Introduction In their article entitled‘Investigating genetic causal relationships between blood pressure and anxiety,depressive symptoms,neuroticism and subjective well-being’,Cai and colleagues1 presented the resul...Introduction In their article entitled‘Investigating genetic causal relationships between blood pressure and anxiety,depressive symptoms,neuroticism and subjective well-being’,Cai and colleagues1 presented the results of a two-sample Mendelian randomisation2(MR)study examining associations between blood pressure traits(systolic,diastolic,hypertension and pulse pressure)and psychological traits(anxiety,depression,neuroticism and subjective well-being).After correction for multiple testing.展开更多
The discovery that small size at birth and during infancy are associated with a higher risk of diabetes and related metabolic disease in later life has pointed to the importance of developmental factors in these condi...The discovery that small size at birth and during infancy are associated with a higher risk of diabetes and related metabolic disease in later life has pointed to the importance of developmental factors in these conditions. The birth size associations are thought to refl ect exposure to adverse environmental factors during early development but the mechanisms involved are still not fully understood. Animal and human work has pointed to the importance of changes in the setpoint of a number of key hormonal systems controlling growth and development. These include the IGF-1/GH axis, gonadal hormones and, in particular, the systems mediating the classical stress response. Several studies show that small size at birth is linked with increased activity of the hypothalamic-pituitary-adrenal axis and sympathoadrenal system in adult life. More recent human studies have shown associations between specif ic adverse experiences during pregnancy, such as famine or the consumption of adverse diets, and enhanced stress responses many decades later. The mediators of these neuroendocrine responses are biologically potent and are likely to have a direct infl uence on the risk of metabolic disease. These neuroendocrine changes may also have an evolutionary basis being part of broader process, termed phenotypic plasticity, by which adverse environmental cues experienced during development modify the structure and physiology of the adult towards a phenotype adapted for adversity. The changes are clearly advantageous if they lead to a phenotype which is well-adapted for the adult environment, but may lead to disease if there is subsequent overnutrition or other unexpected environmental conditions.展开更多
Purpose'. To examine adolescent experiences and perspectives of the GoActive intervention (ISRCTN31583496) using mixed methods processevaluation to determine satisfaction with intervention components and interpret...Purpose'. To examine adolescent experiences and perspectives of the GoActive intervention (ISRCTN31583496) using mixed methods processevaluation to determine satisfaction with intervention components and interpret a*dolescents experiences of the intervention process in order toprovide insights for future intervention design.Methods'. Participants (n = 1542;13.2 土 0.4 years, mean 土 SD) provided questionnaire data at baseline (shyness, activity level) and post-intervention(intervention acceptability, satisfaction with components). Between-group differences (boys vs. girls and shy/inactive vs. others) weretested with linear regression models, accounting for school clustering. Data from 16 individual interviews (shy/inactive) and 11 focus groupswith 48 participants (mean = 4;range 2—7) were thematically coded. Qualitative and quantitative data were merged in an integrative mixedmethods convergence matrix, which denoted convergence and dissonance across datasets.Results'. Effect sizes for quantitative results were small and may not represent substantial between-group differences. Boys (vs. girls) preferredclass-based sessions (0 = 0.2, 95% confidence interval (CI): 0.1—0.3);qualitative data suggested that this was because boys preferred competition,which was supported quantitatively (0 = 0.2, 95%CI: 0.1-0.3). Shy/inactive students did not enjoy the competition (0 = -0.3, 95%CI:—0.5 to —0.1). Boys enjoyed trying new activities more (0 = 0.1, 95%CI: 0.1 -0.2);qualitative data indicated a desire to try new activities acrossall subgroups but identified barriers to choosing unfamiliar activities with self-imposed choice restriction leading to boredom. Qualitative datahighlighted critique of mentorship;adolescents liked the idea, but older mentors did not meet expectations.Conclusion. We interpreted adolescent perspectives of intervention components and implementation to provide insights into future complexinterventions aimed at increasing young people's physical activity in school-based settings. The intervention component mentorship was liked inprinciple, but implementation issues undesirably impacted satisfaction;competition was disliked by girls and shy/inactive students. The resultshighlight the importance of considering gender differences in preference of competition and extensive mentorship training.展开更多
