Search Results (1,140)

Background: The diagnosis and treatment of esophageal cancer often leads to complex and long-lasting psychological distress, such as anxiety and depression, in patients and their partners. This psychological distress can not only potentially worsen the poor prognosis of the disease, but also reduce health-related quality of life by affecting the patient’s ability to function and enjoy life. Objectives: These preliminary data were collected to identify the components required for the development of a health education program pertaining to improving psychological distress. Methods: A narrative review. Results: Two components, diet and physical activity, were identified as important factors for the well-being of esophageal cancer patients and their partners with psychological distress. Moreover, behavioral activation was assumed to be an effective approach for assisting esophageal cancer patients’ behavioral compliance with the given dietary intake and physical activity practices program. Conclusions: A health education program based on the above components (diet and physical activity) with a behavioral activation approach could be developed as a guideline to address the problem of psychological distress among esophageal cancer patients and their partners. However, these conclusions should be treated with caution, given that the findings have not yet been empirically tested. Further rigorous studies are required to confirm their effectiveness and determine which program components may be most effective in improving outcomes. Full article

Ti–Al alloys have widespread applications as targets in hard coatings by PVD (Physical Vapor Deposition). While the importance of target density is recognized, the densification mechanisms of Ti-67 at% Al targets, particularly during spark plasma sintering (SPS), remain poorly understood, hindering process optimization. This study aims to clarify these mechanisms by fabricating Ti-67 at% Al targets via SPS and examining their densification behavior through a detailed analysis of the creep model based on the stress exponent (n) and apparent activation energy (Q_d). The target’s relative density gradually increased in the temperature range of 370–530 °C, whereas the grain size remained relatively constant, indicating that the densification process dominated during this period. The results reveal that densification is primarily controlled by intergranular diffusion (n ≈ 2, Q_d = 97.29 kJ/mol) and dislocation climbing (n ≈ 3, Q_d = 158.74 kJ/mol). The target’s relative density reached 98.25% at 530 °C, with a corresponding grain size of 10.86 ± 1.08 μm. Additionally, as the temperature increased, the Vickers hardness of the target increased from 61.56 HV to 129.66 HV, and the electrical conductivity rose from 0.23 S/cm to 0.86 S/cm. This work provides a fundamental understanding of the densification kinetics in Ti-67 at% Al alloys during SPS, establishing a crucial guideline for fabricating high-performance PVD targets. Full article

Background: Current guidelines endorse the integration of exercise into cancer care. The diagnosis of cancer and its treatment, however, may introduce factors that make exercise engagement difficult, especially for individuals with advanced stages of disease. In this paper, we describe the baseline screening and triage process implemented for the Alberta Cancer Exercise (ACE) hybrid effectiveness-implementation study and share findings that highlight the multifaceted complexity of the process and the direct role of the clinical exercise physiologist (CEP). Methods: ACE was a hybrid effectiveness-implementation study examining the benefit of 12-week cancer-specific community-based exercise program. The ACE screening process was developed by integrating evidence-based guidelines with oncology rehabilitation expertise to ensure safe and standardized participation across cancer populations. The screening process involved four steps: (1) a pre-screen for high-risk cancers, (2) completion of a cancer-specific intake form and the Physical Activity Readiness Questionnaire for Everyone (PAR-Q+), (3) a CEP-led interview to further evaluate cancer status, cancer-related symptoms and other health issues (performed in-person or by phone), and (4) a baseline fitness assessment that included measurement of vital signs. Results: A total of 2596 individuals registered and underwent prescreening for ACE with 2570 (86.6%) consenting to participate. After full screening including the baseline fitness testing, 209 participants (8.1%) were identified as requiring further medical clearance. Of these, 191 (91.4%) had either a high-risk cancer, metastatic disease or were in the palliative end-stage of cancer, and 161 (84.3%) reported cancer-related symptoms potentially affecting their ability to exercise. In total, 806 (31.4%) participants were triaged to CEP-supervised in-person programming, 1754 (68.2%) participants to ACE community programming, and 8 (0.3%) specifically to virtual programming (post-COVID-19 option). Conclusions: The findings highlight the complexity and challenges of the screening and triage process, and the value of a highly trained CEP-led iterative approach that included the application of clinical reasoning. Full article

