A concept analysis of vicarious resilience in mental health nursing

Objective:The introduction of the vicarious resilience concept in psychology and mental health nursing literature is a highly promising advancement.By utilizing this novel concept,experts in various domains can enhance their comprehension of how to foster resilience in individuals by observing and learning from the resilience of others.This concept analysis aims to elucidate the concept of vicarious resilience in mental health nursing by defining its related attributes,antecedents,and consequences.Methods:Walker and Avant’s strategy for concept analysis method was used.This review specifically examined mental health nurse providers.A comprehensive literature search was performed in the PubMed,Medline,the Cochrane Library,and CINAHL databases.The inclusion criterion was Englishlanguage documents on vicarious resilience within mental health nursing.Results:A total of 24 articles were included.The concept’s attributes were empathy,hope,resourcefulness,awareness,and spirituality.Antecedents were associated with listening to patients’trauma narratives,self-care,self-awareness,and support from colleagues.Consequences were enhanced well-being,changes in life goals,adaptation,personal growth,and increased personal resilience.Currently,there is only one tool in the empirical reference.Conclusion:Interpreting the concept of vicarious resilience in mental health nursing and determining its characteristics can be utilized to design nursing interventions to develop vicarious resilience and enhance the quality of care in mental health facilities.

A Study on the Impact of Cheerleading on the Psychological Health of Female College Students

This study investigates the effects of technical cheerleading and dance cheerleading on the psychological health of female college students by utilizing the Symptom Checklist-90(SCL-90),the Comprehensive Diagnostic Scale for Interpersonal Relationships,and the Social Adaptability Diagnostic Scale.The findings indicate the following:(1)Technical cheerleading has a highly significant impact on sensitivity in interpersonal relationships,paranoia,and psychoticism,and a significant effect on anxiety and hostility;dance cheerleading has a highly significant effect on paranoia;(2)Both technical and dance cheerleading have minimal impact on the overall score distribution of interpersonal relationships among female college students,but the dimensions of their effects differ;(3)The impact of technical cheerleading on the social adaptability of female college students is more pronounced than that of dance cheerleading.

The Impact of Sports Games on the Psychological Health of Middle School Students

This study conducted a 16-week comparative experiment with 160 students from Jinan No.5 Middle School in Shandong Province as the experimental subjects.During the implementation of the experiment,the subjects were divided into two groups:an experimental group and a control group.The experimental group was subjected to physical exercise interventions using sports game teaching methods during physical education class,while the control group followed traditional physical education teaching methods.The results showed that the psychological health status of the students in the experimental group was significantly better than that of the control group after the experiment.The application of sports games helps to improve the psychological health of middle school students in the course of physical education,promoting a positive and forward direction in student psychology and is an effective means to enhance the psychological health level of middle school students.

Exploration of Problems and Solutions in Psychological Health Education for Preschool Children

The preschool period is a crucial stage for children’s physical and mental development,and the mental health status during this period directly affects children’s personality shaping and lifelong development.In recent years,China’s preschool education has flourished,with a continuous increase in the enrollment rate of children and an increasing emphasis on mental health education.However,there are still many problems in the current mental health education for preschool children,which urgently requires attention from all sectors of society.This article analyzes the main problems in mental health education for preschool children and proposes corresponding solutions,hoping to provide references for related research.

A Social Intervention Approach to Rehabilitate the Health Psychology of Leftbehind Children with Psychological Problems in Healthcare Settings

Background:Left-behind children are more inclined to generate psychological problems relative to non-leftbehind children,thus how to rehabilitate their health psychology and promote the psychological health development of this special disadvantaged group in healthcare settings should be paid more attention to.Objective:This paper attempts to present a social intervention approach and explore its impact on the rehabilitation of rural leftbehind children’s psychological problems in healthcare settings.Methods:This study firstly designed a social intervention program based on the health psychology theory and the generation causes of left-behind children’s psychological problems,and then three groups were applied to test the effectiveness of the program with comparison analysis.Results:Compared with the control left-behind children(group 2),the left-behind children in the experimental group 1 had positive changes in learning anxiety,physical symptoms,anxiety about people,loneliness tendency,self-blame tendency,allergy tendency,terror tendency and impulse tendency.And their mental health can be rehabilitated to the level of non-left-behind children in group 3.Conclusion:This study revealed positive effects of specially designed social intervention program on the rehabilitation of left-behind children’s psychological problems in healthcare settings.The results have both theoretical and practical implications.

