The Mirror and Obesity
Mirror exposure can positively alter behaviour in obese patients and can be used as an intervention in clinical practice to assist in weight loss and improve health outcomes.
Summary
A Systematic Review On The Effects Of Mirror Exposure On Behaviour and Obese Individuals
[Posted 23/Aug/2022]
AUDIENCE: Nursing
KEY FINDINGS: Mirror exposure can influence behaviour modification in obese patients. Therefore, the use of mirrors should be considered as an adjunct therapy in this group of patients.
BACKGROUND: Purpose of this study was to review the literature regarding the effects of mirror exposure on behaviour and obese patients. The review explored how mirror exposure influences behaviour in obese patients in terms of activity level, psychology and eating habits.
DETAILS: Obesity is a major epidemic that affects people worldwide but is more predominant in the Western world. Many health issues are directly linked to obesity, and current therapies have failed to provide a sustainable resolution to this problem. Mirror exposure has been used in eating disorders such as anorexia nervosa, bulimia and binge eating; however, there exists a gap in the use of mirrors in obese patients. The literature review focuses on the effects of mirror exposure on behaviour and obese patients. Literature that explicitly discussed mirror exposure in obese patients was included; five research articles were reviewed.
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Source: Omondi, H., and Freysteinson, W. (2022). The Mirror and Obesity: A Systematic Review On The Effects Of Mirror Exposure On Behaviour And Obese Individuals. J Clin Nurs. 2022; 31(17-18): 2365-2366. Published: September, 2022. DOI: 0.1111/jocn.16107.
Factors Affecting Hospital Readmission Rates Following An Acute Coronary Syndrome
Strategies that integrate comprehensive discharge planning and individualised care planning to enhance behavioural support are related to a reduction in readmission rates.
KEY FINDINGS: Strategies that integrate comprehensive discharge planning and individualised care planning to enhance behavioural support are related to a reduction in readmission rates. It is recommended that nurses are supported to influence discharge planning and lead the development of nurse-led interventions to ensure discharge planning is both coordinated and person-centred.
BACKGROUND: Objective of this study is to synthesise quantitative evidence on factors that impact hospital readmission rates following ACS with comorbidities.
DETAILS: The search strategy included keywords and MeSH terms to identify English language studies published between 2001 and 2020. The quality of included studies was assessed by two independent reviewers, using Joanna Briggs Institute (JBI) critical appraisal tools. Twenty-four articles were included in the review. All cause 30-day readmission rate was most frequently reported and ranged from 4.2% to 81%. Reported factors that were associated with readmission varied across studies from socio-demographic, behavioural factors, comorbidity factors and cardiac factors. Findings from some of the studies were limited by data source, study designs and small sample size.
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Source: Rashidi, A., Whitehead, L., and Glass, G. (2022). Factors Affecting Hospital Readmission Rates Following An Acute Coronary Syndrome: A Systematic Review. Journal of Clinical Nursing. 2022; Published: July, 2022. DOI: 10.1111/jocn.16122.
Exploring Dyadic Management Of Nutrition Care Throughout And Beyond Head and Neck Cancer Treatment
It is important that healthcare professionals understand information and support needs and preferences within patient - carer dyads prior to HNC treatment commencing and adapt care and interventions based on their changing needs throughout and beyond the treatment period.
KEY FINDINGS: This study highlights the importance of healthcare professionals recognising the patient and carer dyad as a team to enhance engagement in nutrition care and to ensure that their physical and psychological support needs across the cancer continuum are met.
BACKGROUND: Aim of this study is to identify how patients and carers collaborate to manage nutrition care throughout and beyond head and neck cancer (HNC) treatment as a step towards identifying changes to service delivery that are inclusive of the needs of the patient–carer dyad. Research in the field of dyadic interventions in cancer care is emerging, and there has been little work exploring patient–carer dyad needs in the provision of nutrition care in HNC.
