Behavioral weight loss interventions for people with physical disabilities: A systematic review.

AIM: The aim of this study is to examine which interventions lead to clinically significant weight loss among people with physical disabilities. METHODS: We systematically searched three electronic databases (PubMed, Scopus, and CENTRAL) including studies until May 2022 to find randomized controlled trials on behavioral interventions and weight-related outcomes in people with physical disabilities. Pharmacological or surgical interventions were excluded. Study quality was evaluated using the Cochrane Risk of Bias Tool. Interventions were grouped as dietary, physical activity, education/coaching, or multi-component. Mean weight changes, standard deviations, confidence intervals, and effect sizes were extracted or calculated for assessment of the intervention effect. RESULTS: Sixty studies involving 6,511 participants were included in the qualitative synthesis. Most studies (n = 32) included multi-component interventions, incorporating dietary and physical activity components. Limited evidence suggests that extensive dietary interventions or long-term multi-component interventions might lead to a clinically relevant weight reduction of at least 5% for older individuals (age > 50) with mild-to-moderate mobility impairments. DISCUSSION: Due to the high heterogeneity of studies and low study quality, it can be assumed that the range of applicability of the findings is questionable. Further research should examine younger age groups (i.e., children, adolescents, and adults under 40 years) and compare different settings such as schools, clinics, nursing homes, and assisted living facilities.

Designing Well-Being: A Qualitative Investigation of Young Patients' Perspectives on the Material Hospital Environment.

BACKGROUND: Physical surroundings of healthcare facilities are suggested to influence young patients' well-being and hospitalization experiences. PURPOSE: The current research seeks to understand young patients' views and perspectives of the hospital lobby and inpatient rooms. Thus, a qualitative study was carried out in a social pediatric clinic for young patients with disabilities, developmental delays, behavioral problems, and chronic health conditions, that is undergoing reconstruction. METHOD: Operating from a critical realist position, the study employed arts-based methods in conjunction with semi-structured interviews. The data were explored by employing thematic analysis. RESULTS: 37 young people between the age of four and 30 years participated in the study. The analysis illustrates that the built environment should contain comforting and joyful elements, while enabling patients' autonomy. The ideal lobby was depicted as open and accessible and an ideal patient room as practical and adapted to personal needs. CONCLUSION: It is suggested that disabling and medicalized spatial arrangements and features may restrict young people's sense of control and autonomy, while possibly posing a barrier to a health-promoting environment. Large and open spaces with comforting and distracting features are cherished by patients and may be embedded in a comprehensive, yet simple overall design and structural concept.

Does socioeconomic position and gender affect human-nature interactions?

Aim: The growing number of mental health problems worldwide is alarming. Encouraging human-nature interactions (HNIs) could help to tackle this issue. For this reason, the aim of the present research was to investigate certain components that promote HNI in two groups of students with different socioeconomic positions (SEPs) in Mexico. HNIs describe the direct relationship between humans and nature. HNIs are composed of elements such as connectedness to nature (CN) and commitment to the environment (CE), and are beneficial to both physical and mental health. However, the impact of CN and CE on people's lives seems to depend on their SEP, which has been investigated mainly in developed countries where SEP is less salient compared with developing countries. Methods: A survey was sent to students from two universities representing each group. A total of 210 surveys was collected. Results: The results showed no differences in CN (p = .480) and CE (p = .421) regarding SEP. However, gender differences were found with females from a low SEP showing higher levels of CN than men (p = .015) from the same SEP. For high SEP, no differences were found. In addition, men showed a higher CE than women, regardless of their SEP. Conclusion: Given the high vulnerability of women to mental health problems, it is of major importance to conduct more research considering the relationship between gender, HNI, SEP, and health in developing countries.