Complementary and alternative medicine(CAM) use is increasing worldwide; specifically it appears that these treatment modalities are popular among rheumatology patients.The most commonly reported CAM therapies are her...Complementary and alternative medicine(CAM) use is increasing worldwide; specifically it appears that these treatment modalities are popular among rheumatology patients.The most commonly reported CAM therapies are herbal medicines,homeopathy,chiropractic,acupuncture and reflexology.Despite high reported rates of CAM use,the number of patients disclosing use to their rheumatologists remains low.This review highlights rates of current CAM use in rheumatology in studies performed worldwide,and discusses potential reasons for nondisclosure of CAM use to clinicians.展开更多
We aimed to establish gestation age specific reference intervals for Doppler indices of fetal cardiac function from 12 to 40 weeks of pregnancy. In a cross-sectional observational study of singleton pregnancies, exami...We aimed to establish gestation age specific reference intervals for Doppler indices of fetal cardiac function from 12 to 40 weeks of pregnancy. In a cross-sectional observational study of singleton pregnancies, examinations were performed in 221 women evenly distributed across each week of pregnancy. Blood flow through the four cardiac valves was examined with Doppler. For the atrioventricular valves, velocity and duration of early (E) and atrial (A) waves and the interval (a) between E/A complexes was recorded. For the outflow valves, the duration (b), peak and average velocity of flow in systole was measured. Myocardial performance index (MPI) was calculated as (a - b)/b. Outlet valve diameters were measured and cardiac outputs were calculated. Gestation age specific ranges were constructed for all these parameters. We demonstrated that the cardiac output, peak systolic and time-averaged velocity increase with advancing gestation. However the MPI and E/A ratios show little change across gestation. Fetal cardiac physiology can be studied and Doppler indices reliably measured as early as the late first trimester of pregnancy. Establishing gestation age specific ranges for various cardiac indices throughout pregnancy will help the study of development of fetal cardiac function.展开更多
Purpose:To identify co-produced multi-stakeholder perspectives important for successful widespread physically active learning(PAL) adoption and implementation.Methods:A total of 35 stakeholders(policymakers n=9;commer...Purpose:To identify co-produced multi-stakeholder perspectives important for successful widespread physically active learning(PAL) adoption and implementation.Methods:A total of 35 stakeholders(policymakers n=9;commercial education sector,n=8;teachers,n=3;researchers,n=15) attended a design thinking PAL workshop.Participants formed 5 multi-disciplinary groups with at least 1 representative from each stakeholder group.Each group,facilitated by a researcher,undertook 2 tasks:(1) using Post-it Notes,the following question was answered:within the school day,what are the opportunities for learning combined with movement?and(2) structured as a washing-line task,the following question was answered:how can we establish PAL as the norm?All discussions were audio-recorded and transcribed.Inductive analyses were conducted by 4 authors.After the analyses were complete,the main themes and subthemes were assigned to 4 predetermined categories:(1) PAL design and implementation,(2) priorities for practice,(3) priorities for policy,and(4) priorities for research.Results:The following were the main themes for PAL implementation:opportunities for PAL within the school day,delivery environments,learning approaches,and the intensity of PAL.The main themes for the priorities for practice included teacher confidence and competence,resources to support delivery,and community of practice.The main themes for the policy for priorities included self-governance,the Office for Standards in Education,Children’s Services,and Skill,policy investment in initial teacher training,and curriculum reform.The main themes for the research priorities included establishing a strong evidence base,school-based PAL implementation,and a whole-systems approach.Conclusion:The present study is the first to identify PAL implementation factors using a combined multi-stakeholder perspective.To achieve wider PAL adoption and implementation,future interventions should be evidence based and address implementation factors at the classroom level(e.g.,approaches and delivery environments),school level(e.g.,communities of practice),and policy level(e.g.,initial teacher training).展开更多
The global rise in non-communicable diseases(NCDs)presents significant public health challenges.Effectively managing and preventing NCDs necessitates a thorough understanding of their causes and progression,which can ...The global rise in non-communicable diseases(NCDs)presents significant public health challenges.Effectively managing and preventing NCDs necessitates a thorough understanding of their causes and progression,which can be achieved through a lifecourse approach to determine past exposures’impact before NCD onset.However,this approach requires robust backing from data,specifically lifecourse cohort data,which are generally insufficient.To overcome this obstacle,three primary strategies have been employed to establish such cohorts:active follow-up cohorts,registry-based datasets,and technology-based data collection and simulation methods.展开更多
