Effects of portable pedal machines at work on lipoprotein subfraction profile in sedentary workers - the REMOVE study.

BACKGROUND: Sedentary behaviour at work is a major cause of atherosclerosis, particularly in tertiary workers. However, no studies have ever assessed the effect of active workstation on lipoprotein subfraction profile. This study aimed to evaluate the effect of 12-week portable pedal machines (PPMs) on lipoprotein subfraction profile among healthy sedentary workers. METHODS: Healthy administrative workers were randomized into an intervention group using PPMs for 12 weeks or a control group using normal-desk. Lipoprotein subfractions were assessed using Lipoprint® electrophoresis. Main outcomes were explored using mixed models with sensitivity analyses (four models). RESULTS: We included 40 participants (43.7 ± 8.6 years old, 100% women, BMI 23.8 ± 3.4 kg/m2; sedentary time at work 7.7 ± 1.8 h/day). Groups did not differ at baseline in any outcomes. 32 participants finished the trial. Changes in lipoprotein subfractions were especially marked for LDL profile. There was an interaction time x group for all parameters related to LDL and their subfractions: total LDL-cholesterol (p = 0.012), LDL particle size (p = 0.027), large LDL subfractions 1 and 2 (p = 0.001), and small dense LDL subfractions 3 to 7 (p = 0.046), using the crude model. The interaction reflects difference in the direction of changes between groups. The LDL particle size significantly increased in the intervention group (from 271.9 ± 2.5 at t0 to 272.8 ± 1.9 Ångström at t1, p = 0.037) while it did not change in the control group (272.5 ± 1.7 at t0 to 271.8 ± 1.5Å at t1, p = 0.52). All interactions were constantly significant whatever the models. Influencing variables were mainly stress at work that was associated with an increase in total LDL-cholesterol (coefficient 3.15, 95CI 0.20 to 6.11 mg/dl, p = 0.038), and BMI that was associated with Large-LDL, Large-HDL, IDL-C and triglycerides. CONCLUSIONS: Lipoprotein profile was improved after a 12-week PPMs intervention at work in healthy administrative workers. Changes were mainly showed for LDL and LDL subfractions. Lipoprotein profile was worsened by stress at work, BMI and age. TRIAL REGISTRATION: NCT04153214.

Social perceptions and the stigmatization towards fifteen mental illnesses in France: a preliminary study on the role of vital force and burden.

Introduction: This study examined social perceptions and rejection towards fifteen mental illnesses, as well as a preliminary test of the SUBAR model, that hypothesized perceptions of both vital forces and burden would be negatively and positively related to social rejection, respectively. Methods: Using an online survey with participants from France (n = 952), social rejection was assessed using a feeling thermometer and a social distance scale, while social perceptions were measured using visual analog scales. Results: A stigma map for these different disorders is drawn up, revealing the social perceptions and levels of stigmatization specific to certain mental illnesses. Controlling for relevant social perceptions (i.e., danger, warmth, competence), we found that perception of burden was positively and significantly associated to social distance and negative feeling for 73% and 67% of mental illnesses, respectively. The perception of vital force was negatively and significantly related to social distance and negative feeling for 87% and 20% of mental illnesses, respectively. The change in R2 between model 1 (i.e. perception of danger, warmth, competence) and model 2 (i.e. model 1 + perceptions of vital force and burden) significantly improved in 100% of cases for social distance and 67% of cases for negative feeling. Conclusion: These preliminary data provide support for the SUBAR model and call for further investigations to better understand the social rejection of people with mental illnesses.

Impact of 24 h shifts on urinary catecholamine in emergency physicians: a cross-over randomized trial.

