The prevalence and its associated factors of psychological stress among middle school students in China: pooled evidence from a systematic scoping review.

Psychological issues are of significant concern in present-day society, as poor mental well-being results in depression and suicidal behavior. Understanding the current situation of psychological stress among secondary school students will help policy makers to formulate targeted measures to help them cope with stress, and at the same time evaluate the effectiveness of the existing policies to address the shortcomings and enhance the diversification of interventions. The main purpose of this review was to map the existing evidence on the prevalence and levels of psychological stress among adolescents in China, and to identify the associated risk factors. This review strictly adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive search was performed spanning Web of Science, PubMed, and Scopus databases. Studies involving only humans and full text in English were selected. Selection was limited to samples from mainland China, Hong Kong, Macau, and Taiwan. Variables were extracted, exploring the factors that affected the mental wellness of Chinese middle school students. A final 15 articles and 1 report were included. The findings revealed psychological stress is prevalent among Chinese middle school population, with the degree of prevalence from low to severe stress levels. Three dimensions of psychological stress affecting Chinese secondary school students: school, family and lifestyle. Within the school, the factors included academic stress, peer relationships etc. Family-related factors were comprised of parent-child relationship, parents' mental health status etc. Lastly, lifestyle-related factors included poor diet, sedentary and inactivity etc. Our findings suggest that policy makers should reduce the excessive emphasis on examination results and focus on the all-round development of students, and that schools should organize a variety of extra-curricular activities to reduce students' stress. Parents should create a harmonious family atmosphere to minimize conflicts and maintain close communication with teachers. Systematic Review Registration: OSF; https://doi.org/10.17605/OSF.IO/HEFCP.

Prevalence of depression and clinical depressive symptoms in community-dwelling older adults with cognitive frailty.

AIM: The present study determines the prevalence of depression and the extent of clinical depression symptoms among community-dwelling older adults with cognitive frailty and its associated factors. METHODS: A total of 755 older adults aged ≥60 years were recruited. Their cognitive performance was determined using the Clinical Dementia Rating. Fried's criteria was applied to identify physical frailty, and the Beck Depression Inventory assessed their mental states. RESULTS: A total of 39.2% (n = 304) of the participants were classified as cognitive frail. In this cognitive frail subpopulation, 8.6% (n = 26) had clinical depressive symptoms, which were mostly somatic such as disturbance in sleep pattern, work difficulty, fatigue, and lack of appetite. Older adults with cognitive frailty also showed significantly higher depression levels as compared with the noncognitive frail participants (t (622.06) = -3.38; P = 0.001). There are significant associations between depression among older adults with cognitive frailty and multimorbidity (P = 0.009), polypharmacy (P = 0.009), vision problems (P = 0.046), and hearing problems (P = 0.047). The likelihood of older adults with cognitive frailty who experience impairments to their vision and hearing, polypharmacy, and multimorbidity to be depressed also increased by 2, 3, 5, and 7-fold. CONCLUSIONS: The majority of the Malaysian community-dwelling older adults were in a good mental state. However, older adults with cognitive frailty are more susceptible to depression due to impairments to their hearing and vision, multimorbidity, and polypharmacy. As common clinical depressive symptoms among older adults with cognitive frailty are mostly somatic, it is crucial for health professionals to recognize these and not to disregard them as only physical illness. Geriatr Gerontol Int 2024; 24: 225-233.

Association between maximal oxygen consumption and physical performance tests among older adults with cognitive frailty.

INTRODUCTION: Cardiorespiratory fitness has an inverse relationship with cognitive impairment and frailty in older adults. Direct assessment of maximal oxygen consumption (VO2 max) is the gold standard to assess cardiorespiratory fitness. However, it is costly and requires a laboratory setting. Therefore, VO2 max estimation among older adults with cognitive frailty (CF) will allow the assessment of aerobic capacity, which is commonly overlooked due to the complexity of the test. AIM: This study aims to determine the use of one of three physical performance tests (2-minute step, 2-minute walk, and 1-minute sit to stand) to effectively estimate cardiorespiratory fitness among older adults with CF. METHODS: In this cross-sectional study, community-dwelling individuals aged 60 years old and above in Klang Valley were screened for CF. The participants performed three physical performance tests (2-minute walk, 2-minute step, and 1-minute sit to stand) followed by treadmill-based maximal exercise testing on another day. RESULTS: A total of 32 older adults with cognitive frailty (mean age; SD: 67.1;4.7 years) participated in this study. Nearly half of them had hypertension (43.5 %), hypercholesterolemia (43.5 %), and multimorbidity (47.8 %). Among the endurance tests performed, only the 2-minute walk test independently predicted VO2 max by sex-specific with men (R2 = 0.58, p = 0.03) and women (R2 = 0.34, p = 0.01). The 2-minute walk test had good agreement with VO2 max (ICC = 0.77, 95 % CI: -3.1-2.4). CONCLUSION: The 2-minute walk test is a valid tool for estimating cardiorespiratory fitness among older adults with CF. However, it should be further tested across a larger population.