Background: Obesity affects over one billion people globally. Bariatric surgery is the most effective long-term intervention for severe obesity. However, postoperative outcomes can vary considerably, with such factors as baseline fitness and cardiorespiratory reserve influencing surgical outcomes. This systematic review aimed to evaluate the effects of preoperative exercise or physical activity, compared to standard care or no intervention, on preoperative fitness parameters and perioperative surgical outcomes in adults with obesity undergoing metabolic and bariatric surgery. Methods: A systematic review was conducted in accordance with the recommendations of the Cochrane Handbook and the PRISMA guidelines. Randomized controlled trials, non-randomized controlled trials, and cohort studies with control groups evaluating preoperative exercise interventions were included. Two independent reviewers conducted study selection, data extraction, and risk of bias assessment using Cochrane tools. Meta-analyses were performed using random effects models, with standardized mean differences calculated for continuous outcomes. Evidence certainty was assessed using the GRADE approach. Results: A total of 15 studies, including 1378 participants, were identified for qualitative synthesis, with 12 contributing data for quantitative meta-analysis. Preoperative exercise interventions significantly improved six-minute walk test distance (SMD 2.01; 95% CI: 0.51 to 3.50; p = 0.009) and VO₂ peak (SMD 1.02; 95% CI: 0.52 to 1.51; p < 0.0001). BMI reduction was significant (SMD −0.96; 95% CI: −1.75 to −0.16; p = 0.02), while weight change was not statistically significant (SMD −0.81; 95% CI: −1.72 to 0.09; p = 0.08). One study reported a reduction in hospital length of stay of 0.64 days (95% CI: −0.86 to −0.42; p < 0.00001). Evidence certainty was rated as very low to low across all outcomes. Conclusions: Preoperative exercise interventions have been shown to significantly improve cardiorespiratory fitness in bariatric surgery candidates, with large effect sizes for functional capacity measures. Despite the low certainty of the evidence, these findings suggest that supervised exercise programs should be incorporated into the preoperative care of bariatric surgery patients. Full article

Proper hydration is essential for maintaining homeostasis and the effective functioning of physiological systems, including the nervous and circulatory systems. During adolescence, a period characterized by rapid somatic growth, hormonal maturation, and increased physical and mental activity, the demand for water increases significantly. Hydration affects not only the health of young people, but also their cognitive abilities, concentration, mood, and general well-being. Despite clear recommendations from institutions such as EFSA and IOM regarding daily fluid intake, numerous studies indicate that a significant proportion of young people do not achieve the recommended level of hydration. The school environment is particularly worrying, as young people spend a significant part of their day there, and the availability of water, health knowledge, and social conditions may contribute to dehydration or promote unhealthy choices (e.g., sweetened drinks). The aim of this article is to review the current state of knowledge on the importance of hydration in school-age adolescents. The physiological basis of hydration, the impact of insufficient fluid intake on the functioning of the young body, current guidelines, as well as the results of selected epidemiological studies and obstacles to ensuring optimal hydration in the school environment are discussed. Full article

Introduction: Mental health problems in children and adolescents are a growing public health concern. Aerobic physical activity has been identified as a promising, accessible, and low-cost intervention to promote psychological well-being. Methods: This systematic review and meta-analysis was conducted following PRISMA 2020 guidelines and a pre-registered PROSPERO protocol. We searched PubMed, Scopus, Web of Science, and CINAHL for randomized controlled trials published until December 2024, with no language restrictions. Eligibility criteria included interventions based on aerobic physical activity among children and adolescents (5–18 years) reporting outcomes on mental health (e.g., depression, anxiety, self-esteem, mood, resilience). Methodological quality was assessed with the PEDro scale. Results: From 828 initial records, 21 studies met the inclusion criteria and 19 were included in the meta-analysis. The trials, conducted in diverse countries and settings, applied structured aerobic interventions (e.g., running, dancing, cycling, active games) with durations of 6–30 weeks. The pooled results showed significant improvements in depression, anxiety, self-esteem, and stress, with the largest effects observed in stress reduction and self-esteem enhancement. Conclusions: Aerobic physical activity appears to be an effective and feasible strategy to improve mental health in children and adolescents. Its integration into school and community programs is recommended as a preventive and complementary approach to traditional treatments. Full article