24-h shift (24 hS) exposed emergency physicians to a higher stress level than 14-h night shift (14 hS), with an impact spreading on several days. Catecholamines are supposed to be chronic stress biomarker. However, no study has used catecholamines to assess short-term residual stress or measured them over multiple shifts. A shift-randomized trial was conducted to study urinary catecholamines levels of 17 emergency physicians during a control day (clerical work on return from leave) and two working day (14 hS and 24 hS). The Wilcoxon matched-pairs test was utilized to compare the mean catecholamine levels. Additionally, a multivariable generalized estimating equations model was employed to further analyze the independent relationships between key factors such as shifts (compared to control day), perceived stress, and age with catecholamine levels. Dopamine levels were lower during 24 hS than 14 hS and the control day. Norepinephrine levels increased two-fold during both night shifts. Epinephrine levels were higher during the day period of both shifts than on the control day. Despite having a rest day, the dopamine levels did not return to their normal values by the end of the third day after the 24 hS. The generalized estimating equations model confirmed relationships of catecholamines with workload and fatigue. To conclude, urinary catecholamine biomarkers are a convenient and non-invasive strong measure of stress during night shifts, both acutely and over time. Dopamine levels are the strongest biomarker with a prolonged alteration of its circadian rhythm. Due to the relation between increased catecholamine levels and both adverse psychological effects and cardiovascular disease, we suggest that emergency physicians restrict their exposure to 24 hS to mitigate these risks.

Acute Hemodynamic, Metabolic, and Hormonal Responses to a Boxing Exergame with and without Blood Flow Restriction in Non-Athlete Young Individuals.

BACKGROUND: This study aimed to compare acute hemodynamic, metabolic (glucose and blood lactate concentrations), hormonal (growth hormone and normetanephrine), heart rate variability (HRV), and rating of perceived exertion (RPE) responses before and after bouts of a boxing exergame with and without blood flow restriction (BFR) in non-athlete young individuals. METHODS: Fourteen participants (age: 30 ± 10 y; BMI: 21 ± 3 kg.m-2) participated in two sessions of a 20 min boxing exergame. During week one, the participants were randomly divided into two groups and played against one another under normal (n = 7) and BFR (n = 7) conditions. Over the next exercise session, participants were then reallocated to the opposite condition (normal vs. BFR) for data collection. Hemodynamic, metabolic, HRV, and hormonal parameters were measured before and immediately after the exercise protocols. RESULTS: Playing exergame led to a significant increase in hemodynamic variables (except for diastolic blood pressure) regardless of BFR condition with no between-group differences. Regarding HRV, significant reductions in total power (TP) and low-frequency (LF) waves were identified in the non-BFR group (p < 0.0001) compared with the BFR group. Conversely, a significant increase in very LF (VLF) waves was noted for the BFR group (p = 0.050), compared with the non-BFR group. Significant increases were observed in serum concentrations of growth hormone, normetanephrine, and blood lactate concentration from pre- to post-exercise under both conditions (p ≤ 0.05), with no significant differences between the groups. Moreover, no statistically significant changes were observed in glucose levels. RPE responses were significantly greater (p ≤ 0.05) in the BFR group compared with the non-BFR group throughout the exercise session. CONCLUSIONS: We observed similar hemodynamic, hormonal, and metabolic responses after an acute boxing exergame session in young individuals, whether conducted with or without BFR. However, notable differences were observed in certain HRV markers and RPE. Specifically, the inclusion of BFR resulted in an elevation of VLF and a heightened perceived exertion. These findings suggest that BFR may alter cardiac autonomic and perceptual responses during exergaming. Further research is warranted to understand the long-term implications and potential benefits of incorporating BFR into exergaming routines.

Comparison of self-management and spa therapy for upper-extremity musculoskeletal disorders: A randomized controlled trial.

