Effectiveness of a healthy lifestyle program based on a mobile serious game for childhood cancer survivors: A quasi-randomized trial.

PURPOSE: This study aimed to develop and evaluate the effectiveness of a healthy lifestyle program based on a mobile serious game (HLP-MSG) to enhance the lifestyles of childhood cancer survivors (CCSs). METHODS: This program proceeded in two stages: development and evaluation, using a non-synchronized design with a quasi-randomized trial. The participants were CCSs aged 6-13 years whose treatment was terminated at least 12 months prior. Data were collected at baseline, and post-intervention, with a follow-up after four weeks using the Child Healthy Lifestyle Profile (CHLP). The experimental (n = 26) and control groups (n = 25) were compared. Data were analyzed using descriptive statistics, chi-squared tests, t-tests, and repeated-measures ANOVA. RESULTS: The HLP-MSG promoted a healthy lifestyle by solving 26 quests, including seven sub-elements (nutrition, exercise, hygiene, interpersonal relationships, stress management, meaning of life, and health responsibility). This study revealed significant differences in the interaction between measurement time and group assignment in the CHLP (p = .006) and physical activity (p = .013), one of the seven sub-dimensions. CONCLUSIONS: A healthy lifestyle program based on a mobile serious game is a feasible health education modality to enhance the physical, psychological, social, and spiritual health of CCSs. IMPLICATIONS TO PRACTICE: The findings add to scientific evidence on a mobile serious game for health education among CCSs. The HLP-MSG provides an evolutionary educational modality that can be delivered non-face-to-face to promote CCSs' continuous healthy behavior maintenance. Moreover, the HLP-MSG is adolescent-friendly and can be utilized as a healthcare tool for parents and children to cooperate.

Differences in risk of generalized anxiety disorder according to physical activity type in Korea adolescents: The Korea youth risk behavior web-based survey, 2020-2021.

Objective: This study aimed to analyze the association between the types of physical activity (PA) and the level of generalized anxiety disorder (GAD) in Korean adolescents. Methods: This study analyzed data from the Korea Youth Risk Behavior Web-based Survey (KYRBS) for, 2020-2021. The dependent variable was the level of generalized anxiety disorder-7 (GAD-7). The GAD-7 scores were divided into four levels: normal, mild, moderate, and severe. The independent variables were moderate PA, vigorous PA, and strength exercises. Sex, school grade, body mass index, stress, depression, suicidal thoughts, violent victimization, drinking, smoking, substance abuse, sleep satisfaction, and sedentary time were selected as confounding variables. Results: The independent variable and all confounding variables showed significant differences with the level of GAD-7 (all p < .001). After adjusting for all confounding variables, we observed a 1.062 elevation in mild anxiety disorders, a 1.147 increase in moderate anxiety disorders, and a 1.218 increased incidence of severe anxiety disorders in the absence of vigorous PA. In the absence of strength exercises, there was a 1.057 elevation in mild anxiety disorders, a 1.110 increase in moderate anxiety disorders, and a 1.351 increased incidence of severe anxiety disorders. However, in the case of moderate PA, after adjusting for confounding variables, there was no significant association with GAD-7 levels. Conclusion: To prevent anxiety disorders among Korean adolescents, the type of PA should be considered. Vigorous PA or strength exercises may help prevent GAD in Korean adolescents.

Increased Risk of Generalized Anxiety Disorder According to Frequent Sedentary Times Based on the 16th Korea Youth Risk Behavior Web-Based Survey.

This study aimed to identify the association between sedentary behavior and anxiety disorders in 53,510 Korean adolescents. It analyzed data from the 16th (2020) Korea Youth Risk Behavior Web-based Survey (KYRBS). The dependent variable was the generalized anxiety disorder-7 (GAD-7). The GAD-7 scores were divided into normal, mild, moderate, and severe levels. The independent variables were sedentary time for learning, other sedentary times, total sedentary time, and regular physical activity. The confounding variables were sex, grade, stress, depression, substance abuse, suicidal thoughts, violent victimization, drinking, smoking, sleep satisfaction, and smartphone addiction. A chi-squared test, one-way analysis of variance, and logistic regression analysis were used for analysis. After adjusting for all confounding variables, the risk of severe level in GAD-7 increased by 1.045 times each time the sedentary time for learning based on increased by one hour. In other sedentary time and total sedentary time, the risk of severe level in GAD-7 increased by 1.025 times and 1.045 times per hour, respectively. However, in regular physical activity, after adjusting for the confounding variables, there was no significant association with the GAD-7 levels. Therefore, to prevent generalized anxiety disorders in Korean adolescents, it is necessary to reduce the overall sedentary times including sedentary time for learning.