Impacts of fighting against COVID-19 on critical care nurses'psychological and physical health:a literature review

Objective:To provide insight into the effects of the coronavirus disease(COVID-19)pandemic on the physical and psychological health of critical care nurses in adult units.Methods:A systematic search through the CINAHL,MEDLINE,and EMbase databases were performed.Studies that addressed“critical care nurses,”“COVID-19,”“physical effect,”and“psychological effect”from different perspectives were reviewed.Results:A total of 42 ar ticles were reviewed based on 2 aspects:critical care nurses'psychological and physical health.Negative emotions were the most common conditions:fear,anxiety,depression,and post-traumatic stress disorder(PTSD).Burnout,falling ill and having thoughts of self-harm,fatigue,physical burden,sleeping disorders,and chronic work overload also adversely affected the nurses'health.The nurses'health deteriorated because of the changes in the unfamiliar working environment and processes,colossal workload and chronic exhaustion,worries about themselves and their families,social response,and witnessing the death toll.Conclusions:Critical care nurses experienced adverse effects of the institutional reaction,social response,and individuals'reply to the COVID-19 pandemic upon their psychological and physical health.Suppor ting services and preparation for other unprecedented situations should be sustainably available.

Investigation of contemporary college students’mental health status and construction of a risk prediction model

BACKGROUND Due to academic pressure,social relations,and the change of adapting to independent life,college students are under high levels of pressure.Therefore,it is very important to study the mental health problems of college students.Developing a predictive model that can detect early warning signals of college students’mental health risks can help support early intervention and improve overall well-being.AIM To investigate college students’present psychological well-being,identify the contributing factors to its decline,and construct a predictive nomogram model.METHODS We analyzed the psychological health status of 40874 university students in selected universities in Hubei Province,China from March 1 to 15,2022,using online questionnaires and random sampling.Factors influencing their mental health were also analyzed using the logistic regression approach,and R4.2.3 software was employed to develop a nomogram model for risk prediction.RESULTS We randomly selected 918 valid data and found that 11.3%of college students had psychological problems.The results of the general data survey showed that the mental health problems of doctoral students were more prominent than those of junior college students,and the mental health of students from rural areas was more likely to be abnormal than that of urban students.In addition,students who had experienced significant life events and divorced parents were more likely to have an abnormal status.The abnormal group exhibited significantly higher Patient Health Questionnaire-9(PHQ-9)and Generalized Anxiety Disorder-7 scores than the healthy group,with these differences being statistically significant(P<0.05).The nomogram prediction model drawn by multivariate analysis includ-ed six predictors:The place of origin,whether they were single children,whether there were significant life events,parents’marital status,regular exercise,intimate friends,and the PHQ-9 score.The training set demonstrated an area under the receiver operating characteristic(ROC)curve(AUC)of 0.972[95%confidence interval(CI):0.947-0.997],a specificity of 0.888 and a sensitivity of 0.972.Similarly,the validation set had a ROC AUC of 0.979(95%CI:0.955-1.000),with a specificity of 0.942 and a sensitivity of 0.939.The H-L deviation test result was χ^(2)=32.476,P=0.000007,suggesting that the model calibration was good.CONCLUSION In this study,nearly 11.3%of contemporary college students had psychological problems,the risk factors include students from rural areas,divorced parents,non-single children,infrequent exercise,and significant life events.