BACKGROUND: Musculoskeletal disorders (MSDs) are common in the workplace and are a public health issue. Persistent pain despite conservative treatment or surgery may lead to poor long-term outcomes. OBJECTIVE: To compare the effect of a combined 6-day program of exercise, self-management workshops and spa therapy with self-management on functional capacity in personal and professional daily life at 3 months in people with musculoskeletal disorders. METHODS: We conducted a prospective, randomized controlled trial. Participants were employed (any type of work) and aged between 18 and 65 years, with latent or symptomatic upper extremity MSDs, with or without a history of sick leave. They were randomized to participate in 6 days (2 h per day) of spa therapy, exercise, and self-management workshops immediately (intervention) or at 3 months (control). The control group performed self-management until 3 months. The primary outcome was the score on the self-reported Quick Disability of Arm-Shoulder-Hand (QuickDASH) at 3 months. The primary analysis was conducted using analysis of covariance with baseline QuickDASH score as the covariate. RESULTS: In total, 150 participants were randomized (85 % women): 78 to the control group and 72 to the intervention group. At 3 months, the QuickDASH total and work scores did not differ between groups (effect-size [ES] = -0.15, 95 %CI, -0.38 to 0.09, p = 0.215, and ES = -0.11, 95 % CI, -0.35 to 0.12, p = 0.343). However, QuickDASH sport/performing arts score was significantly different between randomization groups at 3 months (ES =-0.25, 95 % CI, -0.48 to -0.02, p = 0.035). CONCLUSIONS: This study provided no evidence in favor of a short-course, personalized self-management, intensive spa therapy intervention over self-management alone for the management of upper-extremity MSDs. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02702466) retrospectively registered.

Stress and job satisfaction over time, the influence of the managerial position: A bivariate longitudinal modelling of Wittyfit data.

BACKGROUND: The managerial position affects stress and job satisfaction of workers, but these influences have always been studied separately. OBJECTIVE: We aimed to assess bivariate influence of the managerial position on workers' stress and job satisfaction and the inter-relationship of these indicators over time. METHODS: We have analyzed data from workers who use the Wittyfit software, collected annually between 2018 and 2021. Stress and job satisfaction were evaluated by self-report questionnaires. Job position (manager or employee) was provided by the software's client companies. RESULTS: Data of 704 workers were included in the study. Cross-sectional and longitudinal multivariate analyses revealed that managerial position improves job satisfaction (p<0.001), but not stress (p = 0.4). Overall, while workers' job satisfaction has improved (p<0.001), stress has remained stable over time (p = 0.3). Three latent groups, with specific evolutionary multi-trajectory of stress and job satisfaction were identified in the sample (entropy = 0.80). Age and seniority, but not gender tended to influence managers' and employees' indicators. Over time, stress and job satisfaction have tended to negatively interconnect, in cross-section and in a cross-lagged manner (p<0.001). CONCLUSIONS: The managerial position improves workers' job satisfaction but has no effect on stress. Sociodemographics including age and seniority, but not gender, can affect this relationship. Stress and job satisfaction can influence each other, both cross-sectionally and over time. To be more effective, organizations should implement holistic strategies targeting multiple indicators. TRIAL REGISTRATION: Clinicaltrials.gov: NCT02596737.

The influence of burnout on cardiovascular disease: a systematic review and meta-analysis.

Background: Burnout is a public health problem with various health consequences, among which cardiovascular disease is the most investigated but still under debate. Our objective was to conduct a systematic review and meta-analysis on the influence of burnout on cardiovascular disease. Methods: Studies reporting risk (odds ratio, relative risk, and hazard ratio) of cardiovascular disease following burnout were searched in PubMed, PsycINFO, Cochrane, Embase, and ScienceDirect. We performed a random-effect meta-analysis stratified by type of cardiovascular disease and searched for putative influencing variables. We performed sensitivity analyses using the most adjusted models and crude risks. Results: We included 25 studies in the systematic review and 9 studies in the meta-analysis (4 cross-sectional, 4 cohort, and 1 case-control study) for a total of 26,916 participants. Burnout increased the risk of cardiovascular disease by 21% (OR = 1.21, 95% CI 1.03 to 1.39) using the most adjusted risks and by 27% (OR = 1.27, 95% CI 1.10 to 1.43) using crude risks. Using stratification by type of cardiovascular disease and the most adjusted risks, having experienced burnout significantly increased the risk of prehypertension by 85% (OR = 1.85, 95% CI 1.00 to 2.70) and cardiovascular disease-related hospitalization by 10% (OR = 1.10, 95% CI 1.02 to 1.18), whereas the risk increase for coronary heart disease (OR = 1.79, 95% CI 0.79 to 2.79) and myocardial infarction (OR = 1.78, 95% CI 0.85 to 2.71) was not significant. Results were also similar using crude odds ratio. The risk of cardiovascular disease after a burnout was not influenced by gender. Insufficient data precluded other meta-regressions. Conclusions: Burnout seems to increase the risk of cardiovascular disease, despite the few retrieved studies and a causality weakened by cross-sectional studies. However, numerous studies focused on the pathophysiology of cardiovascular risk linked to burnout, which may help to build a preventive strategy in the workplace.

