification of the factors affecting exercise adherence is needed to develop more effective exercise interventions in community-dwelling older adults. OBJECTIVE The purposes of this study were to identify (1) barriers and facilitators of exercise adherence in community-dwelling older adults and (2) behavior change techniques (BCTs) and implementation strategies that are potentially effective in improving adherence. METHODS A total of eight databases were searched: PubMed, Web of Science, EMBASE, CENTRAL, PsycINFO, SPORTDiscus, MEDLINE, and Scopus. Studies published from database inception to April 2023 were searched. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool (MMAT). The Capabilities, Opportunities, Motivations, Behavior (COM-B) model and the Theoretical Domain Framework (TDF) were used to identify potential barriers and facilitators. The BCTs were used to identify potential intervention implementation strategies. RESULTS A total of 64 studies were included, including 30 qualitative studies, 12 randomized controlled trials, 12 mixed methods studies, 6 quantitative descriptive studies, and 5 non-randomized trials. 54 factors influencing adherence and 38 potentially effective BCTs were identified from the included studies. The 38 BCTs were further categorized into 8 areas of implementation strategies (tailored exercise program, appropriate exercise environment, multidimensional social support, monitoring and feedback, managing emotional experiences and issues, participants education, enhancing self-efficacy, and exerting participants' autonomy). CONCLUSION This study identified 54 influential factors affecting exercise adherence and identified 8 areas of intervention strategies (containing 38 BCTs). Further refinement, evaluation, and validation of these factors and strategies are needed in future studies.
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Affiliation(s)
- Yi Yang
- School of Nursing, Peking University, Beijing, China
| | - Yajing Gao
- School of Nursing, Peking University, Beijing, China
| | - Ran An
- School of Nursing, Peking University, Beijing, China
| | - Qiaoqin Wan
- School of Nursing, Peking University, Beijing, China.
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Ribeiro M, Fernandes E, Borges M, Pires M, Melo X, Pinto FJ, Abreu A, Pinto R. Reliability and Validity of the Global Physical Activity Questionnaire for Portuguese Adults. Percept Mot Skills 2024:315125241266341. [PMID: 39045817 DOI: 10.1177/00315125241266341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
The Global Physical Activity Questionnaire (GPAQ) has been used often to assess physical activity (PA) patterns. However, the European Portuguese version of this instrument has not been validated. We aimed to validate the self-administered GPAQ, version 2, (GPAQv2) for Portuguese adults. We included 32 participants in a pilot study of a Portuguese adaptation of the test and 108 participants in an assessment of their PA patterns and sedentary behavior (SB) through the GPAQv2. For its validation, we compared the GPAQv2 to the International PA Questionnaire-Long Form (IPAQ-LF) (concurrent validity) and the ActiGraph wGT3X-BT accelerometer (criterion validity). We evaluated PA and SB at baseline and after seven consecutive days. Test-retest reliability with the Kappa test (k) and the Intraclass Correlation Coefficient (ICC) ranged from strong to almost perfect (k: 0.864-0.976) and from moderate to excellent (ICC: 0.56-0.994), respectively. Concurrent validity, assessed by Spearman's Correlation Coefficient, was moderate to substantial (rho: 0.471-0.680), and there was fair to substantial criterion validity (rho: 0.226-0.672). Bland-Altman plots showed that the GPAQv2 overestimated vigorous and moderate to vigorous PA and underestimated moderate PA. The largest difference values were related to SB, since the GPAQv2 underestimated sitting time. In sum, we found the GPAQv2 to have acceptable validity and reliability for assessing PA and SB patterns, and we recommend its use for Portuguese adults.