Objectives: To analyze, across the periods before, during, and after the implementation of Social Isolation and Distancing Measures (IMDIS): (a) changes in the prevalence of non-communicable chronic diseases (NCDs), stratified by age group in the Brazilian population; and (b) the association between physical inactivity (PI), insufficient moderate-to-vigorous physical activity (MVPA), and sedentary behavior (SB) with the occurrence of these conditions. This cross-sectional study used data from VIGITEL (Brazil’s Surveillance System of Risk and Protective Factors for Chronic Diseases by Telephone Survey), an annual population-based telephone survey conducted across the country. Data were collected in 2019, 2021, and 2023, with a total sample size of 101,226 participants. Arterial hypertension (AH) and diabetes mellitus (DM) were self-reported, and obesity (OB) was diagnosed using body mass index. PI, insufficient MVPA, and SB were identified via VIGITEL indicators. Chi-square tests assessed differences in prevalence overall and by age group. Logistic regression models estimated odds ratios (ORs) for associations between demographic variables, behavioral factors, and the studied periods. The prevalence of AH and DM was highest among individuals over 60 years, reaching 61% after IMDIS, a period when OB also peaked across all age groups. Individuals aged 30–59 and those over 60 had higher odds of AH, DM, and OB across all periods. Female participants had higher ORs for AH and DM both before and after IMDIS. PI and insufficient MVPA were associated with increased odds of AH, DM, and OB in all periods, while SB significantly elevated the OR for OB at all time points. After IMDIS, there was an increase in the prevalence of AH, DM, and OB among older adults and younger individuals. PI, insufficient MVPA, SB, and advanced age were all associated with a greater likelihood of NCDs at every stage of the study. The high post-IMDIS rates of AH, DM, and OB highlight the need for urgent public health strategies. Low-cost programs, such as live videos and online group sessions, should be included in national physical activity guidelines. These initiatives are affordable, aligned with WHO goals, and reduce PI in IMDIS scenarios. Incorporating them into Academia da Saúde and Agita Brasil strengthens NCD prevention and increases the resilience of the health system for future health crises. Full article

Diabetes is a chronic and complex pathological syndrome that includes a series of disorders and imbalances, whose first characterization is hyperglycemia, although, as it is a multifactorial phenomenon, it requires risk reduction strategies beyond glycemic control. Continuous education and support for diabetes self-management are essential to prevent acute complications and reduce the risk of long-term complications. Therefore, the guidelines for the treatment of diabetes emphasize the importance of lifestyle changes, including a reduced-calorie diet and increased physical activity. However, for many people, these changes can be difficult to maintain in the long term and eventually they must resort to pharmacological treatment that in most cases requires the combined use of two or more antidiabetic drugs with different mechanisms of action. This review explores the different pharmacological agents, authorized and used therapeutically, for the control of diabetes, especially type 2 diabetes, and analyzes the development strategies of multi-target agents whose effects, through distinct mechanisms and by acting on more than one receptor, could represent a promising alternative in the treatment of a multifactorial disease such as diabetes. As regards therapeutic uses, from metformin to glucose transporter inhibitors (SGLT2i), the potential mechanisms of action, pharmacological and clinical effects, safety, and use in therapeutics are described, presenting, as far as reasonably possible, diverse comparisons between them. In conclusion, although metformin remains the first-line agent for the treatment of type 2 diabetes, the choice of a second-line agent depends on several factors, in particular the cardiovascular risk profile, weight, and renal function of the patient; moreover, the ideal pharmacological treatment, although expected and desired, has in fact not been achieved so far, and physicians must consider not only the glycemic efficacy of the agent but also all the other potential benefits, balanced by the possible adverse effects. Compounds modulating multiple signaling pathways are a promising approach to manage this multifactorial disorder, with the primary objective of maintaining the therapeutic efficacy observed in several clinical studies, alongside reducing adverse effects, the main reason for the discontinuation of developments, to levels that enable a favorable risk–benefit balance. Full article