Effect and Significance of Comprehensive Training in Infection Prevention and Control on the Psychological Health of Oral Health Staff

Background:Oral health staff have close contact with patients in the process of diagnosis and treatment,and it is inevitable for them to come into contact with patients’secretions.Therefore,oral health staff are at greater risk of infectious diseases in their daily work,and their psychological health is also greatly challenged.Objective:To study the effect and significance of comprehensive training in infection prevention and control on the psychological health of oral health staff.Methods:We selected 400 oral health staff from a tertiary stomatological hospital in Guangzhou,China in this study.The respondents were randomly divided into an intervention group and a control group.After the first round of investigation,the intervention group received comprehensive training in prevention and control of infection for three months,while the control group received no intervention.Results:The comprehensive training in infection prevention and control improved the respondents’psychological health and job satisfaction.Further strengthening infection prevention and control training for oral health staff will increase their self-confidence,improve their mental health,and increase their job satisfaction.Conclusion:For oral health staff,it is particularly important to formulate an effective and operable preventive and control training program and then implement it in a standardized manner.

Association between Meeting 24-Hour Movement Guidelines and Psychological Features of Chinese Emerging Adults

Background:Emerging adulthood is a pivotal life stage,presenting significant psychological and social changes,such as decreased sociability,depression,and other mental health problems.Previous studies have associated these changes with an unhealthy lifestyle.The 24-h movement guidelines for healthy lifestyles have been developed to promote appropriate health behaviors and improve individual wellness.However,the relationship between adherence to the 24-h movement guidelines and different characteristics of Chinese emerging adults is yet to be explored.This cross-sectional study aimed to investigate the association between adherence to the 24-h movement guidelines and four characteristics(self-exploration,instability,possibilities,and responsibility)of Chinese emerging adults.Methods:Overall,1,510 Chinese emerging adults aged 18–29 years were included in this study.Each participant completed a self-administered questionnaire that included questions on adherence to the 24-h movement guidelines(physical activity,sedentary behavior,and sleep)and the inventory of dimensions of emerging adulthood.Multivariable logistic regression analysis was employed to investigate the associations between adherence to the 24-h movement guidelines and each of the four characteristics.Results:The proportion of participants who adhered to the 24-h movement guidelines was 31.72%.Multiple regression analysis revealed a significantly negative relationship between adhering to more guidelines and instability(β=−0.51,p<0.001).A statistically significant association was observed between instability and meeting only sedentary behavior(β=−1.27,95%confidence interval[CI]:[−2.32,−0.24],p=0.02),sedentary behavior+sleep(β=−1.30,95%CI:[−2.24,−0.35],p<0.01),and physical activity+sedentary behavior(β=−1.08,95%CI:[1.94,−0.21],p=0.02)guidelines.Further,positive and significant associations were observed between possibilities and meeting the guidelines for only physical activity(β=0.70,95%CI:[0.14,1.27),p=0.01),only sleep(β=0.61,95%CI:[0.01,1.21],p=0.04),physical activity+sedentary behavior(β=0.56,95%CI:[0.04,1.07),p=0.01),and physical activity+sleep(β=0.76,95%CI:[0.23,1.27],p=0.01).Conclusions:These findings suggest that adherence to the 24-h movement guidelines was associated with instability in Chinese emerging adults.Future studies are warranted to verify our findings to highlight the importance of maintaining a heath lifestyle to promote health in emerging adulthood.

Evaluation of Effectiveness of Integrated Intervention Program in Improving Drug Addicts' Psychological Health