Assessment of discordance between radiologists and emergency physicians of RADIOgraphs among discharged patients in an emergency department: the RADIO-ED study.

BACKGROUND: The possibility to perform standard X-rays is mandatory for all French Emergency Department (ED). Initial interpretation is under the prescriber emergency physician-who continually works under extreme conditions, but a radiologist needs to describe a report as soon as possible. We decided to assess the rate of discordance between emergency physicians and radiologists among discharged patients. METHODS: We performed a monocentric study on an adult ED among discharged patients who had at least one X-ray during their consult. We used an automatic electronic system that classified interpretation as concordant or discordant. We review all discordant interpretation, which were classified as false negative, false positive, or more exam needed. RESULTS: For 1 year, 8988 patients had 12,666 X-rays. We found a total of 742 (5.9%) discordant X-rays, but only 277 (2.2%) discordance had a consequence (new consult or exam not initially scheduled). We found some factors associated with discordance such as male sex, or ankle, foot, knee, finger, wrist, ribs, and elbow locations. CONCLUSIONS: On discharged patients, using a systematic second interpretation of X-ray by a radiologist, we found a total of 2.2% discordance that had an impact on the initial care.

Sex modulation of faces prediction error in the autistic brain.

Recent research suggests that autistic females may have superior socio-cognitive abilities compared to autistic males, potentially contributing to underdiagnosis in females. However, it remains unclear whether these differences arise from distinct neurophysiological functioning in autistic males and females. This study addresses this question by presenting 41 autistic and 48 non-autistic adults with a spatially filtered faces oddball paradigm. Analysis of event-related potentials from scalp electroencephalography reveal a neurophysiological profile in autistic females that fell between those of autistic males and non-autistic females, highlighting sex differences in autism from the initial stages of face processing. This finding underscores the urgent need to explore neurophysiological sex differences in autism and encourages efforts toward a better comprehension of compensation mechanism and a clearer definition of what is meant by camouflaging.

High-Protein Diets during either Resistance or Concurrent Training Have No Detrimental Effect on Bone Parameters in Resistance-Trained Males.

BACKGROUND: The effects of combining resistance training (RT) and concurrent training (CT; resistance + endurance training) with varied protein doses on bone measures remain poorly understood. Hence, we conducted a comparison of the impacts of two high-protein diets (1.6 or 3.2 g kg-1 d-1) over 16 weeks in resistance-trained males, either with CT or RT alone. METHODS: A total of forty-eight males, all of whom were resistance-trained, had the following demographics: 26.6 ± 6 years, body mass index: 25.6 ± 2.9 kg m-2 administered either 3.2 g kg-1 d-1 protein (CT2; n = 12; RT2; n = 12) or 1.6 g kg-1 d-1 protein (CT1; n = 12; RT1; n = 12) during 16 weeks (four sessions·w-1). Bone parameters were assessed pre- and post-intervention. RESULTS: There was no significant interaction between the intervention group and time for the legs, arms, ribs, or pelvis area BMC and BMD (p > 0.05). For the BMD of the pelvis and the BMC of the right ribs, however, there were significant time effects noted (p < 0.05). Furthermore, there was a significant interaction between the intervention group and time in the lumbar and thoracic spines, with a particular time effect noted for the thoracic spine region (p < 0.05). The regional differences in skeletal responses to the intervention are highlighted by these data. CONCLUSION: Our findings show that the intake of two high-protein diets combined with RT and CT during 16 weeks had no adverse effects on bone tissue parameters. While these findings indicate that protein intake between 2 and 3 times the current RDI does not promote bone demineralization when consumed in conjunction with exercise, future studies investigating the long-term effects of chronic high protein intake on bone tissue health are warranted.

