Effectiveness of a 12-week school-based educational preventive programme on weight and fasting blood glucose in “at-risk” adolescents of type 2 diabetes mellitus: Randomized controlled trial

A systematic review and meta-analysis of the child-level effects of family-based interventions for the prevention of type 2 diabetes mellitus

AIMS

The purpose of this systematic review and meta-analysis was to investigate the effects of family-based health promotion interventions on child-level risk factors for type 2 diabetes in vulnerable families.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist for systematic reviews formed the methodological framework. CINAHL, Embase, MEDLINE, PsycINFO, and Web of Science were searched on January 12, 2024. The NTP-OHAT Risk of Bias Assessment Tool was used to assess the risk of bias in the individual studies, and meta-analyses were performed.

RESULTS

The 4723 studies were identified, and 55 studies met the inclusion criteria. Results showed significant effects on children's body mass index (mean difference [MD], -0.18, 95% CI [-0.33 to -0.03], p = 0.02), body fat percentage (MD, -2.00, 95% CI [-3.31 to -0.69], p = 0.003), daily activity (standardized mean difference [SMD], 0.23, 95% CI [0.01; 0.44], p = 0.04), physical activity self-efficacy (SMD, 0.73, 95% CI [0.36 to 1.10], p < 0.01), intake of snacks (MD, -0.10, 95% CI [-0.17 to -0.04], p = 0.002), and sugar-sweetened beverages (SMD, -0.21, 95% CI [-0.42 to -0.01], p = 0.04). Subgroup analyses suggested that interventions aiming to change child and parent behavior simultaneously have larger effect on fasting glucose and nutrition consumption, and that interventions longer than 26 weeks have larger effects on body composition and physical activity behavior than shorter interventions.

Effect of a family-based lifestyle intervention on weight reduction among Jordanian children with obesity aged 6-9 years

This study aimed to evaluate the effect of a family-based lifestyle intervention on reducing body weight among Jordanian children with obesity aged 6-9 years old. The pretest-posttest control group design was conducted among 162 children (75 in the intervention group and 87 in the control group) with obesity aged 6-9 years old at four primary schools in Jordan during the period from March 2021 to July 2021. The results found that, after the intervention, there was a statistically significant change in the F scores in the control group vs. in the intervention group (M = 37.07, SD = 2.77; M = 33.48, SD = 2.73; t (160) = 8.29, P < 0.001), where the mean BMI percentile was reduced by 2.05 in the intervention group. A significant difference was demonstrated in the median BMI percentile in the intervention and control groups post-intervention (P < 0.001). A significant difference was also noticed between the average weekly reported dietary habits and the physical activities of both the control group and the intervention group post-intervention. The findings support the effect of family-based lifestyle interventions. Healthcare providers should adopt such interventions for children living with obesity. Future study is required to evaluate the long-term effectiveness of this intervention on weight reduction.

Prevalence and Triggering Factors of Headache among Jordanian Adolescents in Al-Mafraq Region

Aims

This study evaluates the epidemiology of headache and migraine among adolescents aged 12 to 15.

Methods

A school-based cross-sectional study was conducted to collect and analyze data from students in grades 7-10 over the course of one month, using a simple random sampling method. The overall number of participants in this study was 692, with an average age of 13.9 years (SD = 1.3). Descriptive measures and Fisher's exact test were computed. Multivariate regression was calculated to assess the predictors of headache and migraine. Findings. Approximately one-half of the students reported having headaches: tension-type headaches (10.3%), migraines (4.8%), and other headache types (31.5%). Moreover, girl students in the age group of 14-15 reported more headaches and migraines.

Conclusion

The prevalence of headache and migraine in Jordan is high and increasing as students grow older. Health education programs led by school nurses and other healthcare practitioners are urgently needed.