Corrigendum: Effects of aerobic exercise and dietary flavonoids on cognition: a systematic review and meta-analysis.

[This corrects the article DOI: 10.3389/fphys.2023.1216948.].

Effects of aerobic exercise and dietary flavonoids on cognition: a systematic review and meta-analysis.

Introduction: Studies have shown that exercise increases angiogenesis and perfusion in the hippocampus, activates neurogenesis in the dentate gyrus and increases synaptic plasticity, as well as increases the complexity and number of dendritic spines, all of which promote memory function and protect against cognitive decline. Flavonoids are gaining attention as antioxidants in health promotion due to their rich phenolic content, particularly for their modulating role in the treatment of neurodegenerative diseases. Despite this, there has been no comprehensive review of cognitive improvement supplemented with flavonoid and prescribed with exercise or a combination of the two interventions has been conducted. The purpose of this review is to determine whether a combined intervention produces better results when given together than when given separately. Methods: Relevant articles assessing the effect of physical exercise, flavonoid or in combination on cognitive related biomarkers and neurobehavioral assessments within the timeline of January 2011 until June 2023 were searched using three databases; PubMed, PROQUEST and SCOPUS. Results: A total of 705 articles were retrieved and screened, resulting in 108 studies which are in line with the objective of the current study were included in the analysis. Discussion: The selected studies have shown significant desired effect on the chosen biomarkers and neurobehavioral assessments. Systematic Review Registration: identifier: [CRD42021271001].

A framework for design and usability testing of telerehabilitation system for adults with chronic diseases: A panoramic scoping review.

Objective: This scoping review aimed to identify the design and usability testing of a telerehabilitation (TR) system, and its characteristics and functionalities that are best-suited for rehabilitating adults with chronic diseases. Methods: Searches were conducted in PubMed, EBSCO, Web of Science, and Cochrane library for studies published between January 2017 and December 2022. We followed the Joanna Briggs Institute guidelines and the framework by Arksey and O'Malley. Screening was undertaken by two reviewers, and data extraction was undertaken by the first author. Then, the data were further reviewed and discussed thoroughly with the team members. Results: A total of 31 results were identified, with the core criteria of developing and testing a telerehabilitation system, including a mobile app for cardiovascular diseases, cancer, diabetes, and chronic respiratory disorders. All developed systems resulted from multidisciplinary teams and employed mixed-methods research. We proposed the "input-process-output" framework that identified phases of both system design and usability testing. Through system design, we reported the use of user-centered design, iterative design, users' needs and characteristics, theory underpinning development, and the expert panel in 64%, 75%, 86%, 82%, and 71% of the studies, respectively. We recorded the application of moderated usability testing, unmoderated testing (1), and unmoderated testing (2) in 74%, 63%, and 15% of the studies, respectively. The identified design and testing activities produced a matured system, a high-fidelity prototype, and a released system in 81.5%, 15%, and 3.5%, respectively. Conclusion: This review provides a framework for TR system design and testing for a wide range of chronic diseases that require prolonged management through remote monitoring using a mobile app. The identified "input-process-output" framework highlights the inputs, design, development, and improvement as components of the system design. It also identifies the "moderated-unmoderated" model for conducting usability testing. This review illustrates characteristics and functionalities of the TR systems and healthcare professional roles.

Associations between biopsychosocial factors and transportation patterns of older adults residing in Klang Valley, Malaysia.