Objective To investigate the social mental state of drug addicts in a compulsive drug abuse treatment center; evaluate the effectiveness of integrated program for the prevention of abuse relapse and improvement of drug addicts＇ psychological health. Methods The study subjects were addicts from the Wuhan Compulsive Drug Abuse Treatment Center between October 2003 and June 2004, who satisfied the inclusion criteria. A non-randomized control-intervention study design was adopted. Volunteers willing to take part in intervention were put into the intervention group with their full awareness and willingness to prevent drug abuse relapse. The control group was composed of the addicts who were willing to prevent relapse and to be followed up after their discharge. Results The effectiveness of the integrated intervention program in promoting addicts＇ psychological health： before the intervention, the scores of Self-Rating Anxiety Scale （SAS）, the positive and negative dimensionalities of Simple Coping Style Questionnaire （SCSQ） and Chinese Perceived Stress Scales （CPSS） had no significant differences between the intervention group and the control group. After the intervention, except that the SCSQ＇s positive dimensionality in the intervention group was significantly higher than that in the control group, other indices in the intervention group were lower. Before and after the intervention, the psychological health level in both the groups was lower than that in the normal population; there were significant differences between addicts and normal subjects in regards with all of the indices above. Conclusion Drug abuse was associated closely with addicts＇ social mental factors. The integrated intervention program can alleviate anxiety and stress, reduce co-morbid mental disorders and effectively improve their coping style. In conclusion, the program can promote addicts＇ psychological health significantly.

Associations of physical activity, sedentary time, and physical fitness with mental health during pregnancy: The GESTAFIT project

Purpose:This study was aimed to analyze the associations of objectively measured physical activity(PA),sedentary time,and physical fitness with mental health in the early second trimester(16§2 gestational weeks)of pregnancy.Methods:From 229 women initially contacted,124 pregnant women participated in the present cross-sectional study.Data were collected between November 2015 and March 2017.The participants wore Actigraph GT3X+Triaxial accelerometers for 9 consecutive days to objectively measure their PA levels and sedentary time.A performance-based test battery was used to measure physical fitness.Self-report questionnaires assessed psychological ill-being(i.e.,negative affect,anxiety,and depression),and psychological well-being(i.e.,emotional intelligence,resilience,and positive affect).Linear regression analyses were adjusted for age,educational level,accelerometer wear time,miscarriages,and low back pain.Results:Moderate-to-vigorous PA was negatively associated with depression(b=0.222,adjusted R2=0.050,p=0.041).Higher levels of sedentary time were negatively associated with positive affect(b=0.260,adjusted R2=0.085,p=0.017).Greater upper-body flexibility was positively associated with better emotional regulation(b=0.195,adjusted R2=0.030,p=0.047).The remaining associations were not significant(all p>0.05).Conclusion:An active lifestyle characterized by higher levels of moderate-to-vigorous PA and lower levels of sedentary time during pregnancy might modestly improve the mental health of pregnant women.Although previous research has focused on the benefits of cardiorespiratory exercise,the present study shows that only upper-body flexibility is related to emotional regulation in early pregnant women.If the present findings are corroborated in further experimental research,physical exercise programs should focus on enhancing flexibility to promote improvements in emotional regulation during early second-trimester of pregnancy.

Plate vs reverse shoulder arthroplasty for proximal humeral fractures:The psychological health influence the choice of device?