DETAILS: Narrative interviews were completed with 13 patients and 15 carers over a 12-month period (prior to treatment commencing, and 2 weeks, 3 months and 12 months post-treatment completion). Deductive analysis of interview transcripts was performed using directed content analysis guided by the Theory of Dyadic Illness Management (TDIM). COREQ guidelines were used. Seven themes across four TDIM constructs were identified: (1) understanding and adapting to physical challenges impacting nutrition intake, (2) adjusting to emotional impact of changes to eating and drinking, (3) providing practical support, (4) intrapersonal characteristics, (5) interpersonal characteristics, (6) healthcare culture and (7) managing carer burnout.
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Source: Hiatt, J., Young, A., Brown, T., et al. (2022). Exploring Dyadic Management Of Nutrition Care Throughout And Beyond Head And Neck Cancer Treatment. Journal of Clinical Nursing. Published: July, 2022. DOI: 10.1111/jocn.16096.
Diverging Temporal Trends in Stroke Incidence in Younger vs Older People
The consistently divergent temporal trend in stroke incidence at younger vs older ages highlights the urgent need to better understand etiology and prevention of stroke t younger ages.
Summary
A Systematic Review and Meta-analysis
[Posted 16/Aug/2022]
AUDIENCE: Neurology, Pediatric, Internal Medicine
KEY FINDINGS: Temporal trends in stroke incidence are diverging by age in high-income countries, with less favorable trends at younger vs older ages, highlighting the urgent need to better understand etiology and prevention of stroke at younger ages.
BACKGROUND: Overall stroke incidence is falling in high-income countries, but data on time trends in incidence of young stroke (ie, stroke in individuals younger than 55 years) are conflicting. An age-specific divergence in incidence, with less favorable trends at younger vs older ages, might be a more consistent underlying finding across studies. Purpose of this study was to compare temporal trends in incidence of stroke at younger vs older ages in high-income countries.
DETAILS: For all retrieved studies, 2 authors independently reviewed the full text against the inclusion criteria to establish their eligibility. Meta-analysis was performed with the inverse variance-weighted random-effects model. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline was followed. The main outcome was age-specific divergence (55 vs >=55 years) in temporal trends in stroke incidence (relative temporal rate ratio [RTTR]) in studies extending to at least 2000. RTTRs were calculated for each study and pooled by random-effects meta-analysis, with stratification by administrative vs prospective population-based methodology, sex, stroke subtype (ischemic vs intracerebral hemorrhage vs subarachnoid hemorrhage) and geographical region. Among 50 studies in 20 countries, 26 (13 prospective population-based and 13 administrative studies) reported data allowing calculation of the RTTR for stroke incidence at younger vs older ages across 2 or more periods, the latest extending beyond 2000. Reported trends in absolute incidence of young individuals with stroke were heterogeneous, but all studies showed a less favorable trend in incidence at younger vs older ages (pooled RTTR = 1.57 [95% CI, 1.42-1.74]). The overall RTTR was consistent by stroke subtype (ischemic, 1.62 [95% CI, 1.44-1.83]; intracerebral hemorrhage, 1.32 [95% CI, 0.91-1.92]; subarachnoid hemorrhage, 1.54 [95% CI, 1.00-2.35]); and by sex (men, 1.46 [95% CI, 1.34-1.60]; women, 1.41 [95% CI, 1.28-1.55]) but was greater in studies reporting trends solely after 2000 (1.51 [95% CI, 1.30-1.70]) vs solely before (1.18 [95% CI, 1.12-1.24]) and was highest in population-based studies in which the most recent reported period of ascertainment started after 2010 (1.87 [95% CI, 1.55-2.27]).
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Source: Scott, C. A., Li, L., Rothwell, P. M. (2022). Diverging Temporal Trends in Stroke Incidence in Younger vs Older People: A Systematic Review and Meta-analysis. JAMA Neurology. Published: August 9, 2022. DOI: 10.1001/jamaneurol.2022.1520.
Effects of Low-to-Moderate Physical Activities On Older Adults With Chronic Diseases
Low-to-moderate levels of regular physical activity could be encouraged among community-dwelling older adults to improve their physical health.