Nita G Forouhi和同事们认为,我们可以找到预防、管理和可能缓解2型糖尿病的饮食方法基本要点。饮食因素在2型糖尿病的预防和管理中至关重要。尽管在制定循证饮食指南方面取得了进展,但争议和困惑依然存在。在本文中,我们研究了现有证据...Nita G Forouhi和同事们认为,我们可以找到预防、管理和可能缓解2型糖尿病的饮食方法基本要点。饮食因素在2型糖尿病的预防和管理中至关重要。尽管在制定循证饮食指南方面取得了进展,但争议和困惑依然存在。在本文中,我们研究了现有证据,确定2型糖尿病饮食指南中哪些领域取得了共识,哪些还存在不确定性或争议。展开更多
Recent epidemiological studies have suggested a positive association between ultra-processed food consumption and breast cancer risk,although some studies also reported no association.Furthermore,the evidence regardin...Recent epidemiological studies have suggested a positive association between ultra-processed food consumption and breast cancer risk,although some studies also reported no association.Furthermore,the evidence regarding the associations between intake of food with lower degrees of processing and breast cancer risk is limited.Thus,we investigated the associations between dietary intake by degree of food processing and breast cancer risk,overall and by breast cancer subtypes in the European Prospective Investigation into Cancer and Nutrition(EPIC)study.Dietary intake of EPIC participants was assessed via questionnaires at baseline.More than 11,000 food ingredients were classified into four groups of food processing levels using the NOVA classification system:unprocessed/minimally processed(NOVA 1),culinary ingredients(NOVA 2),processed(NOVA 3)and ultra-processed(NOVA 4).Cox proportional hazards models were used to estimate hazard ratios(HRs)and 95%confidence intervals(CIs)of breast cancer per standard deviation increase in daily consumption(grams)of foods from each NOVA group.The current analysis included 14,933 breast cancer cases,diagnosed among the 318,686 EPIC female participants,(median follow-up of 14.9 years).No associations were found between breast cancer risk and the level of dietary intake from NOVA 1[HR_(per 1 SD)=0.99(95%CI 0.97-1.01)],NOVA 2[HR_(per 1 SD)=1.01(95%CI 0.98-1.03)]and NOVA 4[HR_(per 1 SD)=1.01(95%CI 0.99-1.03)]foods.However,a positive association was found between NOVA 3 and breast cancer risk[HR_(per 1 SD)=1.05(95%CI 1.03-1.07)]which became non-significant after adjustment for alcohol intake[HR_(per 1 SD)=1.01(95%CI 0.98-1.05)]or when beer and wine were excluded from this group[HR_(per 1 SD)=0.99(95%CI 0.97-1.01)].The associations did not differ by breast cancer subtype,menopausal status or body mass index.Findings from this large-scale prospective study suggest that the positive association between processed food intake and breast cancer risk was likely driven by alcoholic beverage consumption.展开更多
基金This study was funded by the Medical Research Council(MC_UU_00011/6,MC_UU_00011/1).
文摘Introduction In their article entitled‘Investigating genetic causal relationships between blood pressure and anxiety,depressive symptoms,neuroticism and subjective well-being’,Cai and colleagues1 presented the results of a two-sample Mendelian randomisation2(MR)study examining associations between blood pressure traits(systolic,diastolic,hypertension and pulse pressure)and psychological traits(anxiety,depression,neuroticism and subjective well-being).After correction for multiple testing.
文摘The discovery that small size at birth and during infancy are associated with a higher risk of diabetes and related metabolic disease in later life has pointed to the importance of developmental factors in these conditions. The birth size associations are thought to refl ect exposure to adverse environmental factors during early development but the mechanisms involved are still not fully understood. Animal and human work has pointed to the importance of changes in the setpoint of a number of key hormonal systems controlling growth and development. These include the IGF-1/GH axis, gonadal hormones and, in particular, the systems mediating the classical stress response. Several studies show that small size at birth is linked with increased activity of the hypothalamic-pituitary-adrenal axis and sympathoadrenal system in adult life. More recent human studies have shown associations between specif ic adverse experiences during pregnancy, such as famine or the consumption of adverse diets, and enhanced stress responses many decades later. The mediators of these neuroendocrine responses are biologically potent and are likely to have a direct infl uence on the risk of metabolic disease. These neuroendocrine changes may also have an evolutionary basis being part of broader process, termed phenotypic plasticity, by which adverse environmental cues experienced during development modify the structure and physiology of the adult towards a phenotype adapted for adversity. The changes are clearly advantageous if they lead to a phenotype which is well-adapted for the adult environment, but may lead to disease if there is subsequent overnutrition or other unexpected environmental conditions.