BACKGROUND Proximal humeral fractures represent the third most common observed osteoporotic fracture;the treatment in three and four-part proximal humeral fractures in patients over 65 years is still controversial.Among the treatments described in literature,open reduction and internal fixation(O.R.I.F)and reverse shoulder arthroplasty(RSA)are gaining an increasing popularity.AIM To investigate the correct treatment for three and four-part proximal humeral fractures according to psychological aspects.METHODS It was conducted a prospective study with a series of 63 patients treated with O.R.I.F.(group A)and with RSA(group B)for three and four-part proximal humeral fractures according to Neer classification system.A conservative treatment group,as control,was finally introduced.One independent observer performed clinical and a psychological evaluation at one(T0),six(T1)and twelve months(T2)postoperatively.The Constant’s score and The Disabilities of the Arm,Shoulder and Hand(DASH score)were used for clinical evaluation,while General Anxiety Disorder-7(GAD-7)and Caregiver Strain Scale(CSS)were used for psychological evaluation.RESULTS At one month follow up in group A the mean values were DASH score 50.8,Constant score 36.1,GAD-7 score 5.4,CSS 5.0.For the group B,the average values at T0 were:DASH score 54.6,Constant score 32.0;GAD-7 score 6.4,CSS 6.2.At six months in group A the average values were DASH score 42.1,Constant score 47.3,GAD-7 score 4.3,CSS 3.9.For the group B,the average values at T1 were:DASH score 39.1,Constant score 43.2,GAD-7 score 5.7,CSS 5.5.At twelve months in the group A,the mean values were DASH score 32.8,Constant score 60.0,GAD-7 score 3.2,CSS 3.1.For the group B shown these mean values:DASH score 33.6,Constant score 52.9,GAD-7 score 4.3,CSS 4.5.We demonstrated a better clinical and psychological outcome at T2 in the group treated with osteosynthesis compared to the group treated with arthroplasty(Constant P=0.049,GAD-7 P=0.012 and CSS P=0.005).A better clinical and psychological outcome emerged in control group at T2 comparing with surgical group(DASH score P=0.014,Constant score P<0.001,GAD-7 P=0.002 and CSS P=0.001).CONCLUSION Both open osteosynthesis and reverse shoulder arthroplasty are valid treatments for proximal humeral fractures.According to the best osteosynthesis results the authors suggested to perform a psychological analysis for each patient in order to choose the appropriate treatment.

ANALYSIS OF PSYCHOLOGIC HEALTH STATE AND INFLUENCING FACTORS IN COLLEGE AND SECONDARY SCHOOL STUDENTS IN SHAANXI PROVINCE

Objective The psychologic health level of college and secondaryschool students and the relevant factors were investigated to scientific basis and guidance for school mental health work.Methods Standard 1251 cases were drawn from 1‰ of students in colleges and middle schools of Shaanxi province.Taking 14 psychic health level indexes in SCL 90 as dependent variable and 109 indexes of psychic health back ground as in dependent variable, multi factor analyses have been made.Results 22.6% of students had relatively serious psychological problems.The score of SCL 90 in females was a little bit higher than that in males.The scores of students at both universities and senior middle schools were higher than that in junior middle schools students.The score of SCL 90 of students who came from the countryside was higher than that of city students.The score of the whole students was higher than that of the normal.The students with psychic problems showed obsession,interpersonal sensitivity,depression,anxiety,paranoia and hostility.Factor analysis showed that influencing factors included history of positive individual risking behavior,physical conditions,grade,address,family influences,menses and sexual prombles,bad relation with others,poor self assessment.Conclusion The psychologic health level of the students investigated is lower than that of the whole society.The factors,which hamper psychic health of students, are biological,psychological and social in nature.

Intervention effect of mindfulness-based stress reduction for psychological health among nurses:A meta-analysis

Objective:To systematically evaluate the effects of MBSR on psychological health intervention in nurses.Methods:The randomized controlled trial(RCT)and self-controlled trial(SC)investigating the application of mindfulness-based stress reduction in nursing staff were retrieved from CNKI,WanFang,VIP,PubMed,Cochrane Library,Web of Science,EMBASE databases.The retrieval time was set from the establishment of the database to April 2020.The Review Manager 5.3 software were used for meta-analysis.Result:9 RCTs and 5 self-control trails were included with 1421,712 subjects in the experimental group and 709 subjects in the control group.The results of the meta-analysis showed that compared with the control group,mindfulness-based stress reduction therapy can effectively reduce the psychological symptoms of clinical nurses[SMD=-0.96,95%CI(-1.51,-0.38),P=0.001],reduces nurses'anxiety levels[SMD=-1.28,95%CI(-2.18,-0.38),P=0.005],relieve the nurse's depression[SMD=-1.08,95%CI(-2.15,-0.02),P=0.005],improve the mental resilience of nurse[SMD=7.05,95%CI(3.93,10.17),P=0.03],showing a statistical meaning.Conclusion:The mental health of nurses is often neglected by themselves and there is insufficient awareness that MBSR can improve mental health.There has been a debate about whether MBSR actually improves the mental health of nurses,so it is necessary to further explore this issue and seek better methods and opportunities for practice.

