BACKGROUND: Physical activity is pivotal in managing heart failure with reduced ejection fraction, and walking integrated into daily life is an especially suitable form of physical activity. This study aimed to determine whether a 6-month lifestyle walking intervention combining self-monitoring and regular telephone counseling improves functional capacity assessed by the 6-minute walk test (6MWT) in patients with stable heart failure with reduced ejection fraction compared with usual care. METHODS: The WATCHFUL trial (Pedometer-Based Walking Intervention in Patients With Chronic Heart Failure With Reduced Ejection Fraction) was a 6-month multicenter, parallel-group randomized controlled trial recruiting patients with heart failure with reduced ejection fraction from 6 cardiovascular centers in the Czech Republic. Eligible participants were ≥18 years of age, had left ventricular ejection fraction <40%, and had New York Heart Association class II or III symptoms on guidelines-recommended medication. Individuals exceeding 450 meters on the baseline 6MWT were excluded. Patients in the intervention group were equipped with a Garmin vívofit activity tracker and received monthly telephone counseling from research nurses who encouraged them to use behavior change techniques such as self-monitoring, goal-setting, and action planning to increase their daily step count. The patients in the control group continued usual care. The primary outcome was the between-group difference in the distance walked during the 6MWT at 6 months. Secondary outcomes included daily step count and minutes of moderate to vigorous physical activity as measured by the hip-worn Actigraph wGT3X-BT accelerometer, NT-proBNP (N-terminal pro-B-type natriuretic peptide) and high-sensitivity C-reactive protein biomarkers, ejection fraction, anthropometric measures, depression score, self-efficacy, quality of life, and survival risk score. The primary analysis was conducted by intention to treat. RESULTS: Of 218 screened patients, 202 were randomized (mean age, 65 years; 22.8% female; 90.6% New York Heart Association class II; median left ventricular ejection fraction, 32.5%; median 6MWT, 385 meters; average 5071 steps/day; average 10.9 minutes of moderate to vigorous physical activity per day). At 6 months, no between-group differences were detected in the 6MWT (mean 7.4 meters [95% CI, -8.0 to 22.7]; P=0.345, n=186). The intervention group increased their average daily step count by 1420 (95% CI, 749 to 2091) and daily minutes of moderate to vigorous physical activity by 8.2 (95% CI, 3.0 to 13.3) over the control group. No between-group differences were detected for any other secondary outcomes. CONCLUSIONS: Whereas the lifestyle intervention in patients with heart failure with reduced ejection fraction improved daily steps by about 25%, it failed to demonstrate a corresponding improvement in functional capacity. Further research is needed to understand the lack of association between increased physical activity and functional outcomes. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03041610.
- MeSH
- chůze MeSH
- dysfunkce levé srdeční komory * MeSH
- funkce levé komory srdeční MeSH
- kvalita života MeSH
- lidé MeSH
- senioři MeSH
- srdeční selhání * terapie farmakoterapie MeSH
- tepový objem MeSH
- životní styl MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
The rapid evolution of technologies is a key innovation in the organisation and management of physical activities (PA) and sports. The increase in benefits and opportunities related to the adoption of technologies for both the promotion of a healthy lifestyle and the management of chronic diseases is evident. In the field of telehealth, these devices provide personalised recommendations, workout monitoring and injury prevention. The study aimed to provide an overview of the landscape of technology application to PA organised to promote active lifestyles and improve chronic disease management. This review identified specific areas of focus for the selection of articles: the utilisation of mobile APPs and technological devices for enhancing weight loss, improving cardiovascular health, managing diabetes and cancer and preventing osteoporosis and cognitive decline. A multifactorial intervention delivered via mobile APPs, which integrates PA while managing diet or promoting social interaction, is unquestionably more effective than a singular intervention. The main finding related to promoting PA and a healthy lifestyle through app usage is associated with "behaviour change techniques". Even when individuals stop using the APP, they often maintain the structured or suggested lifestyle habits initially provided by the APP. Various concerns regarding the excessive use of APPs need to be addressed.