Introduction: People who exercise outdoors in urban environments may inhale increased amounts of polluted air due to temporary respiratory changes induced by physical activity. The objective of this scoping review was to map the physiological, morphological, and/or functional responses of the respiratory system to air pollution in healthy adults who exercise outdoors in urban environments. Methods: This review was conducted following the guidelines of the Preferred Reporting Items Extension for Scoping Reviews (PRISMA-ScR). A comprehensive search of Medline (PubMed), Redalyc, Scielo, and Web of Science was conducted to identify clinical trials, quasi-experimental studies, and cross-sectional studies published in the last 10 years in English. Studies with healthy adult participants engaged in outdoor physical activity in urban environments were included. Texts with participants with preexisting respiratory diseases, elite athletes, animal models, and computer simulations were excluded. Results: The most frequently reported air pollutants were PM_2.5, PM₁₀, and ozone (O₃); the most common forms of exercise were walking, running, and cycling. Exposure to air pollutants during physical activity was associated with reductions in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV₁), as well as increases in the fraction of exhaled nitric oxide (FeNO) and proinflammatory biomarkers. Conclusion: The findings indicated that there are modifications in lung function in those who exercise outdoors. However, the association between these respiratory responses and air pollution was not statistically significant in most cases. Some authors suggested that the health benefits of physical activity could mitigate the harmful effects of air pollution. Full article

Background/Objectives: The Internet of Things (IoT), integrated with application software, has increasingly been used to support health management through monitoring indicators like physical activity, sleep, and heart rate, in pregnant and postpartum women. However, limited evidence exists regarding its effectiveness in improving health outcomes for pregnant and postpartum women. The objective of this systematic review and meta-analysis was to evaluate and synthesize the role of IoT in enhancing the health outcomes of pregnant and postpartum women. Methods: A systematic search was conducted on 13 February 2023, across CENTRAL, CINAHL, ClinicalTrials.gov, Embase, MEDLINE, PsycINFO, PubMed, and WHO ICTRP to identify all randomized controlled trials. Studies were included if they involved pregnant or postpartum women in high-income countries and used sensor-based data collection via smartphones or wearable devices. Two reviewers independently selected the studies, extracted data, and assessed the risk of bias using the Cochrane Collaboration’s risk of bias assessment tool 2.0. We performed a pairwise meta-analysis using a random effects model. The findings were reported according to PRISMA guidelines. Results: Seven studies with 1638 pregnant and postpartum women were included in this review. Of the seven included studies, half targeted women with gestational diabetes and the other half targeted obese women. A meta-analysis revealed that IoT interventions may reduce gestational weight gain in women with obesity with a mean difference of −3.35 kg (95% confidence interval (CI): −5.23 to−1.46; I² = 36%; two studies; 242 women; moderate certainty of evidence). Conclusions: This review suggested that IoT interventions may limit gestational weight gain in pregnant women with obesity. Future studies should evaluate the long-term effects of IoT-based interventions on maternal and neonatal health outcomes. Full article