Traditional Chinese medicine for promoting mental health of patients with COVID-19:a scoping review

Objective:This study aimed to systematically review and depict the current studies of traditional Chinese medicine for the mental health of patients with coronavirus disease 2019(COVID-19).Methods:A scoping review was conducted by searching PubMed,Web of Science,CNKI,Wanfang database,VIP database,and SinoMed,with the retrieval time being from the establishment of the database to April 18,2022.The basic information of the included studies,objective,design,types of patients,interventions,outcomes,etc.,was reviewed and summarized narratively.Methodological quality was assessed using the Cochrane Risk of Bias assessment tool,the methodological index for nonrandomized studies or the Newcastle-Ottawa scale.Results:We identified 30 traditional Chinese medicine(TCM)studies from six databases.Among them,finished randomized controlled trials(n=16)accounted for most of the studies,followed by single-arm studies(n=9).In terms of study theme,20 studies defined the mental health of patients with COVID-19 as the research theme.Psychological assessment was included in the inclusion criteria(performed before participation)of nine studies,whereas the other studies only mentioned the mental outcomes.TCM interventions included TCM exercises(Yijinjing,Baduanjin,Liuzijue,Taichi),acupoint stimulation(auricular and body points),moxibustion,decoction,or granules based on TCM syndrome differentiation,decoction,or granules with fixed formulae(Baidu Jieduan granules,Xuanfei Baidu decoction,and Qingfei Paidu decoction),Chinese patent medicine(Jinhua Qinggan granules),TCM psychological therapy(TCM ideological therapy,TCM five-tone therapy,and TCM psychological sand table),and TCM nursing(dialectical care,dialectical diet,and psychological counseling).Anxiety and depression were the main outcomes evaluated in regard to mental health in patients with COVID-19.The limitations of methodological quality were predominantly from follow-up,blinding,and registration.Positive results were reported by 27 studies(90%,n=30).Conclusion:We summarized the existing literature about the impact of TCM on mental health in patients with COVID-19.The number of studies evaluating the impact of TCM on mental health is encouraging,but overall methodological quality was low.Several TCM interventions warrant further evaluation,particularly among populations outside of China,for the purpose of establishing supporting evidence.More importantly,research with stronger methodological quality needs to be developed.

Investigation on Psychological Health and Resilience of Clinical Nursing Students in “Post-Pandemic Era”

The study aims to learn about the psychological health and counseling situation of nursing students in the post-pandemic era through investigation on the psychological health, resilience and counseling demand of nursing students by randomly selecting clinical nursing students interned in a Grade III Level A hospital in Guangzhou from June 2020 to January 2021 as the objects of study. The internship can be divided into three stages: initial (1st - 3rd month), middle (4th - 7th month) and final (8th - 12th month). The investigator educated the nursing students about psychological health in the initial stage to improve their adaptability to clinical practice. Then they were given questionnaires including Symptom Checklist 90 (SCL-90), Connor-Davidson Resilience Scale (CD-RISC) and general questionnaires. And this study further completed difference analysis on psychological health and resilience in gender, educational background, internship stages and non-only/only children. It turned out that all factors scored above the national norm except anxiety in nine symptom clusters and three dimensions of CD-RISC. As for the scores of four factors of somatization, interpersonal relationship, hostility and bigotry and three dimensions of tenacity, optimism and strength in the CD-RISC, the difference was considered to indicate statistical significance (P < 0.001). Among factors affecting the psychological health of clinical nursing students, score differences involving somatization and compulsion (P < 0.001, P < 0.05) under different educational backgrounds showed statistically significant. With regard to different clinical stages, there were significant differences in somatization, compulsion, tenacity and strength (P < 0.001, P < 0.05). Finally, the conclusion is drawn that, during the period of pandemic prevention and control, the overall psychological status of clinical nursing students was good, but there remain part of cases with mild psychological problems that cannot be ignored. In the post-pandemic era, it is necessary to strengthen the awareness of teaching groups of clinical hospitals to psychological counseling for nursing students.