The Managerial Role and Psychosocial Factors of Job Satisfaction: A Cross-sectional Study Among Wittyfit's Users.

OBJECTIVE: Job satisfaction is an emerging indicator for measuring workers' occupational well-being; however, this has been poorly studied in managers. We aimed to explore job satisfaction between managers and employees and assess its factors. METHODS: Data from Wittyfit's users were collected between January 2018 and February 2020. Volunteers anonymously provided their sociodemographic profile, their sense of job satisfaction, and their psychosocial feelings (ambiance, meaning, organization, recognition, values, work-life balance). RESULTS: Data of 10,484 employees and 836 managers were collected. Job satisfaction was higher in managers than employees. All psychosocial factors had an impact on job satisfaction in workers. There was a higher prevalence of satisfied managers than employees. Managerial position and other sociodemographic variables influenced this prevalence. CONCLUSIONS: Managers seem to be more satisfied than employees. Psychosocial and sociodemographic factors can influence workers' job satisfaction.

Determinants of Return to Work After a Stroke: A Systematic Review and Meta-analysis.

OBJECTIVE: To identify prognostic factors for return to work (RTW) after stroke. DATA SOURCES: PubMed, MEDLINE, Cochrane, and Embase were systematically searched. STUDY SELECTION: Studies had to include people of working age (<65 years old) at the time of stroke (ischemic, hemorrhagic, or subarachnoid hemorrhage). The evaluation of RTW and rate of RTW had to be mentioned. Study selection was done by 2 independent authors. In total, 1241 articles were screened, 39 met all inclusion criteria. DATA EXTRACTION: Characteristics of included studies were recorded independently by 2 authors. Differences were resolved through discussion or with a third author. Quality was assessed using the Scottish Intercollegiate Guidelines Network quality assessment tool. DATA SYNTHESIS: Among the 39 studies, prognostic factors for RTW were hemorrhagic stroke (odds ratio 0.53 [95% confidence interval 0.45-0.60], n=18 studies), sex (men) (1.26 [1.14-1.40], n=31), aphasia (0.37 [0.20-0.69], n=7), occupation (white collar worker) (1.84 [1.64-2.06], n=17), independence in activities of daily living (3.99 [1.73-9.23], n=7), and stroke severity (NIHSS) (1.23 [1.08-1.39], n=6). CONCLUSIONS: This meta-analysis highlighted positive and negative prognostic factors associated with RTW after stroke. Two categories were distinguished: modifiable and non-modifiable prognostic factors. This study provides information to help understand the issues, set appropriate objectives and implement appropriate strategies to guide people to RTW after stroke. Randomized controlled studies are needed to better evaluate work-place intervention programs as well as the effects of intravenous thrombolysis, and cognitive and neuropsychological rehabilitation on return-to-work rates after stroke.

The COVISTRESS oral-health study: Dental-care access in France during the COVID-19 pandemic / Accès aux soins dentaires pendant la pandémie de Covid-19 en France : l'enquête COVISTRESS-santé orale

The COVID-19 pandemic led to an interruption in dental-care services during the initial lockdown period. This study assesses the impact of this period on the perception of oral health and accessibility to dental care in France. A questionnaire survey was carried out (COVISTRESS.ORG) to study the stress and health behaviors of adults before, during, and after the first lockdown, i.e., at the time of the response. An "oral health" questionnaire assessed changes in the perceived difficulties for accessing dental care. Between November 2020 and April 2021, 339 adults completed the "oral health" section. The perceived-difficulty-in-accessing-dental-care score (on a scale of 0 to 100) was 21.6 ± 26.7 before the pandemic, 52.9± 39.5 during lockdown, and 38.1± 35.3 after it. Before the pandemic, this score was linked to an unfavorable perception of oral health and to difficulties in accessing health care. During lockdown, the score was associated with high dental care needs (RR=4.1; CI95%=1.2­13.8), and perceived difficulties in accessing the health care system (5.06; 1.8­14.1), particularly transport difficulties (3.0; 1.1­9.1). The factors explaining the change in difficulties from before to after the lockdown differ according to when the assessment was done. This study demonstrates the negative impact of the pandemic on perceived difficulties for accessing dental care, within a population with few socially disadvantaged people.