Introduction: Aging is associated with physiological changes in multiple systems in the body and may impact the transportation choices of older adults. In this study, we examine the associations between biopsychosocial factors and the transportation choices of Malaysian older adults. Methods: One hundred and nineteen (119) older adults, aged 60 and above, living in Klang Valley, Malaysia were recruited for this cross-sectional study. Participants were interviewed face-to-face to obtain sociodemographic data, health status (whether there were and, if yes, the number of comorbidities), outdoor mobility and transportation patterns, Instrumental Activity Daily Living (IADL) status and cognitive function. Participants' physical performance (dominant handgrip strength, 10-m walk, and timed up and go tests), hearing threshold (pure tone audiometry), and vision function (visual acuity, contrast sensitivity) were measured. Transportation patterns of older adults were categorized into three groups, that is, flexible (using public transport and/or private vehicles), using only private vehicles and restricted (relying on others or walking). Results: Further information is needed to enable such older adults as older women, those with comorbidities and poorer functional status to access transportation, especially to meet their health care needs. Discussion: The majority (51%) of participants were in the 'using only private vehicles' group, followed by the 'flexibles' (25%) and the 'restricted' (24%). Factors significantly associated with the restricted transportation group were: (a) being female (AdjOR 15.39, 95% CI 0.86-23.39, p < 0.001); (b) being Malay (AdjOR 21.72, 95% CI 0.36-16.12, p < 0.001); (c) having higher number of comorbidities (AdjOR 14.01, 95% CI 0.20-13.21, p = 0.007); and (d) being dependent in IADL (AdjOR 13.48, 95% CI 0.51-1.78, p = 0.002).

Changes in cardiovascular-health blood biomarkers in response to exercise intervention among older adults with cognitive frailty: A scoping review.

Introduction: Cardiovascular health contributes significantly to the incidence of cognitive impairment. Prior to conducting exercise-related intervention, it is crucial to explore cardiovascular health blood parameters that have been commonly used as guidance for the purpose of monitoring. Information on the effectiveness of exercise on cardiovascular-related biomarkers is lacking, especially among older adults with cognitive frailty. Therefore, we aimed to review existing evidence on cardiovascular-related blood parameters and their changes following exercise intervention among older adults with cognitive frailty. Methods: A systematic search was conducted on PubMed, Cochrane, and Scopus databases. Related studies involving only human and full text in either English or Malay language were selected. Types of impairment were limited to cognitive impairment, frailty, and cognitive frailty. Studies were restricted to randomized controlled trial and clinical trial design studies. For charting purposes, all variables were extracted and tabulated. Trends in types of parameters studied were explored. Results: A total of 607 articles were screened, and the final 16 were included in this review. Four cardiovascular-related blood parameter categories were extracted: inflammatory, glucose homeostasis, lipid profile, and hemostatic biomarkers. The common parameters monitored were IGF-1 and HbA1c, glucose, and insulin sensitivity in some studies. Out of the nine studies on inflammatory biomarkers, exercise interventions showed a reduction in pro-inflammatory markers, namely, IL-6, TNF-α, IL-15, leptin, and C-reactive protein and an increase in anti-inflammatory markers, namely, IFN-γ and IL-10. Similarly, in all eight studies, glucose homeostasis-related biomarkers had improved with exercise intervention. The lipid profile was tested in five studies, with four studies showing improvements with exercise intervention via a decrease in total cholesterol, triglycerides, and low-density lipoprotein and an increase in high-density lipoprotein. A decrease in pro-inflammatory biomarkers and an increase in anti-inflammatory biomarkers were demonstrated with multicomponent exercise, including aerobic exercise in six studies and aerobic exercise on its own in the remaining two studies. Meanwhile, four out of six studies that yielded improvements in glucose homeostasis biomarkers involved only aerobic exercise and the remaining two studies involved multicomponent with aerobic exercise. Conclusion: The most consistent blood parameters studied were glucose homeostasis and inflammatory biomarkers. These parameters have been shown to improve with multicomponent exercise programs, particularly with the inclusion of aerobic exercise.

Breathing exercise for hypertensive patients: A scoping review.