KEY FINDINGS: Regular physical activity ranging from low-to-moderate intensity should be encouraged among older adults with chronic diseases.
BACKGROUND: Examined the evidence of low-to-moderate-intensity physical activities to assess the effect in managing hypertension, diabetes mellitus and hyperlipidaemia conditions among community-dwelling older adult. Physical activity is recommended for the maintenance and improvement of health. However, high-intensity physical activity may adversely impact exercise adherence by older adults.
DETAILS: This review was conducted with reference to methods set out in the Cochrane Handbook for Systematic Reviews of Interventions. The PRISMA statement was employed to guide the reporting of the systematic review and meta-analyses. This review included randomised controlled trials and cluster-randomised controlled trials on interventions of physical activities with low-to-moderate intensities compared against usual care without physical activities. Two reviewers independently extracted data and assessed the risk of bias using the Cochrane Risk of Bias Tool. Meta-analysis was performed using RevMan, with Cochran Q and I2 used for determining heterogeneity. The overall effect was reviewed with z scores. Results Fifteen randomised controlled trials with 940 total participants were evaluated. Low-to-moderate-intensity physical activity significantly improved systolic blood pressure [Z = 3.59, p = .0003], HbA1C [Z = 2.10, p = .04] and high-density lipoprotein (HDL) levels [Z = 3.83, p = .0001], compared to usual care. A further subgroup analysis found no significant difference in systolic blood pressure level after three sessions a week as well as after three months. There were insufficient papers to evaluate for both HbA1C and HDL levels.
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Source: Tan, K. H. L. and Siah, C. J. R. (2022). Effects of Low-to-Moderate Physical Activities On Older Adults With Chronic Diseases: A Systematic Review And Meta-Analysis. Journal of Clinical Nursing. 2022; 31(15-16):2072-2086. Published: August, 2022. DOI: 10.1111/jocn.16087.
Effectiveness of Horticultural Therapy On Physical Functioning and Psychological Health Outcomes For Older Adults
As a safe and promising nonpharmacological intervention, healthcare professionals may consider the HT intervention when caring for older adults with cancer, dementia and frailty.
KEY FINDINGS: Horticultural therapy has potentially positive effects on the physical functioning and psychological health of older adults. However, more rigorous randomised controlled trials with larger populations are required to confirm the findings.
BACKGROUND: Purpose of this study is to systematically determine the effectiveness of horticultural therapy (HT) on the physical functioning and psychological health of older people. With advancing age and increased chronic diseases, older adults are vulnerable to physical deterioration and psychological problems. There is evidence that horticultural therapy (HT) has positive effect among older adults. However, less attention has been devoted to systematically evaluating the physical functioning and psychological health effects of HT in older adults. Systematic review and meta-analysis were conducted based on the checklist for PRISMA.
DETAILS: The searches were conducted in PubMed, EMBASE, CINAHL, PsycINFO, Cochrane, China Network Knowledge Infrastructure, Wan Fang, and China Science and Technology Journal Database, from their inception until June 2021. Randomised controlled trials published in either English or Chinese were reviewed. The Review Manager 5.4 software was used for meta-analyses. The quality of included studies was evaluated using the Cochrane risk of bias tool by two independent researchers. Ten studies involving 884 participants were included. Compared with the control group, HT can significantly improve upper body flexibility and aerobic endurance in older adults with cancer. Besides, HT was found to be more effective for promoting emotional functioning and well-being, subjective social functioning, and quality of life among the elderly. The attendance rate for HT was 66%–100%, and no negative events were found.
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Source: Lin, Y., Lin, R., Liu, W., et al. (2022). Effectiveness of Horticultural Therapy On Physical Functioning and Psychological Health Outcomes For Older Adults: A Systematic Review and Meta-Analysis. J Clin Nurs. 2022; 31(15-16): 2087-2099. Published: August, 2022. DOI: 10.1111/jocn.16095.
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