METHODS: A comprehensive systematic literature search was conducted from January 2000 to February 2023 across Web of Science, Google Scholar, and MEDLINE via PubMed. The review sought studies on technology-based exercise prescriptions for adults ≥ 18 years, evaluating features that enhance motivation or adherence.
RESULTS: Out of 1724 articles reviewed, 45 met the criteria, demonstrating that mobile applications, exercise gaming, wearable trackers, and websites are commonly used technologies for prescribing exercise in healthcare setting. Common features, special features, and motivating features were found to be important in all technology-based exercise tools to enhance users' adherence and motivation.
CONCLUSION: This review provides a comprehensive overview of the technological types and approaches that can support and improve exercise adherence among health service users. The findings also emphasize on specific features that can address current gaps in technology-driven fitness interventions.
PRACTICE IMPLICATIONS: Healthcare professionals should make informed decisions when recommending these tools to health service users, since technology does play a significant role in promoting long-term adherence to exercise programs.
METHODS: The National Health and Nutrition Examination Survey (NHANES) is a population-based observational study, conducted periodically in Mexican American, Other Hispanic, Non-Hispanic (NH) White, NH Black, and other racial/ethnic participants. We linked 2009-12 survey data of 8199 adults to the mortality data until 2019. By analyzing RNA gene sequences from oral rinse samples, microbiome alpha diversity within individuals was assessed using operational taxonomic unit (OTU) richness. Potential mediators included obesity, diabetes mellitus, dyslipidemia, hypertension, and periodontitis. Multivariable Cox proportional hazards regression and causal mediation analysis were used.
RESULTS: Baseline mean ± standard deviation (SD) age was 42.1 ± 15.1 years. Over a median follow-up of 9.1 years, 405 all-cause mortality occurred (CVD, 105; non-CVD, 300). Each 1-SD increment in OTU richness was inversely associated with all-cause mortality (hazard ratio [HR] 0.92, 95 % confidence interval [CI] 0.90-0.95), CVD mortality (HR, 0.92; 95 % CI, 0.90-0.95), and non-CVD mortality (HR, 0.92; 95 % CI, 0.90-0.95). With evidence of significant racial and ethnic groups-interaction (p <0.05), these associations were evident in Mexican American, NH White, and others racial/ethnic participants. None of the potential mediators significantly mediated the associations of OTU richness with all-cause, CVD, and non-CVD mortality.
CONCLUSIONS: Lower oral microbiome alpha diversity is associated with higher risk for all-cause, CVD, and non-CVD mortality, and the associations are varied by racial and ethnic groups.
METHODS: A survey was developed by multicenter consensus. The survey captured institutional characteristics, geographic distributions, intracranial EEG utilization, and barriers to SEEG. Respondents were representative epilepsy centers across the region.
RESULTS: Four epilepsy centers with established intracranial/ SEEG and two centers from a country without any access to SEEG participated. The responses identified that 1. Access to SEEG remained highly restricted across the region with an estimated one capable epilepsy center per 100 million people; 2. The region includes over half a billion people living in countries with no access to SEEG; 3. Staffing/ financial constraints were universal factors that limited growth of services or development of new services; 4. SEEG numbers have plateaued as a result of these challenges.
CONCLUSION: The study puts into real numbers the challenges faced by the region in accessing SEEG. SEEG remains highly underutilized and future approaches should focus on regional training and referral pathways.
METHODS: A realist review of articles reporting program outcomes as measures of resilience through the use of via validated psychometric surveys was conducted to investigate which contexts favour the development of resilience of healthcare and health sciences students and which mechanisms have to be activated to achieve this outcome.
RESULTS: Thirteen Context-Mechanism-Outcome Configurations were synthesised from data presented in 43 articles. These were combined with theories explaining the theoretical and psychological frameworks underpinning programs to develop a program theory of how and why resilience fostering programs work. Contexts which favour the development of resilience were the use of validated psychological frameworks as program foundation, e.g. Cognitive Behavioural Therapy, mindfulness-based training. Expert facilitation, longitudinal integration into curricula, flexible and multi-modal design and delivery, and opportunities for students to apply and practice resilience-building strategies also created favourable contexts. Meeting students' or practitioners' needs activated mechanisms of trust, engagement and recognition of a program's value and real-world benefits. An increase in resilience was achieved by students developing reflective skills, metacognitive awareness and positive habits of mind.
CONCLUSION: The program theory established via a realist review provides guidance on how the individual resilience of healthcare students can be fostered throughout their undergraduate, postgraduate degrees and early practice, potentially supporting them to flourish and remain long-term in their chosen professional roles.