Background: Non-pharmacological management of hypertension includes weight loss, alcohol and sodium restriction, regular exercise, and relaxation. In people with overweight hypertension, systolic blood pressure (SBP) and diastolic blood pressure (DBP) can be decreased via exercise and weight loss together. Breathing exercises are one method of relaxing. Objectives: The aim of this scoping review is to map the information that is currently available about the advantages of breathing exercises in decreasing blood pressure in hypertension patients. Methods: This scoping review adheres to Arksey and O'Malley's framework, which entails identifying review questions, seeking pertinent evidence, choosing pertinent studies, mapping data, and discussing, concluding, and reporting the findings. The PRISMA flowchart is used to show how the evidence search process works. Results: As a result, 339 articles in total were retrieved from the three databases. 20 papers total were included in this review after screening. In 14 of the 20 investigations, participants with stage 1 and stage 2 essential hypertension, two with pre-hypertension, and four with Isolated Systolic Hypertension (ISH) were studied. The respondents' ages ranged from 18 to 75. The systolic blood pressure declined by 4-54.22 mmHg, while the diastolic blood pressure dropped by 3-17 mmHg. Conclusion: Slow breathing can be used as an alternate, non-pharmacological therapy for hypertension individuals to reduce blood pressure. Systematic Review Registration: (https://osf.io/ta9u6/).

Strategies to Reduce the Rate of Plate Waste in Hospitalized Patients: A Scoping Review.

There is evidence that hospital waste is indisputably high, and various strategies have been used to reduce the hospital's rate of plate waste. This study aimed to map the currently implemented strategies in lowering the rate of plate waste in hospitals and categorize the different types of strategies used as interventions, as well as determine their impact based on specific parameters. The scoping review method included a search of three databases using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-SCR). The duplicate articles (n = 80) were removed. A total of 441 articles remained for the title and abstract screening. After 400 were excluded, 41 articles were reviewed for eligibility. Thirty-two full articles were eliminated due to a lack of focus on plate waste evaluation. Finally, nine accepted studies were grouped into five categories: menu modification, room service implementation, menu presentation, meal-serving system, and dietary monitoring tool. In conclusion, results showed that the majority of the studies implemented either of the five strategies to reduce plate waste; however, the cook-freeze system and staff training for both kitchen and ward staff were not yet part of any intervention strategy. The potential of this method should be explored in future interventions.

Incidence and Predictors of Physical Inactivity Among Malaysian Community-Dwelling Older Persons.

The aim of this study was to determine the incidence of physical inactivity and identify the predictors for low physical activity among community-dwelling older persons living in Malaysia in 3 years follow-up. In this prospective study, physical activity levels were measured using the Physical Activity Scale for the Elderly. The arbitrary cutoff for Physical Activity Scale for the Elderly in this study was ≤70.9 for low and >141 for high physical activity levels. Out of the 955 physically active participants at baseline, 555 of them (mean [SD] age 68.82 [4.92] years) were successfully followed up to 3 years. Cumulative incidence of being physically inactive was 21% with rate of 7 per 100 person-years. It was found that being older (<.001), from Malay ethnic group (<.05), smokers (<.01), having lower gait speed (<.001), and lower cognitive status (<.05) were predictors for physical inactivity among Malaysian community-dwelling older persons in 3 years follow-up. These factors should be taken into consideration when planning for intervention and promotion strategies to increase physical activity levels among Malaysian older persons.

Mediating role of cognitive status on performance in the two-minute step test and its normative data among Malaysian community-dwelling older persons.

INTRODUCTION: The two-minute step test (2MST) has been used to estimate cardiorespiratory fitness and optimum scores are needed for performing activities of daily living with ease among older persons. However, there is limited information on the mediating role of cognitive impairment on 2MST performance and the 2MST normative data. Hence, we aim to identify the mediating role of cognitive status on performance in the 2MST among community-dwelling older adults and to establish the normative values of the 2MST. METHODS: Participants aged 60 years and above were recruited through multistage random sampling from four states in Malaysia. The participants performed the 2MST using standard protocols. Mean comparison was done using an independent sample t-test or one-way analysis of variance. The 2MST normative values were then outlined descriptively. RESULTS: Older age groups (60-69 years: 65.4 ± 21.9 times; 70-79 years: 61.7 ± 22.9 times; ≥80 years: 51.6 ± 24.5 times) had significantly lower levels of 2MST performance (p < 0.001). Women (56.6 ± 20.9 times) and participants with mild cognitive impairment (MCI) (58.7 ± 21.7 times) also had significantly lower levels of 2MST performance (p < 0.001) compared with men (69.1 ± 20.7 times) and participants with normal cognition (63.7 ± 21.6 times). Cognitive status had a significant mediation effect for age and sex on 2MST performance (p < 0.001). Therefore, the 2MST normative values were stratified according to cognitive status, sex, and age groups. CONCLUSION: Validation of these findings in a larger number of older populations with MCI may provide directions for cardiorespiratory fitness training to be emphasised among older persons with MCI. Geriatr Gerontol Int 2022; 22: 950-955.