La pandémie de Covid-19 a entraîné une interruption des soins dentaires lors du premier confinement. Cette étude évalue les répercussions de cette période sur la perception de la santé orale et de l'accès aux soins dentaires en France. Une enquête par questionnaire a été menée (COVISTRESS) pour étudier le stress et les comportements de santé des adultes avant, pendant et après le premier confinement, soit au moment de la réponse. Un questionnaire « santé orale ¼ a évalué l'évolution de la perception des difficultés d'accès aux soins dentaires. Entre novembre 2020 et avril 2021, 339 personnes ont répondu au volet « santé orale ¼. Le score de difficulté perçue d'accès aux soins dentaires (0 à 100) passe de 21,6 ± 26.7 avant la pandémie à 52,9 ± 39,5 pendant le confinement et à 38,1 ± 35,3 après celui-ci. Avant la pandémie, ce score est lié à une perception défavorable de la santé orale et aux difficultés d'accès aux soins de santé. Pendant le confinement, le score est lié à un besoin élevé en soins dentaires (RR=4,1 ; IC95 %=1,2-13,8), à la perception de difficultés d'accès au système de santé (5,06 ; 1,8-14,1), notamment des difficultés de déplacement (3,0 ; 1,1-9,1). Les facteurs expliquant l'évolution des difficultés avant et après le confinement diffèrent selon le temps d'évaluation. Cette étude montre les répercussions négatives de la pandémie sur la perception de l'accès aux soins, dans une population intégrant peu de personnes socialement défavorisées.

Isolate Whey Protein Promotes Fluid Balance and Endurance Capacity Better Than Isolate Casein and Carbohydrate-Electrolyte Solution in a Warm, Humid Environment.

Protein ingestion is known to enhance post-exercise hydration. Whether the type of protein (i.e., whey, casein) can alter this response is unknown. Accordingly, this study aimed to compare the effects of the addition of milk-derived whey isolate or casein protein to carbohydrate-electrolyte (CE) drinks on post-exercise rehydration and endurance capacity. Thirty male soldiers (age: 24 ± 2.1 y; VO2max: 49.3 ± 4.7 mL/kg/min) were recruited. Upon losing ~2.2% of body mass by running in warm and humid conditions (32.3 °C, 76% relative humidity [RH]), participants ingested either a CE solution (66 g/L carbohydrate [CHO]), or CE plus isolate whey protein (CEW, 44 g/L CHO, 22 g/L isolate whey), or CE plus isolate casein protein (CEC, 44 g/L CHO, 22 g/L isolate casein) beverage in a volume equal to 150% of body mass loss. At the end of the 3 h rehydration period, a positive fluid balance was higher with CEW (0.22 L) compared to CEC (0.19 L) and CE (0.12 L). Overall mean fluid retention was higher in CEW (80.35%) compared with the CE (76.67%) and CEC trials (78.65%). The time of the endurance capacity test [Cooper 2.4 km (1.5 miles) run test] was significantly higher in CEC (14.25 ± 1.58 min) and CE [(12.90 ± 1.01 min; (p = 0.035)] than in CEW [(11.40 ± 1.41 min); (p = 0.001)]. The findings of this study indicate that the inclusion of isolate whey protein in a CE solution yields superior outcomes in terms of rehydration and enhanced endurance capacity, as compared to consuming the CE solution alone or in conjunction with isolate casein protein.

A Systematic Review and Meta-Analysis Investigating Head Trauma in Boxing.