基金funded by the National Institute for Health Research School for Primary Care Research (NIHR SPCR)Funding from the British Heart Foundation,Cancer Research UK,Economic and Social Research Council,Medical Research Council,and the National Institute for Health Research,under the auspices of the UK Clinical Research Collaboration
基金funded by the National Institute for Health Research (NIHR) Public Health Research Programme (13/90/18)supported by the Medical Research Council (Unit Program number MC_UU_12015/7)and was undertaken under the auspices of the Centre for Diet and Activity Research (CEDAR),a UKCRC Public Health Research Centre of Excellence+2 种基金Funding from the British Heart Foundation, Cancer Research UK,Economic and Social Research Council, Medical Research Council,National Institute for Health Research,and Wellcome Trust,under the auspices of the UK Clinical Research Collaboration,is gratefully acknowledged(087636/Z/08/ZES/G007462/1MR/K023187/1)
文摘Purpose'. To examine adolescent experiences and perspectives of the GoActive intervention (ISRCTN31583496) using mixed methods processevaluation to determine satisfaction with intervention components and interpret a*dolescents experiences of the intervention process in order toprovide insights for future intervention design.Methods'. Participants (n = 1542;13.2 土 0.4 years, mean 土 SD) provided questionnaire data at baseline (shyness, activity level) and post-intervention(intervention acceptability, satisfaction with components). Between-group differences (boys vs. girls and shy/inactive vs. others) weretested with linear regression models, accounting for school clustering. Data from 16 individual interviews (shy/inactive) and 11 focus groupswith 48 participants (mean = 4;range 2—7) were thematically coded. Qualitative and quantitative data were merged in an integrative mixedmethods convergence matrix, which denoted convergence and dissonance across datasets.Results'. Effect sizes for quantitative results were small and may not represent substantial between-group differences. Boys (vs. girls) preferredclass-based sessions (0 = 0.2, 95% confidence interval (CI): 0.1—0.3);qualitative data suggested that this was because boys preferred competition,which was supported quantitatively (0 = 0.2, 95%CI: 0.1-0.3). Shy/inactive students did not enjoy the competition (0 = -0.3, 95%CI:—0.5 to —0.1). Boys enjoyed trying new activities more (0 = 0.1, 95%CI: 0.1 -0.2);qualitative data indicated a desire to try new activities acrossall subgroups but identified barriers to choosing unfamiliar activities with self-imposed choice restriction leading to boredom. Qualitative datahighlighted critique of mentorship;adolescents liked the idea, but older mentors did not meet expectations.Conclusion. We interpreted adolescent perspectives of intervention components and implementation to provide insights into future complexinterventions aimed at increasing young people's physical activity in school-based settings. The intervention component mentorship was liked inprinciple, but implementation issues undesirably impacted satisfaction;competition was disliked by girls and shy/inactive students. The resultshighlight the importance of considering gender differences in preference of competition and extensive mentorship training.
文摘Complementary and alternative medicine(CAM) use is increasing worldwide; specifically it appears that these treatment modalities are popular among rheumatology patients.The most commonly reported CAM therapies are herbal medicines,homeopathy,chiropractic,acupuncture and reflexology.Despite high reported rates of CAM use,the number of patients disclosing use to their rheumatologists remains low.This review highlights rates of current CAM use in rheumatology in studies performed worldwide,and discusses potential reasons for nondisclosure of CAM use to clinicians.
文摘We aimed to establish gestation age specific reference intervals for Doppler indices of fetal cardiac function from 12 to 40 weeks of pregnancy. In a cross-sectional observational study of singleton pregnancies, examinations were performed in 221 women evenly distributed across each week of pregnancy. Blood flow through the four cardiac valves was examined with Doppler. For the atrioventricular valves, velocity and duration of early (E) and atrial (A) waves and the interval (a) between E/A complexes was recorded. For the outflow valves, the duration (b), peak and average velocity of flow in systole was measured. Myocardial performance index (MPI) was calculated as (a - b)/b. Outlet valve diameters were measured and cardiac outputs were calculated. Gestation age specific ranges were constructed for all these parameters. We demonstrated that the cardiac output, peak systolic and time-averaged velocity increase with advancing gestation. However the MPI and E/A ratios show little change across gestation. Fetal cardiac physiology can be studied and Doppler indices reliably measured as early as the late first trimester of pregnancy. Establishing gestation age specific ranges for various cardiac indices throughout pregnancy will help the study of development of fetal cardiac function.