The Impact of Listening to, Reciting, or Memorizing the Quran on Physical and Mental Health of Muslims: Evidence From Systematic Review.

Objectives: Listening to or memorizing the Quran has been suggested to affect the psychosocial health and well-being of Muslims. Muslims who memorized Quran have a higher quality of life (QoL) and lower anxiety and stress. Hence, this systematic review was conducted to evaluate the studies that assessed the effect of listening to, reciting, or memorizing the Quran on physical and mental health. Methods: This review was performed on articles published from the inception and April 2021. Databases including ProQuest, PubMed and Web of Science were searched on 19 April 2021. Keywords such as "Quran", "al- Quran," "al- Kareem," "Holy Quran," "memori," "Tahfiz," "Huffaz," "listening" and "reciting" were used for databases searching. The risk of bias was assessed using Cochrane risk of bias tool and Joanna Briggs Institute (JBI). Only 20 articles were included in data synthesis out of a total of 230. Results: The findings revealed that listening to, reciting or memorizing the Quran had a favorable effect on depression, anxiety, physiologic parameters, quality of life, quality of sleep and intelligence quotient. Conclusion: The current evidence suggests that, listening to, reciting or memorizing the Quran may be useful as an intervention to improve physical and mental health.

Description of a Hybrid Mindfulness-Integrated Multidisciplinary Workplace Weight Management Intervention Module 'Mind-SLIMSHAPE' Using the TIDieR Checklist.

Published reports of workplace-based weight management interventions are often poorly described and are focused on dietary, physical, and behavioral management. These strategies are often unsustainable and only have short-term effectiveness. The Mind-SLIMSHAPETM is a mindfulness-integrated multidisciplinary intervention developed to address overweight and obesity problems among desk-bound employees while improving weight-related behavior through mindfulness meditation and mindful eating exercises. The integration of mindfulness and mindful eating aims to improve the individual's focus on the present and heighten their sensitivity towards internal and external eating cues. The aim of this article is to describe the Mind-SLIMSHAPETM intervention program using The Template for Intervention Description and Replication (TIDieR) checklist. The Mind-SLIMSHAPETM module is a 24-week intervention program that was delivered in a quasi-experimental study among employees with BMI ≥ 25.0 kg/m² in a selected higher learning institution. The module was delivered via hybrid sessions that included both face-to-face and virtual online sessions. The novelty of our description includes summaries of each intervention component with its intensity, details of the theory grounded for this program, and the rationale for the intervention components. The Mind-SLIMSHAPETM module is ready to be implemented and replicated in a similar setting with possible refinement and enhancement of the mindfulness and mindful eating elements.

Development and Validation of Huffaz ProHealth 1.0©: A Module to Improve the Well-Being of Tahfiz Students in Selangor, Malaysia.

The increase in the number of Tahfiz schools in Malaysia indicates a high demand from the community for Tahfiz education. Tahfiz schools provide a Quran memorization syllabus as the main part of the curriculum at the primary and secondary levels. There is no holistic module that combines learning and health for Tahfiz students in Malaysia. Huffaz ProHealth 1.0© Module is a health intervention module developed explicitly for Tahfiz students by a group of researchers from Universiti Kebangsaan Malaysia Kuala Lumpur (UKMKL). The module encompasses educational and motivational components for the Tahfiz students, and acts as a guide for their teachers and staff to improve the students' health and quality of life. The module consists of three components: physical health, nutritional and psychological well-being. Each component is divided into several units with specific activities. The Sidek Module Development Model (SDMM) was used as a reference model. The study involved two phases: the development (Phase I) and evaluation (Phase II). In Phase I, a needs assessment was conducted among students and teachers from Tahfiz schools to evaluate their knowledge, attitude, and practice on the related topics. Meanwhile, the module's validity and feasibility were assessed by healthcare experts and Tahfiz teachers in Phase II. The item-content validity index (I-CVI), content validity value, Tool to Evaluate Materials used in Patient Education (TEMPtEd) score, and expert feedback were evaluated. In conclusion, the Huffaz ProHealth 1.0© module was successfully developed and evaluated. Strong validity values were observed in all components, indicating high suitability to be employed at Tahfiz schools.