Psychological Health of the Youth Cause for Concern

ON February 23, 2002, astudent named LiuHaiyang from TsinghuaUniversity threw vitriolover the black bears on Bear Hillin Beijing Zoo, causing seriousand extensive burns to one, andcompletely blinding another.

Superficial Inquiry on the Mechanism of Psychological Health Education of College Students under the Background of Anti Epidemic

Psychological health education has been highly valued by the party and the state.During the fight against the COVID-19,colleges and universities have made a beneficial exploration in carrying out psychological health education.In older to further understand the impact of the epidemic on the psychological health of college students,a survey was carried out based on questionnaire survey,depth interview and expert consultation.The survey found that the epidemic increased the psychological pressure and posed new challenges to the psychological health education in colleges and universities.Based on the analysis of the causes from the four aspects of society,family,college and individual,this thesis put forwards some suggestions on how to effectively carry out the psychological health education of college students in the context of fighting against the epidemic.

Assessment of clinical depression metrics in cardiac patients using the patient health Questionnaire-9 before and after phase-II cardiac rehabilitation

Cardiovascular disease remains a leading cause of morbidity and mortality,a fact that is commonly associated with co-morbidities such as clinical depression.While phase II cardiac rehabilitation is an established intervention for those with cardiovascular disease,its effect on patients who also suffer from depression are under studied.Aim:To quantify Pre-and Post-cardiac rehabilitation questionnaire scores collected from a large patient data registry.For this investigation,27670 patients completed Patient Health Questionnaire-9 questionnaires both Pre-and Post-rehabilitation(averaging[28.08.7]phase II sessions).Findings reveal that questionnaire scores decreased by 40%–48%across all groups,a finding that was independent of assigned sex,race,and ethnicity.Moreover,when data were stratified for questionnaire scores that may indicate major and minor depressive disorder,phase II cardiac rehabilitation outcomes were lower by 61%and 49%respectively.While all groups exhibited lower questionnaire scores following cardiac rehabilitation participation,numerical differences at Preand Post-rehabilitation time points indicate that males and White patients have more favorable scores.This latter observation,while not confirmed currently,appears to be linked to referral rates to phase II cardiac rehabilitation,which remain poor for females,racial and ethnic minorities.

Neglected features of lifestyle: Their relevance in nonalcoholic fatty liver disease

AIMTo investigated in non-alcoholic-fatty-liver-disease (NAFLD), with ultrasound (US)-detected fatty liver, and in a group of non-alcoholic and otherwise healthy subjects, relationship of neglected features of lifestyle with NAFLD and obesity. METHODSFive hundred and thirty-two NAFLD and 667 non-NAFLD healthy subjects, age 21-60 years were studied. Severity of liver steatosis was assessed by US bright liver score. The adherence to mediterranean diet score (AMDS) was assessed on the basis of a 1-wk recall computerized questionnaire which included a detailed physical activity reports (Baecke questionnaire). The western dietary profile score, as a simplified paradigm of unhealthy diet, a questionnaire quantifying sun exposure score and a sleep habits questionnaires provided a further comprehensive lifestyle assessment. RESULTSBody mass index (BMI), insulin resistance (HOMA), and triglycerides, poorer adherence to a mediterranean diet profile, sedentary habits, minor sun exposure and use of &ldquo;western diet&rdquo; foods are greater in NAFLD. Multiple linear regression analysis, weighted by years of age, displays BMI, HOMA and AMDS as the most powerful independent predictors of fatty liver severity; however, also the physical activity score, the western diet habit and the sun exposure score are acting inside the model with significant independent effects. CONCLUSIONArticulated clinical intervention, according to our results, are justified in NAFLD and can be pursued addressing by focused intervention nutritional profile, physical exercise mainly in open-air subsets for enhancing sun exposure and healthier sleep duration and rhythm.