基金supported by an internal research grant from the School of Sport,Leeds Beckett University
文摘Purpose:To identify co-produced multi-stakeholder perspectives important for successful widespread physically active learning(PAL) adoption and implementation.Methods:A total of 35 stakeholders(policymakers n=9;commercial education sector,n=8;teachers,n=3;researchers,n=15) attended a design thinking PAL workshop.Participants formed 5 multi-disciplinary groups with at least 1 representative from each stakeholder group.Each group,facilitated by a researcher,undertook 2 tasks:(1) using Post-it Notes,the following question was answered:within the school day,what are the opportunities for learning combined with movement?and(2) structured as a washing-line task,the following question was answered:how can we establish PAL as the norm?All discussions were audio-recorded and transcribed.Inductive analyses were conducted by 4 authors.After the analyses were complete,the main themes and subthemes were assigned to 4 predetermined categories:(1) PAL design and implementation,(2) priorities for practice,(3) priorities for policy,and(4) priorities for research.Results:The following were the main themes for PAL implementation:opportunities for PAL within the school day,delivery environments,learning approaches,and the intensity of PAL.The main themes for the priorities for practice included teacher confidence and competence,resources to support delivery,and community of practice.The main themes for the policy for priorities included self-governance,the Office for Standards in Education,Children’s Services,and Skill,policy investment in initial teacher training,and curriculum reform.The main themes for the research priorities included establishing a strong evidence base,school-based PAL implementation,and a whole-systems approach.Conclusion:The present study is the first to identify PAL implementation factors using a combined multi-stakeholder perspective.To achieve wider PAL adoption and implementation,future interventions should be evidence based and address implementation factors at the classroom level(e.g.,approaches and delivery environments),school level(e.g.,communities of practice),and policy level(e.g.,initial teacher training).
基金Supported by the National Natural Science Foundation of China(42271433)the National Key R&D Program of China(2023YFC3604701)+4 种基金the“0 to 1”Innovation Research Project of Sichuan University(2023CX21)the Key R&D Project of Sichuan Province(2023YFS0251)Renmin Hospital of Wuhan University(JCRCYG-2022-003)the Wuhan University Specific Fund for Major School-level Internationalization Initiatives(WHU-GJZDZX-PT07)the International Institute of Spatial Lifecourse Health(ISLE).
文摘The global rise in non-communicable diseases(NCDs)presents significant public health challenges.Effectively managing and preventing NCDs necessitates a thorough understanding of their causes and progression,which can be achieved through a lifecourse approach to determine past exposures’impact before NCD onset.However,this approach requires robust backing from data,specifically lifecourse cohort data,which are generally insufficient.To overcome this obstacle,three primary strategies have been employed to establish such cohorts:active follow-up cohorts,registry-based datasets,and technology-based data collection and simulation methods.
文摘Nita G Forouhi和同事们认为,我们可以找到预防、管理和可能缓解2型糖尿病的饮食方法基本要点。饮食因素在2型糖尿病的预防和管理中至关重要。尽管在制定循证饮食指南方面取得了进展,但争议和困惑依然存在。在本文中,我们研究了现有证据,确定2型糖尿病饮食指南中哪些领域取得了共识,哪些还存在不确定性或争议。
基金supported by a Wellcome Trust PhD studentship in Molecular,Genetic and Lifecourse Epidemiology(224982/Z/22/Z).
文摘Recent epidemiological studies have suggested a positive association between ultra-processed food consumption and breast cancer risk,although some studies also reported no association.Furthermore,the evidence regarding the associations between intake of food with lower degrees of processing and breast cancer risk is limited.Thus,we investigated the associations between dietary intake by degree of food processing and breast cancer risk,overall and by breast cancer subtypes in the European Prospective Investigation into Cancer and Nutrition(EPIC)study.Dietary intake of EPIC participants was assessed via questionnaires at baseline.More than 11,000 food ingredients were classified into four groups of food processing levels using the NOVA classification system:unprocessed/minimally processed(NOVA 1),culinary ingredients(NOVA 2),processed(NOVA 3)and ultra-processed(NOVA 4).Cox proportional hazards models were used to estimate hazard ratios(HRs)and 95%confidence intervals(CIs)of breast cancer per standard deviation increase in daily consumption(grams)of foods from each NOVA group.The current analysis included 14,933 breast cancer cases,diagnosed among the 318,686 EPIC female participants,(median follow-up of 14.9 years).No associations were found between breast cancer risk and the level of dietary intake from NOVA 1[HR_(per 1 SD)=0.99(95%CI 0.97-1.01)],NOVA 2[HR_(per 1 SD)=1.01(95%CI 0.98-1.03)]and NOVA 4[HR_(per 1 SD)=1.01(95%CI 0.99-1.03)]foods.However,a positive association was found between NOVA 3 and breast cancer risk[HR_(per 1 SD)=1.05(95%CI 1.03-1.07)]which became non-significant after adjustment for alcohol intake[HR_(per 1 SD)=1.01(95%CI 0.98-1.05)]or when beer and wine were excluded from this group[HR_(per 1 SD)=0.99(95%CI 0.97-1.01)].The associations did not differ by breast cancer subtype,menopausal status or body mass index.Findings from this large-scale prospective study suggest that the positive association between processed food intake and breast cancer risk was likely driven by alcoholic beverage consumption.