- MeSH
- behaviorální terapie MeSH
- cvičení psychologie MeSH
- dieta MeSH
- lidé MeSH
- mobilní aplikace * MeSH
- telemedicína * MeSH
- životní styl MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
BACKGROUND: Interventions to improve physical activity (PA) among adolescents continue to be a public health priority. To promote PA more effectively, we need to identify the main factors contributing to (not) engagement in PA in the perspective of adolescents themselves. Thus, we explored the barriers and enablers for sufficient moderate-to-vigorous physical activity (MVPA) in adolescents from their point of view. METHODS: We used qualitative data collected as part of the international Health Behaviour in School-Aged Children study. We obtained data from 14-17 years old adolescents from the first year of Slovak high school. We conducted 11 online, semi-structured individual and group interviews with 24 participants in total (7 boys; mean age = 15.17, SD = 0.87) in Slovakia. We analysed the data using consensual qualitative research and thematic analysis. RESULTS: In the statements of adolescents, four main themes were identified regarding factors contributing to (not) engagement in PA among adolescents. 'Myself as a source' represents the importance of adolescents' own efforts, knowledge, physical predispositions and PA experience. 'How PA can be done' represents school as an opportunity for PA, and PA teachers and sports coaches as specialists who can create an enabling environment for sports. 'Others as a source' represents the social circle that can set a positive sports example and can encourage adolescent's efforts in PA. 'Factors outside' represents other factors that can inspire adolescents, e.g. by giving them a comfortable space and time to exercise, or can be a barrier to PA. CONCLUSION: The potential factors that include adolescents' perspectives can be more leveraged in designing supportive, inclusive, enjoyable, and skills-appropriate PA programmes.
There is increasing knowledge in the recognition of individuals at risk for progression to rheumatoid arthritis (RA) before the clinical manifestation of the disease. This prodromal phase preceding the manifestation of RA may represent a "window of opportunity" for preventive interventions that may transform the clinical approach to this disease. However, limited evidence exists in support of effective interventions to delay the onset or even halt the manifestation of RA. Given the multifactorial nature of RA development and disease progression, the latest guidelines for established RA stress the use of integrative interventions and multidisciplinary care strategies, combining pharmacologic treatment with non-pharmacological approaches. Accordingly, individuals at risk of RA could be offered an integrative, multifactorial intervention approach. Current data point toward pharmacological intervention reverting the subclinical inflammation and delay in the disease onset. In addition, targeting life style modifiable factors (smoking cessation, dental health, physical activity, and diet) may presumably improve RA prognosis in individuals at risk, mainly by changes in epigenetics, autoantibodies, cytokines profiles, and microbiome. Nonetheless, the benefits of multidisciplinary interventions to halt the manifestation of RA in at-risk individuals remain unknown. As there is a growing knowledge of possible pharmacological intervention in the preclinical phase, this narrative review aims to provide a comprehensive overview of non-pharmacological treatments in individuals at risk of RA. Considering the mechanisms preceding the clinical manifestation of RA we explored all aspects that would be worth modifying and that would represent an integrative non-pharmacological care for individuals at risk of RA.
- MeSH
- autoprotilátky MeSH
- lidé MeSH
- prognóza MeSH
- revmatoidní artritida * terapie farmakoterapie MeSH
- zánět MeSH
- životní styl MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
V primární prevenci nádorových onemocnění může hrát významnou roli úprava stravovacích zvyklostí. Ta zahrnuje nejen eliminaci rizikových složek potravy, ale také cílený výběr potravin s vysokým obsahem ochranných látek. Tyto ochranné látky jsou po stránce biochemické různorodé: patří mezi ně fenoly, organosírové sloučeniny, terpeny, polysacharidy atd. Jsou obsaženy například v ovoci, zelenině, luštěninách, jedlých houbách, celozrnných potravinách nebo v některých druzích koření. Mezi nejdiskutovanější patří sulforafan obsažený v brokolici a brokolicových klíčcích. Tato látka je zkoumána rovněž z hlediska možného potlačení kmenových buněk určitých typů nádorů. Na ochraně proti nádorovým onemocněním se podílí střevní mikroflóra a významné místo ve stravě tak má příjem fermentovaných potravin. Za dobře akceptovatelný model stravování v rámci primární prevence nádorových onemocnění je možno považovat tzv. středomořskou dietu.
The modification of eating habits can play an important role in the primary prevention of cancer. This includes not only the elimination of risky food components but also the targeted selection of foods with a high content of protective substances. These protective substances are biochemically diverse: they include phenols, organosulfur compounds, terpenes, polysaccharides, etc. They are contained, for example, in fruits, vegetables, legumes, edible mushrooms, whole grain foods or in some types of spices. Among the most discussed is sulforaphane which is present in broccoli and broccoli sprouts. This substance is also being investigated for its possible suppression of stem cells in certain types of tumors. Intestinal microflora is involved in the protection against cancer, and the consumption of fermented foods plays an important role in the diet. The so-called Mediterranean diet can be considered as a well-accepted diet model in the primary prevention of cancer.