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Affiliation(s)
- Mariana Ribeiro
- Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), CAML, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Elisabete Fernandes
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Mariana Borges
- Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), CAML, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Madalena Pires
- Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), CAML, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Xavier Melo
- Egas Moniz Interdisciplinary Research Center (CiiEM), Egas Moniz School of Health and Science, Campus Universitário, Almada, Portugal
| | - Fausto J Pinto
- Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), CAML, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Ana Abreu
- Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), CAML, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Rita Pinto
- Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), CAML, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
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Wu J, Li C, Zhu L, Liu X, Peng B, Wang T, Yuan S, Zhang Y. Nonlinear and threshold effects of built environment on older adults' walking duration: do age and retirement status matter? Front Public Health 2024; 12:1418733. [PMID: 39005992 PMCID: PMC11239551 DOI: 10.3389/fpubh.2024.1418733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 06/17/2024] [Indexed: 07/16/2024] Open
Abstract
Introduction Walking plays a crucial role in promoting physical activity among older adults. Understanding how the built environment influences older adults' walking behavior is vital for promoting physical activity and healthy aging. Among voluminous literature investigating the environmental correlates of walking behaviors of older adults, few have focused on walking duration across different age groups and life stages, let alone examined the potential nonlinearities and thresholds of the built environment. Methods This study employs travel diary from Zhongshan, China and the gradient boosting decision trees (GBDT) approach to disentangle the age and retirement status differences in the nonlinear and threshold effects of the built environment on older adults' walking duration. Results The results showed built environment attributes collectively contribute 57.37% for predicting older adults' walking duration, with a higher predicting power for the old-old (70+ years) or the retired. The most influencing built environment attribute for the young-old (60-70 years) is bus stop density, whereas the relative importance of population density, bus stop density, and accessibility to green space or commercial facilities is close for the old-old. The retired tend to walk longer in denser-populated neighborhoods with better bus service, but the non-retired are more active in walking in mixed-developed environments with accessible commercial facilities. The thresholds of bus stop density to encourage walking among the young-old is 7.8 counts/km2, comparing to 6 counts/km2 among the old-old. Regarding the green space accessibility, the effective range for the non-retired (4 to 30%) is smaller than that of the retired (12 to 45%). Discussion Overall, the findings provide nuanced and diverse interventions for creating walking-friendly neighborhoods to promote walking across different sub-groups of older adults.
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Affiliation(s)
- Jiani Wu
- State Key Laboratory of Ocean Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Chaoyang Li
- State Key Laboratory of Ocean Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Li Zhu
- JSTI Group, Nanjing, China
| | - Xiaofei Liu
- Key Laboratory of Advanced Public Transportation Science, China Academy of Transportation Sciences, Ministry of Transport, Beijing, China
| | - Bozhezi Peng
- State Key Laboratory of Ocean Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Tao Wang
- State Key Laboratory of Ocean Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Shengqiang Yuan
- Shanghai Municipal Engineering Design Institute (Group) Co., Ltd., Shanghai, China
| | - Yi Zhang
- State Key Laboratory of Ocean Engineering, Shanghai Jiao Tong University, Shanghai, China
- Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
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Kahan D. Physical Inactivity Prevalence in the Islamic World: An Updated Analysis of 47 Countries. J Phys Act Health 2023; 20:1133-1142. [PMID: 37758262 DOI: 10.1123/jpah.2023-0317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/07/2023] [Accepted: 08/11/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Physical inactivity prevalence estimates for youth and adults have been published on a global scale and for various geographical and geopolitical permutations. Only one such study has presented estimates for adults in Muslim countries, and it is nearly 10 years old. I conducted an update of this study by incorporating newer data, refining methods, and including youth estimates. METHODS I identified 47 Muslim countries with physical inactivity data for youth, adults, or both. Data were extracted by country primarily from global estimates reported by Guthold et al in 2018 and 2020 and from World Health Organization surveillance data repositories. Weighted prevalence calculations for total prevalence and by sex, ethnicity (Arab vs non-Arab), and country income group accounted for country population, study sample size, and a country's proportion of Muslims. Z tests and chi-square tests, and follow-up odds ratios and percentage deviations, respectively, were used to determine differences by sex, ethnicity, and country income group. RESULTS Overall physical inactivity prevalence was 84.2% (youth) and 29.6% (adults). Gaps favoring males over females were observed for youth (5.6% lower prevalence) and adults (9.6% lower prevalence). Gaps favoring non-Arabs over Arabs were observed for youth (3.9% lower) and adults (3.8% lower). No pattern emerged for country income group for youth; however, prevalence for adults trended upward across income groups from low (22.7%) to high (62.0%). CONCLUSIONS Gaps by sex and ethnicity have narrowed since the original report and prevalence values are somewhat higher than current global estimates.
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Affiliation(s)
- David Kahan
- Coastal Carolina University, Conway, SC, USA
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Wang X, Wang Y, Xu Z, Guo X, Mao H, Liu T, Gong W, Gong Z, Zhuo Q. Trajectories of 24-Hour Physical Activity Distribution and Relationship with Dyslipidemia. Nutrients 2023; 15:nu15020328. [PMID: 36678199 PMCID: PMC9860816 DOI: 10.3390/nu15020328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/03/2023] [Accepted: 01/06/2023] [Indexed: 01/11/2023] Open
Abstract
The association between physical activity (PA) and dyslipidemia is well known, but the relationship between a temporal pattern of PA and dyslipidemia remain unknown. Here, we aimed to identify the intensity and temporal patterns of PA clustered by the trajectory model and their relationship with dyslipidemia. The participants were 701 adults (305 males) aged 18−60 years undergoing continuous measurement of PA with Actigraph GT3X+ accelerometers for at least 3 days. A trajectory analysis was applied based on moderate-to-vigorous intensity physical activity (MVPA) accumulated values over every period per day. The association between PA and dyslipidemia was estimated using a logistic regression model. Four distinct PA trajectory groups in the population were identified (continued low, stable and moderate, late increasing, and early increasing). Specifically, the “moderate and stable group” was associated with a decreased rate of high TG (p < 0.05) and the “moderate and stable group” and “late increasing group” were associated with decreased rates of low HDL-C (p < 0.05). In conclusion, there were four activity trajectory groups in this population and the continued low PA trajectory was associated with a high prevalent rate of an abnormal lipid profile, and continued and moderate activity or late afternoon increasing activity might have lower HDL-C distribution.