Objectives: Chronic psychological stress among college students increases sensitivity to negative emotional stimuli. Emotion regulation, a critical coping mechanism, draws upon cognitive resources and may impair subsequent cognitive control. Physical exercise has been proposed as an effective intervention to enhance both emotional and cognitive functioning. This study investigated whether a 12-week structured exercise intervention could modulate emotion regulation outcomes and improve cognitive control in college students experiencing high psychological stress. Methods: Forty-seven college students, identified as highly stressed via the Chinese College Students Psychological Stress Scale, were randomly assigned to either an exercise group (n = 25) or a control group (n = 22). The exercise group participated in supervised rope-jumping sessions three times per week for 40 min, following ACSM guidelines, over 12 weeks. Before and after the intervention, participants completed tasks measuring two emotion regulation strategies—expressive suppression and cognitive reappraisal—and tasks assessing cognitive control. Results: A significant group × time × strategy interaction emerged for subjective emotional valence: following the intervention, the exercise group reported attenuated negative valence under expressive suppression. For subjective arousal, post-intervention ratings decreased under suppression but increased under reappraisal in the exercise group, suggesting strategy-specific modulation by physical activity. Regarding cognitive control, electrophysiological measures revealed that the P3 component showed a significant interaction: the exercise group exhibited enhanced P3 amplitudes in congruent versus incongruent conditions after the intervention. Moreover, P3 interference scores were significantly reduced post-intervention in the exercise group compared to both its pre-intervention baseline and the control group. Conclusions: A 12-week aerobic exercise intervention enhanced emotion regulation outcomes and improved cognitive control under high psychological stress. These findings underscore the utility of physical exercise as a non-pharmacological approach to bolster cognitive–affective resilience in young adults. Full article

Background/Objectives: Evidence suggests a J-shaped association between alcohol consumption and depression, but it remains unclear whether this reflects a true causal effect, reverse causation, or methodological bias. This uncertainty is particularly relevant in older adults, who are at increased risk for both depression and alcohol-related harms. This study aimed to examine the association between varying levels of alcohol consumption and depression risk in community-dwelling older adults. Methods: We analyzed 16,563 community-dwelling older adults (mean age 75.1 ± 4.6 years) from the ASPirin in Reducing Events in the Elderly (ASPREE) trial. Alcohol intake, reported at baseline and follow-up, was categorized as abstinent, occasional, moderate, or above-guideline. Both intention-to-treat (classified by baseline alcohol consumption, regardless of later changes) and per-protocol (using annual time-updated alcohol consumption ) analyses were performed. To address confounding, informative censoring, and selection bias, we applied marginal structural models with inverse probability weighting. Results: In per-protocol analyses, abstainers (OR 1.17), occasional drinkers (OR 1.11), and above-guideline drinkers (OR 1.15) were significantly associated with a higher risk of depression compared with moderate drinkers, consistent with a J-shaped association. Sensitivity analyses excluding former drinkers and those with baseline depressive symptoms showed similar results. The association remained robust after adjusting for social isolation, social support, social interactions, physical activity, pain, sleep duration, sleep difficulties, and sleep medication use (n = 14,892; Australian sub-sample), and did not differ by sex. Conclusions: Moderate alcohol consumption was associated with the lowest depression risk, confirming a J-shaped relationship after comprehensive confounder adjustment. Full article

Background/Objectives: Despite global efforts to promote moderate-to-vigorous physical activity (MVPA) among youth, limited evidence exists regarding adolescents’ knowledge of official physical activity (PA) guidelines. The aim of this study was to assess adolescents’ knowledge of MVPA guidelines and examine its potential association with meeting PA recommendations and levels of sedentary behavior. Methods: This cross-sectional study was conducted in 2025 with a sample of 1032 adolescents (50.5% boys) from northernmost Brazil. Data were collected using a self-administered questionnaire and included information on knowledge of PA guidelines, PA levels, sedentary behavior duration, and sociodemographic characteristics. Associations were tested using logistic regression models. Results: Only 11.7% of adolescents accurately identified all components of the PA recommendations. Boys who met PA guidelines were 15.76 times more likely to be aware of the official recommendations (95% CI: 7.14–24.48), while girls had 10.05 times higher odds (95% CI: 4.43–16.67). Adolescents who were less sedentary (<3 h/day) were significantly more likely to know the guidelines, both among boys (OR = 2.00; 95% CI: 1.08–3.70) and girls (OR = 3.13; 95% CI: 1.12–8.33). Conclusions: The low level of awareness regarding official PA guidelines among adolescents is concerning, particularly given the strong association between such knowledge and the adoption of more active and less sedentary behaviors. Public health and educational strategies should prioritize health literacy in school curricula and community-based programs to promote more active lifestyles and reduce sedentary behavior among youth. Future studies should use longitudinal designs to clarify causal links and test practical interventions. Full article