- MeSH
- fyziologie výživy * MeSH
- lidé MeSH
- nádory * prevence a kontrola MeSH
- primární prevence MeSH
- zdravá strava MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Východisko: Životní styl dětí s onkologickým onemocněním může mít významný vliv na jejich dlouhodobé zdravotní výsledky, především z důvodu vzniku možných pozdních následků léčby. Cíle: Hlavním cílem této studie bylo charakterizovat životní styl dětí s onkologickým onemocněním v období remise. Dílčím cílem bylo posoudit rozdíly v oblasti životního stylu mezi dětmi s onkologickým onemocněním v období remise a jejich zdravými vrstevníky a dále posoudit tyto rozdíly při zohlednění faktoru pohlaví zúčastněných dětí. Metody: Výzkumný soubor tvořilo celkem 60 probandů, kteří byli rozděleni na výzkumnou a kontrolní skupinu. Výzkumnou skupinu tvořilo 23 dětí s onkologickým onemocněním v období remise, které absolvovaly aktivní onkologickou léčbu ve Fakultní nemocnici v Brně na Klinice dětské onkologie. Kontrolní skupina byla tvořena jejich 37 zdravými vrstevníky. Pro sběr dat byl použit dotazník zkonstruovaný z otázek zaměřených na životní styl dětí a mládeže, které jsou standardně využívány v mezinárodní studii Health Behaviour of School-Aged Children. Výsledky: Z celkového pohledu se děti s onkologickým onemocněním v období remise nelišily ve sledovaných aspektech životního stylu od svých zdravých vrstevníků. Významné rozdíly mezi sledovanými skupinami byly nalezeny pouze v dílčí analýze u chlapců. Závěr: Výsledky mohou naznačovat potřebu zohledňovat při koncipování intervenčních a vzdělávacích programů v oblasti životního stylu faktor pohlaví dětí s onkologickým onemocněním v období remise.
Background: The lifestyle of children with oncological diseases can exert a profound influence on their long-term health outcomes, primarily due to the potential emergence of late treatment-related effects. Objective: This study aimed to characterize the lifestyle of children with oncological diseases during the remission period, while also assessing differences in lifestyle between children in remission and their healthy peers. Additionally, we sought to evaluate these differences while considering the factor of gender among the participants. Methods: The research sample comprised a total of 60 subjects, divided into a research group and a control group. The research group consisted of 23 children in remission who underwent active oncological treatment at the Department of Pediatric Oncology, University Hospital in Brno. The control group consisted of their 37 healthy peers. Data collection was performed using a questionnaire constructed from standardized items focusing on the lifestyle of children and adolescents, as utilized in the international study, Health Behaviour of School-Aged Children. Result: Overall, children with oncological diseases in remission did not exhibit significant differences in lifestyle compared to their healthy peers. However, a subgroup analysis among boys revealed notable distinctions between the studied groups. Conclusions: These findings suggest the importance of considering gender when designing intervention and educational programs related to the lifestyle of children with oncological diseases in remission.
- Klíčová slova
- sledování obrazovky,
- MeSH
- dítě MeSH
- lidé MeSH
- nádory * MeSH
- pohybová aktivita MeSH
- průzkumy a dotazníky MeSH
- spánek MeSH
- stravovací zvyklosti MeSH
- životní styl * MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- MeSH
- antihypertenziva terapeutické užití MeSH
- fixní kombinace léků MeSH
- hypercholesterolemie farmakoterapie prevence a kontrola MeSH
- hypertenze farmakoterapie prevence a kontrola MeSH
- hypolipidemika terapeutické užití MeSH
- kardiovaskulární nemoci * prevence a kontrola terapie MeSH
- kongresy jako téma MeSH
- lidé MeSH
- randomizované kontrolované studie jako téma MeSH
- rizikové faktory kardiovaskulárních chorob MeSH
- zdravý životní styl MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- novinové články MeSH
- MeSH
- lidé MeSH
- nutriční podpora MeSH
- stravovací zvyklosti MeSH
- střevní mikroflóra * MeSH
- zdravá strava MeSH
- Check Tag
- lidé MeSH