Enablers and Barriers of Accessing Health Care Services among Older Adults in South-East Asia: A Scoping Review.

South-East Asia (SEA) is the home of the largest number of the world's older population. In this scoping review, we aimed to map the existing enablers and barriers of accessing healthcare services among older adults in SEA countries. Articles that were published from January 2001 until November 2021 were searched in four data sources (PubMed, Web of Science, EBSCO Host and The Cochrane Library). Studies pertaining to the factors which assist or obstruct older Southeast Asian adults from assessing healthcare services were chosen for this scoping review. First, two reviewers screened the titles and abstracts of articles in the data sources. After identifying appropriate articles, the reviewers read them. Data extracted by one reviewer were verified by the other reviewer. The findings were then classified according to Penchansky and Thomas's five domains of access. A total of 19 studies were included in the final scoping review. Accessibility and acceptability were the two factors most often identified as enablers or barriers to older adults from accessing healthcare. Other often mentioned factors were finances, transportation and social/family support. Older adults living in rural areas were especially impacted by these factors. To promote healthy ageing, optimum healthcare and wellbeing among older adults in Southeast Asia, it is extremely important to consider accessibility and acceptability when planning healthcare services.

The Challenges and Strategies towards Healthy Eating during COVID-19 Home Confinement Period among Working Adults with BMI ≥ 25 kg/m2 Enrolled in a Weight Loss Program: Qualitative Findings.

The COVID-19 pandemic has been affecting our lifestyles, such as work, living, and health. In Malaysia, the Restriction of Movement Order (RMO) was first announced in March 2020 to curb the spread of the virus. Since then, many Malaysians have been confined to their own home. This new lifestyle can cause a change of eating habits where healthy eating may be a challenge. Hence, our qualitative study explored the challenges and strategies for healthy eating during the first wave of the COVID-19 home confinement period among working adults overweight and obese in Malaysia. Eleven participants were individually interviewed through phone calls. The interviews were audio-recorded, transcribed verbatim, and then coded with NVIVO 12 based on thematic analysis. We found that social pressure, changes in the social setting, more free time to access food, and extra stock of unhealthy foods at home were among the challenges to healthy eating. Some participants countered these perceived challenges by reducing unhealthy food stock, limiting kitchen visits, and utilizing self-monitoring apps to monitor their calorie intake. Social media was not consistently perceived to influence their eating behavior during this period. We conclude that COVID-19 home confinement has created challenges to healthy eating habits among overweight and obese adults with overweight and obesity. Our study provides evidence that vulnerable groups such as overweight and obese individuals require specific nutritional support during pandemic-related confinement to enhance eating self-efficacy.

Can Acute Exercise Lower Cardiovascular Stress Reactivity? Findings from a Scoping Review.

Exaggerated cardiovascular reactivity to and delayed recovery from stress increase the risk of cardiovascular diseases in the future. While exercise training has been shown to attenuate stress-induced cardiovascular reactivity and enhance recovery from stress, the effects with acute exercise are less characterized. The aim of this scoping review was to explore the range and characteristics of published evidence regarding acute exercise on cardiovascular reactivity and stress recovery. The secondary objective was to highlight research gaps and implications for future research. A total of 36 articles met the review inclusion/exclusion criteria, involving 1200 participants from various age groups, fitness and health status. Blood pressure (BP) reactivity was the most measured outcome, followed by heart rate (HR) reactivity, and to some extent, heart rate variability. Overall, acute exercise particularly of the moderate-intensity aerobic type effectively reduced stress-induced BP reactivity in the general population. The effects on HR reactivity and cardiovascular recovery were inconclusive. Further research would be recommended to establish if other forms of exercise intensity or type are equally beneficial to lower exaggerated cardiovascular responses to stress. Despite methodological differences and limitations, the available evidence supports the therapeutic potential of acute exercise in addressing the ill effects of stress on cardiovascular health.

Development and Evaluation of Integrated Chrono-Nutrition Weight Reduction Program among Overweight/Obese with Morning and Evening Chronotypes.