OBJECTIVES: Although physical trauma has been reported in boxing since its inception, boxing still appeals to athletes and spectators. This systematic review and meta-analysis assess both acute and chronic neurological and neuropsychological effects that boxing has on the brain. Further assessments in terms of comparisons of the concussion ratio in boxing to other combat sports, as well as the efficiency of wearing headguards, are also performed. DATA SOURCES: This systematic review and meta-analysis used the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. The outcomes incorporated included physical chronic abnormalities of the brain, neuropsychiatric, and neurological disorders sustained in amateur or professional boxing, in addition to the safety benefits of boxing headguards. Odds ratios, descriptive statistics, and inferential statistics are also reported. MAIN RESULTS: From the 84 articles reviewed, the 35 included articles suggested that boxers have a significantly elevated risk of sustaining a concussion compared with other combat sports (risk ratio [RR]: 0.253 vs RR: 0.065, P < 0.001). From the 631 amateur and professional boxers analyzed, 147 (23.30%) had cavum septum pellucidum, whereas 125 of 411 amateur and professional boxers (30.41%) presented with some form of brain atrophy. Dementia or amnesia was observed in 46 of 71 boxers (61.79%), 36 of 70 (51.43%) had various forms and severities of cognitive disorders, and 57 of 109 (52.29%) displayed abnormal computed tomography or electroencephalogram scan results. Utilization of headguards significantly increased the risk for stoppages in amateur bouts, compared with boxers not wearing a headguard (OR: 1.75 vs 0.53, P < 0.050). CONCLUSIONS: Boxing is a hazardous sport that has the potential to have fatal and negative life-changing results. Because of the limited reliable data regarding the efficiency of boxing headguards, future research should focus on the overall significance that headguards may have for reducing head trauma.

Rehabilitation in Older Adults Affected by Immobility Syndrome, Aided by Virtual Reality Technology: A Narrative Review.

Individual mobility deficit in older adults induces a variety of medical conditions, diminishing their functional capacity in pursuing activities of daily living. In immobility syndrome patients, such conditions are prone further deterioration through a drastically reduced scope of physical activity, owing mostly to poor self-motivation and the monotonous character of conventional rehabilitation regimens. As evidenced by published research, virtual reality technology solutions in rehabilitation management actually add significantly to patients' self-motivation, while promoting their active involvement in therapy through visual, auditory, and kinaesthetic stimuli. Effective rehabilitation training aided by virtual reality solutions helps patients acquire specific physical and cognitive skills to be subsequently emulated in the real-world environment. The extra added advantage lies in facilitating such training within patients' own home environments, combined with online monitoring of their progress, when not personally supervised by a physiotherapist, which also boosts the overall cost effectiveness of the therapeutic management itself. This narrative review appears to be the very first one principally focused on critically comparing individual immobilisation with immobility syndrome, especially through the application of the Authors' own substantial hands-on therapeutic experience in managing various rehabilitation schemes, specifically aided by diverse virtual reality technology solutions.

Erector Spinae Muscle Activation During Forward Movement in Individuals With or Without Chronic Lower Back Pain: A Systematic Review and Meta-analysis.

Objective: To investigate the differences between erector spinae muscle activation in healthy individuals and patients with Chronic Lower Back Pain (CLBP) by conducting (a) systematic review and (b) meta-analysis. Data Sources: PubMed, ScienceDirect, SPORTDiscus, and Google Scholar were used to conduct the searches, which included studies up to the 31st of March 2023 with no start date specified. Study Selection: Any study otherwise meeting eligibility criteria was included if it reported either (1) a standard mean difference effect size; or (2) the means, SDs, and sample sizes for both the patient group and the comparator group. Data Extraction: A total of 7 case control trials were used for the systematic review and meta-analysis. Data Synthesis: The systematic review and meta-analysis revealed that total standardized mean difference in erector spinae muscle activation between healthy individuals vs patients with CLBP expressed in % maximum voluntary isometric contraction was 0.48 (95% confidence interval=0.21-0.74; P<.001) with the heterogeneity being I2=0% (P=.890). The electromyography (EMG) outputs showed significant differences in activation levels between the healthy and CLBP cohorts (P<.001). Conclusions: A small effect size was found in the meta-analysis. The muscle activation levels of the erector spinae during forward propulsion were higher in CLBP individuals compared with healthy cohorts. The findings provide more clarity about the muscles that were the focus of previous research, what procedures were used to evaluate muscular contributions and what speeds the participants were moving at during the test sessions. Given the limited methodological quality of the included studies, the findings should be interpreted with caution. Future research should evaluate the effect of other factors such as walking distance and any changes in walking surfaces and gradients (ie, non-flat surfaces).