Ameliorative effect of selenium yeast in combination with pioglitazone on diabetes outcomes in streptozotocin-induced

Anti-diabetic therapies possess many side effects; thus, searching for alternative strategies with low cost, minimal side effects, and high therapeutic value is very important. The present study aimed to explore the combined use of selenium yeast (SY) and standard anti-diabetic drug pioglitazone (PGZ) for diabetes mellitus (DM) treatment in streptozotocin (STZ)-induced DM. STZ was injected daily intraperitoneally with a low dose (40 mg/kg) into Sprague-Dawley rats to induce DM. The synergistic effect of the SY (0.2 mg/kg) and PGZ (0.65 mg/kg) on DM complications was evaluated after 88 weeks of treatment. The impact of our medication on glucose levels, insulin sensitivity, lipid abnormalities, oxidative mediators, and inflammatory markers was assessed by biochemical techniques. STZ-induced diabetes has toxic effects, including toxic hepatic tissues, lipid disturbances, massive oxidative damage, and hyperinflammation. Experimental rats either treated with monotherapy alone or combined therapy resulted in a significant anti-diabetic effect. The PGZ+ SY combination has the best effect, as illustrated by significant (P < 0.05) decreases in fasting blood glucose, (FBG) insulin, HbA1c, and HOMA-IR levels. This combination attenuated (P < 0.05) lipid disturbances and their associated elevated atherogenicity biomarkers. At the same time, treatments with PGZ+ SY exhibited an anti-inflammatory effect as they ameliorated the increase in inflammatory parameters (CRP, TNF-α, IL-6). Also, it restored the total antioxidant capacity and peroxisome proliferator-activated receptor (PPARƔ) levels that were decreased by STZ-DM induction. In conclusion, this study finds PGZ+ SY as a promising DM therapeutic alternative. This synergistic combination alleviates most DM-related complications and insulin resistance.

Lifestyle interventions for type 2 diabetes prevention in children and adolescents of African descent in OECD countries: a systematic review protocol

OBJECTIVES

The objectives of this review are to investigate the effectiveness of lifestyle interventions for type 2 diabetes prevention in children and adolescents of African descent in the Organisation for Economic Co-operation and Development (OECD) member countries and to attempt to ascertain what aspects of these interventions are most effective in this population.

INTRODUCTION

Lifestyle interventions have been shown to prevent or delay the onset of type 2 diabetes;however, the extent to which these interventions are effective for children and adolescents of African descent is not well established. The increasing type 2 diabetes incidence and prevalence in children and adolescents of African descent in some OECD member countries underscores the need to pool available evidence to ascertain the effectiveness of lifestyle interventions for type 2 diabetes prevention in this population.

INCLUSION CRITERIA

Lifestyle interventions to be considered include individual-or group-based lifestyle or behavioral modification interventions aimed at preventing or delaying the onset of type 2 diabetes in children and adolescents of African descent aged 19 years and under in OECD countries. Randomized controlled trials and non-randomized studies that assess the effectiveness of lifestyle interventions for type 2 diabetes prevention will be considered.

METHODS

The databases to be searched include MEDLINE, Embase, CINAHL, PsycINFO, Social Services Abstracts, Cochrane Central Register of Controlled Trials, and ProQuest Dissertations and Theses Global databases. There will be no language or date limits placed on the search. Two independent reviewers will conduct the title, abstract, and full-text screening, followed by critical appraisal and data extraction. Data will undergo meta-analysis where appropriate, and will otherwise be presented as narrative synthesis.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42021247267.

Spatiotemporal trends in diabetes-related mortality by school district in the state of Michigan

OBJECTIVES

This study examined the spatiotemporal epidemiological status of diabetes-related death in relation to school district boundaries in the state of Michigan, United States.

METHODS

A retrospective observational study was conducted using death records spanning the years 2007–2014 in Michigan, with school districts as the geographic unit of analysis. Geocoding was performed for each death record. Cluster analysis used spatial autocorrelation with local Moran’s I, and spatiotemporal analysis used the Space Time Pattern Mining tool in ArcGIS Pro 2.1.