This paper describes the development of an integrated chrono-nutrition weight reduction program and the evaluation of the attendance, retention, satisfaction and compliance towards the chrono-nutrition components among morning and evening chronotypes for overweight/obese non-shift workers. The present study was conducted in two phases: Phase I was composed of needs assessments on the chronotypes' dietary patterns and chrono-nutrition through a scoping review and integrating the chrono-nutrition components (temporal eating pattern, meal timing and sleeping habits) alongside the existing weight reduction module, SLIMSHAPE™. Phase II consisted of a feasibility study to evaluate the integrated chrono-nutrition weight reduction program (SLIMSHAPE™ Chrono). A total of 91 overweight/obese non-shift workers participated in the 12-week weight reduction program (Age: 39.6 ± 6.3 years; 74.7% women; BMI: 31.2 ± 4.5 kg/m2). Low attrition rate was recorded, with 85 participants (93.4%) completing the pre- and post-intervention assessments. Overall, morning and evening chronotypes had increased their % energy intake in the early eating window (MT: 64.8 vs. 67.2%, ET: 62.7 vs. 65.6%, Mean difference (MD): 2.8, 95%CI: 0.3, 5.1, p = 0.028) and reduced their intake in the late eating window (MT: 35.2 vs. 32.8%, ET: 37.3 vs. 34.4%, MD: −2.8, 95%CI: −5.1, −0.3, p = 0.028) and earlier midpoint of eating (MT: 14:02 vs. 13:49; ET: 14:27 vs. 14:18, 95%CI: −0.4, −0.02, p = 0.029) and had a reduced night eating syndrome score (MT: 10.0 vs. 8.9; ET: 10.7 vs. 8.9, MD: −1.5, 95%CI: −2.5, −0.5, p = 0.004). There was no significant change in the first (MT: 08:12 vs. 08:04, ET: 08:24 vs. 08:22, MD: −0.1, 95%CI: −0.2, 0.03, p = 0.170) and last mealtime (MT: 19:52 vs. 19:33, ET: 20:29 vs. 20:14, MD: −0.3, 95%CI: −0.6, −0.04, p = 0.081), eating duration (MT: 11.7 vs. 11.5 h, ET: 12.1 vs. 11.9 h, MD: −0.2, 95%CI: −0.6, 0.2, p = 0.251) and the elapse time between sleep onset and last meal (MT: 3.1 vs. 3.5 h, ET: 3.5 vs. 3.2 h, MD: 0.1, 95%CI: −0.3, 0.4, p = 0.678). In terms of sleep, evening chronotypes increased their sleep duration (MD: 0.8 h, 95% CI: 0.4, 1.2, p < 0.001) and reduced social jetlag (MD: 19 min, 95% CI: 1.7, 36.3, p = 0.031) post-intervention compared to morning chronotypes. The integrated chrono-nutrition weight reduction program among morning and evening chronotypes improved the temporal pattern of energy intake, meal timing, night eating syndrome and sleep habits post-intervention. The chrono-nutrition practice could be a potentially modifiable behavior as an adjunct strategy in weight management.

A Scoping Review for Usage of Telerehabilitation among Older Adults with Mild Cognitive Impairment or Cognitive Frailty.

Older adults are vulnerable towards cognitive frailty that can lead to adverse health outcomes and telerehabilitation appears to be a potential platform to reverse cognitive frailty among older adults. The aim of this coping review is to identify the usage of telerehabilitation and its common platform of delivery among older adults with mild cognitive impairment (MCI) or cognitive frailty (CF). Articles published from January 2015 until October 2020 were selected. Out of the 1738 articles retrieved, six studies were identified. Two articles were randomized controlled trials, one was a pilot study and three were qualitative studies. The outcome suggests that telerehabilitation may improve the quality of life among participants as well as it can be a useful and supportive digital platform for health care. Some types of technologies commonly used were smartphones or telephones with internet, television-based assistive integrated technology, mobile application and videoconference. Telerehabilitation utilization in managing cognitive frailty among older adults is still limited and more research is required to evaluate its feasibility and acceptability. Although telerehabilitation appears to be implemented among older adults with MCI and CF, some social support is still required to improve the adherence and effectiveness of telerehabilitation. Future research should focus on the evaluation of acceptance and participants' existing knowledge towards telerehabilitation to achieve its target.