Activation of AMP-activated protein kinase induce expression of FoxO1, FoxO3a, and myostatin after exercise-induced muscle damage.

AMP-activated protein kinase (AMPK) has been shown to regulate protein metabolism in skeletal muscle. We previously found that levels of Forkhead box proteins, FoxO1 and FoxO3a, and myostatin in rat gastrocnemius increased after exercise-induced muscle damage (EIMD). Eccentric muscle contractions (ECs), defined as elongation of muscle under tension, were used for inducing EIMD. The objective of this study was to clarify whether AMPK participates in activation and expression of FoxO proteins and myostatin in rat gastrocnemius muscle after EIMD. Wistar rats were randomly assigned into the following three groups; CON (n = 6), 180ECs group (ankle angular velocity, 180°/s; n = 6), and 30ECs group (ankle angular velocity, 30°/s; n = 6). 20 ECs were conducted with percutaneous electrical stimulation of gastrocnemius and simultaneous forced dorsiflexion of ankle joint (from 0° to 45°). To evaluate activation of AMPK, we measured the phosphorylated states of AMPK and acetyl CoA carboxylase. For evaluation of the direct relationships of AMPK and other proteins, we also examined contents of FoxOs and myostatin with stimulation of L6 myotube with AMPK agonist, 5 -aminoimidazole -4 -carboxamide -1-ß-d-ribofuranoside (AICAR) (0.1, 0.5, 1, 1.5, and 2 mM). Western blotting was employed for protein analysis. Significant torque deficit was only observed in the 180ECs, suggesting EIMD. We also observed that phosphorylated AMPKα was induced in response to 180ECs (p < 0.01 vs. CON). Additionally, the level of phosphorylated acetyl CoA carboxylase was significantly higher in response to 180ECs and 30ECs. The phosphorylated states of FoxO1, FoxO3a, and myostatin expression were increased significantly in response to 180ECs. Furthermore, treatment of L6 myotubes with AICAR showed similar tendencies to that observed in in vivo gastrocnemius muscle treated with 180ECs. Therefore, we conclude that activation of AMPK plays a key role in increasing the level of FoxO1, FoxO3a, and myostatin in gastrocnemius after EIMD.

Eccentric contractions of gastrocnemius muscle-induced nerve damage in rats.

INTRODUCTION: We examined the effects of gastrocnemius eccentric contractions (ECs) on the sciatic nerve in rats. METHODS: Rats were divided randomly into the following 3 groups: control, 180EC (ECs with 180°/s angular velocity), and 30EC (ECs with 30°/s angular velocity). Twenty ECs were induced by electrical stimulation of the gastrocnemius. On days 3, 7, and 10 after the ECs, nerve conduction velocity (NCV) was measured, and sciatic nerve branches were harvested for analysis. RESULTS: A significant decrease in NCV was observed between the control and day-7 180EC. Significant reduction in the levels of myelin sheath protein zero (p0) between day 7 and day 3 180EC and a significant increase of macrophage-related protein and tyrosine kinase receptor C were observed between day 7 180EC and day 7 30EC. CONCLUSIONS: ECs with fast angular velocities induce functional and structural damage in innervating nerve.

Design of a computerized provider order entry system for ordering of chemotherapy.

With the developments in medical information systems and the widespread establishment of medical information systems that include computerized order communication systems (OCSs), there has been an increase in the establishment of computerized chemotherapy order systems. In this study, we aim to design an improved computerized provider order entry (CPOE) system that integrates a chemotherapy ordering system that can issue a customized order in response to a provider's diverse chemotherapy prescription needs with an automated issuance of dosage, treatment schedule, and treatment method. We expect the newly designed system to be able to prevent the common errors in complex chemotherapy ordering systems and reduce the time required for ordering.