New Insights into High-Fat Diet with Chronic Diseases.

Chronic diseases, encompassing conditions such as heart disease, cancer, and diabetes, represent a significant global health challenge and are the leading causes of mortality worldwide [...].

Influence of COVID-19 on Stress at Work During the First Wave of the Pandemic Among Emergency Health Care Workers.

OBJECTIVES: For more than 2 years, coronavirus disease (COVID-19) has forced worldwide health care systems to adapt their daily practice. These adaptations add to the already stressful demands of providing timely medical care in an overcrowded health care system. Specifically, the COVID-19 pandemic added stress to an already overwhelmed emergency and critical care health care workers (HCWs) on the front lines during the first wave of the pandemic.This study assessed comparative subjective and objective stress among frontline HCWs using a visual analog scale and biometric data, specifically heart rate variability (HRV). METHODS: This is a prospective, observational study using surveys and heart rate monitoring among HCWs who work in 3 frontline health care units (emergency department, mobile intensive care unit, and intensive care unit) in the University Hospital of Clermont-Ferrand, France. Two sessions were performed: 1 during the first wave of the pandemic (April 10 to May 10, 2020) and 1 after the first wave of the pandemic (June 10 to July 15, 2020).The primary outcome is the difference in stress levels between the 2 time points. Secondary objectives were the impact of overcrowding, sociodemographics, and other variables on stress levels. We also assessed the correlation between subjective and objective stress levels. RESULTS: Among 199 HCWs, 98 participated in biometric monitoring, 84 had biometric and survey data, and 12 with only biometric data. Subjective stress was higher during the second time point compared to the first (4.39 ± 2.11 vs 3.16 ± 2.34, P = 0.23). There were higher objective stress levels with a decrease in HRV between the first and the second time points. Furthermore, we found higher patient volumes as a source of stress during the second time point. We did not find any significant correlation between subjective and objective stress levels. CONCLUSION: HCWs had higher stress levels between the 2 waves of the pandemic. Overcrowding in the emergency department is associated with higher stress levels. We did not find any correlation between subjective and objective stress among intensive care and emergency HCWs during the first wave of the pandemic.

Integration of exercise prescription into medical provision as a treatment for non-communicable diseases: A scoping review.

Background: The purpose of this scoping review is to stimulate interest and to raise awareness, among researchers, healthcare practitioners, and policymakers regarding the current scientific literature related to exercise prescription for non-communicable diseases (NCDs). Exercise prescription is a safe and cost-effective method that enables physicians to use exercise as a complementary addition to NCDs management and treatment. Methods: This scoping review followed the PRISMA Extension Guidelines for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Using this framework, we considered information from qualitative and quantitative studies to identify research gaps. We provide feasible suggestions to guide future research for the implementation of exercise prescription in the healthcare environment. The literature search was conducted using SPIDER and PICO tools for qualitative, quantitative, and mixed-study designs. Inclusion criteria included articles that investigated patients with NCDs and considered exercise interventions. Systematic searches of PubMed, Web of Science, MEDLINE, EMBASE, and ScienceDirect were undertaken on 26 July 2022 and all reference lists were manually searched. Data processing was performed using EndNote 2.0 software and data charts were used for numerical summary and thematic analysis. Results: There were 10,951 articles retrieved, of which 28 met the inclusion criteria. Based on the evidence, exercise was a feasible, safe, and acceptable method to prevent and manage non-communicable diseases in inpatient and outpatient settings. Six research directions were identified and discussed. In addition, implementation evidence and suggestions for policy-reconfiguration are also provided. Conclusion: This scoping review summarizes the current evidence for the effectiveness of exercise in the treatment of non-communicable diseases. The review provides key findings supporting exercise prescription for the inpatient and outpatient healthcare service. We suggest that governments and healthcare policymakers globally advocate the inclusion of structured exercise prescription within the NCDs treatment setting.