RESULTS

The study revealed spatial clusters of high-high locations of diabetes-related mortality rate by school district in Michigan from 2007 to 2014. Spatiotemporal analysis showed grids with intensifying, consecutive, sporadic, and persistent hotspots of diabetes-related death in the Lansing, Royal Oak, Flint City, Berkley, Detroit City, East Lansing, South Lake, and Holt public school districts. These school districts should be prioritized for school-based diabetes prevention programs

CONCLUSIONS

The study demonstrated the presence of various hotspots of diabetes-related deaths within the state of Michigan across the 8-year period of analysis. Understanding spatial and temporal hotspots could further improve our ability to evaluate diabetes burden across both time and space.

Nurse-led interventions in the prevention and treatment of overweight and obesity in infants, children and adolescents: A scoping review

BACKGROUND AND OBJECTIVE

Nurses are well-placed in primary care, school and community settings to identify and manage paediatric overweight and obesity. This scoping review examined what types of nurse-led interventions have been undertaken for the prevention, treatment and management of obesity and overweight in infants, children and adolescents.

DESIGN

Scoping review.

DATA SOURCES

CINAHL, Cochrane Library, Embase, MEDLINE, ProQuest Central, ProQuest Dissertations & Theses Global, and Scopus. Searches were undertaken from inception to 2019.

METHODS

Database searches and handsearching were used to identify academic and grey literature, such as scientific reports and university theses and dissertations, on nurse-led interventions undertaken in school, primary health care and community settings. Studies focused on addressing overweight and obesity in children and adolescents, for studies published from 1999 onwards. Studies included focused on experimental and quasi-experimental research that implemented interventions, and described new practice or change in practice.

RESULTS

117 references encompassing 83 studies or programs were selected for inclusion. 16 trials were analysed descriptively, and 67 trials were analysed descriptively and quantitatively. The analysis structured intervention settings and outcomes using the socioecological model, encompassing intrapersonal, interpersonal, community, organisation and policy factors. Studies included were clinically heterogeneous for intervention setting and multicomponent strategies. Education for nutrition, physical activity and behaviour change was the most common strategy used, and nutrition and physical activity knowledge most consistently improved after intervention. Nursing roles focused on education; counselling and behaviour change in primary care; advocacy in school and community environments; and implementing policy in child care settings. Fifty-four studies received financial or resource funding and support to implement the study. On sustainability, seven programs and two research studies were ongoing at time of writing.

CONCLUSIONS

While the clinical heterogeneity of studies makes synthesis of outcomes complex, it demonstrates the breadth of nursing interventions to address paediatric overweight and obesity. Incentives that encourage routine health promotion, upskilling of nurses, and embedding food and nutrition education into the school curricula, are suitable strategies that support nurse-led interventions against paediatric obesity.

REGISTRATION NUMBER

Not applicable. Tweetable abstract: Scoping r/v - what interventions are led by nurses to address paediatric obesity? 83 studies investigate nurses' work in school, primary health, community care.

Assent and consent in adolescent research: teachers' perspectives from a developing country

Teachers play a vital role in facilitating research in schools. However, teachers' views of informed consent/assent for children participation in research in the Middle East have not been investigated. In this study, focus group interviews were conducted to understand high-school teachers' perspectives toward adolescent assents and consents. The teachers indicated that parent consent is important and should be coupled with sufficient information about the research study. The teachers added that assent is most important for children above 13 years old. Conversely, the teachers believed that parent approval is only important for invasive (such as research involves blood withdrawal) but not simple procedures. Most importantly, for procedures that are considered simple, part of the teachers do not acknowledge the significance of parental approval, such as body weight, or beneficial, such as new treatment. The results indicate that some of the teachers' views were consistent with proper conduction of pediatric research. However, other views were worrisome and might warrant further studies and actions. Risks related need to be assessed and policies needs to be developed in order to ensure the proper conduction of pediatric research.