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Affiliation(s)
- Xiaojing Wang
- Key Laboratory of Trace Element Nutrition of National Health Commission (NHC), National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yongjun Wang
- Key Laboratory of Trace Element Nutrition of National Health Commission (NHC), National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- Department of Clinical Nutrition, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250014, China
| | - Zechao Xu
- Beijing Chaoyang District Center for Disease Control and Prevention, Beijing 100050, China
| | - Xiang Guo
- Beijing Chaoyang District Center for Disease Control and Prevention, Beijing 100050, China
| | - Hongmei Mao
- Key Laboratory of Trace Element Nutrition of National Health Commission (NHC), National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Tingting Liu
- Key Laboratory of Trace Element Nutrition of National Health Commission (NHC), National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Weiyi Gong
- Key Laboratory of Trace Element Nutrition of National Health Commission (NHC), National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Zhaolong Gong
- Key Laboratory of Trace Element Nutrition of National Health Commission (NHC), National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Qin Zhuo
- Key Laboratory of Trace Element Nutrition of National Health Commission (NHC), National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
- Correspondence: ; Tel.: +86-10-66237240
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Yadav AK, Parihar M, Mariani I, Giorgino R, Mangiavini L, Ursino N, D'Ambrosi R. High tibial osteotomy with an external fixator or unicompartmental knee arthroplasty for varus knee in young patients? J Orthop 2022; 34:254-259. [PMID: 36148179 PMCID: PMC9486030 DOI: 10.1016/j.jor.2022.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/24/2022] [Accepted: 09/08/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose This study compares the functional results and survivorship of unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO) with an external fixator for medial compartment osteoarthritis (OA) of the knee. Methods Two cohorts of patients aged less than 60 years who had undergone either a cemented medial mobile-bearing UKA or an HTO with an external fixator were included in the study. The first cohort included patients undergoing a series of 197 consecutive medial UKA procedures (UKA group). The second cohort consisted of 60 consecutive patients undergoing HTO with an external fixator (HTO group). Each patient was assessed based on the Oxford Knee Score (OKS), the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Subjective International Knee Documentation Committee (IKDC) score/questionnaire. A clinical evaluation was conducted on the day of the surgery (T0) and at the follow-up visit (T1) (minimum follow-up time was 60 months). Complications and failures resulting from the surgery were recorded for each patient. Results Only the age of the patients at the pre-operative time differed significantly between the two groups, with the HTO group being significantly younger (47.7 ± 8.0 versus 55.8 ± 2.2).After the final follow-up visit, all scores improved in both groups (p < 0.05).IKDC and Oxford scores were higher for the UKA group (p < 0.05). In the HTO group, three complications occurred (5%), including two superficial infections and one deep infection. On the other hand, the UKA group reported four complications (2%): three aseptic mobilisations and one infection requiring revision surgery. There was no difference in the complication rate between the two groups (p = 0.208). Conclusions In young patients (<60 years) with an isolated medial knee OA, both HTO and UKA led to good to excellent clinical results with a low rate of complications at mid-term follow-up; both surgical procedures may be considered in this patient population. Level of evidence Level III.
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Affiliation(s)
- Amit Kumar Yadav
- Sir HN Reliance Foundation Hospital and Research Center, Mumbai, India
| | - Mangal Parihar
- Mangal Ananad Hospital, Swastik Park Chembur East, Mumbai, Maharashtra, India
| | - Ilaria Mariani
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Riccardo Giorgino
- IRCCS Orthopedic Institute Galeazzi, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, 20133, Milan, Italy
| | - Laura Mangiavini
- IRCCS Orthopedic Institute Galeazzi, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, 20133, Milan, Italy
| | | | - Riccardo D'Ambrosi
- IRCCS Orthopedic Institute Galeazzi, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, 20133, Milan, Italy
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