Background/Objectives: Chemotherapy is an aggressive form of oncological treatment often accompanied by numerous adverse effects. A patient’s baseline status significantly influences the course of therapy, its efficacy, quality of life, and overall survival. This review aims to analyze the published peer-reviewed studies in this area and to assess whether they permit the formulation of preliminary recommendations for future prehabilitation protocols. Methods: An integrative review was conducted due to the limited number of relevant studies. Four databases—MEDLINE/PubMed (Medical Literature Analysis and Retrieval System Online/National Library of Medicine), Scopus, Cochrane, and Web of Science—were systematically searched for English-language articles published between 2010 and 13 January 2025, using the terms “prehabilitation,” “chemotherapy,” “drug therapy,” and “neoadjuvant.” A total of 162 records were retrieved. After duplicate removal, titles and abstracts were screened. The remaining papers were subjected to detailed analysis, resulting in ten studies with diverse methodologies being included. Results: We reviewed ten (n = 10) studies, most of which were reviews focused on breast cancer, indicating variation in the state of knowledge across different cancer types. A protein intake of 1.4 g/kg body mass helps preserve fat-free mass, with whey being more effective than casein. Supplementing EPA at a dose of 2.2 g/day may help prevent chemotherapy-related neurotoxicity and support appetite and weight maintenance. Physical activity, especially when it includes strength training, improves VO₂max, preserves fat-free mass, and may reduce stress and anxiety. We identified one randomized controlled trial in which a single exercise session before the first dose of doxorubicin resulted in a smaller reduction in cardiac function. Continuous psychological support should be available. A combined behavioural and pharmacological approach appears to be the most effective strategy for smoking cessation. Conclusions: No official guidelines exist for prehabilitation before chemotherapy, and the availability of studies on this topic is very limited. The pre-treatment period represents a critical window for interventions. Further research is needed to evaluate the effectiveness and applicability of particularly single-component interventions. Full article

Background/Objectives: Noncommunicable diseases (NCDs) are the leading causes of global mortality among adults. The aim of this study was to examine the association between adherence to 24 h movement behavior guidelines and the diagnosis of NCDs. Methods: This cross-sectional study was conducted with users of the Health Academy Program in Brazil. The sample consisted of 1212 individuals (92.9% female), aged 18 years or older. Dependent variables included self-reported hypertension, diabetes, hypercholesterolemia, and cardiovascular disease based on previous medical diagnosis. Independent variables (physical activity, screen time, and sleep) were self-reported. Binary and multinomial logistic regressions were performed and adjusted for sex, age, educational level, body mass index, and marital status. Results: Participants who did not meet any of the 24 h movement behavior recommendations had higher odds of hypertension (OR: 1.35; 95% CI: 1.15–1.77), diabetes (OR: 1.07; 95% CI: 1.03–2.01), and having two (OR: 1.29; 95% CI: 1.09–2.91) or three or more NCDs (OR: 1.40; 95% CI: 1.11–2.13). Not meeting the physical activity recommendation was associated with higher odds of hypercholesterolemia (OR: 1.37; 95% CI: 1.06–1.76). In contrast, meeting the physical activity guideline alone (OR: 0.32; 95% CI: 0.11–0.85) or in combination with adequate sleep (OR: 0.32; 95% CI: 0.11–0.90) was associated with lower odds of cardiovascular disease. All of these results remained significant after adjustments for multiple comparisons. Conclusions: Not meeting any of the 24 h movement behavior guidelines, especially those related to physical activity, was associated with a higher occurrence of NCDs. Full article