METHODS: We performed a pooled analysis of individual patient data from cohort studies that included consecutive patients with ischemic stroke aged 18-50 years. We studied differences in prevalence of risk factors and causes of ischemic stroke between different ethnic and racial groups, geographic regions, and countries with different income levels. We investigated differences in 3-month mortality by mixed-effects multivariable logistic regression.
RESULTS: We included 17,663 patients from 32 cohorts in 29 countries. Hypertension and diabetes were most prevalent in Black (hypertension, 52.1%; diabetes, 20.7%) and Asian patients (hypertension 46.1%, diabetes, 20.9%). Large vessel atherosclerosis and small vessel disease were more often the cause of stroke in high-income countries (HICs; both p < 0.001), whereas "other determined stroke" and "undetermined stroke" were higher in low and middle-income countries (LMICs; both p < 0.001). Patients in LMICs were younger, had less vascular risk factors, and despite this, more often died within 3 months than those from HICs (odds ratio 2.49; 95% confidence interval 1.42-4.36).
DISCUSSION: Ethnoracial and regional differences in risk factors and causes of stroke at young age provide an understanding of ethnic and racial and regional differences in incidence of ischemic stroke. Our results also highlight the dissimilarities in outcome after stroke in young adults that exist between LMICs and HICs, which should serve as call to action to improve health care facilities in LMICs.
OBJECTIVE: The study aimed to explore youth perceptions of the My-Elderly-Care-Skills Module intervention and its perceived feasibility.
METHODS: This study involved youth respondents (18-30 years old) from low-income households who are accountable to providing care for independent older people (60 years or above) living in the same house. A qualitative study using a case study design was used to assess youth perceptions based on the content of the My-Elderly-Care-Skills module, by focusing on its implementation usage and usefulness for the care of the elderly. A total of 30 youths voluntarily participated in the online training workshop during the COVID-19 pandemic movement restriction order period. There were multiple sources of data, such as video recorded on reflection of care given at home, text messages in a WhatsApp group, and in-depth interviews during small group online meetings. Data were recorded and transcribed verbatim for common themes before a theme analysis was conducted. Inductive content analysis was performed after the saturation point was met.
RESULTS: Thematic analysis derived two domains of feasibility: operational and technical feasibility. There were three themes under operational practicality (improving awareness, addressing the caregiving skills needs, and seeking resources for knowledge) and three themes for technical practicality (easily used and informative, skill in effective communication, and program fulfillment).
CONCLUSION: It was verified that it is feasible for young caregivers of the elderly to participate in the My-Elderly-Care-Skills training intervention as it helps in improving knowledge and skills performance in managing and caring for the elderly.
METHODS: Data from 75 adolescents aged 11 or 12 years and 2,061 teeth without dental caries were analyzed in this study. Annual dental examinations to assess dental caries were conducted between 2018 and 2021. Salivary cotinine and Dentocult SM-Strip level were measured at baseline. Information on the smoking habits of parents, snack frequency, regular dental visits, and use of fluoride toothpaste was collected at baseline from parent-reported questionnaires.
RESULTS: During the 3-year follow-up, dental caries was noted in 21 adolescents and 43 teeth. Participants exposed to parental smoking had higher salivary cotinine levels than those whose parents did not smoke. The multilevel Cox regression model showed that a high salivary cotinine level was associated with the incidence of dental caries, after adjusting for potential confounding factors (hazard ratio, 3.39; 95% confidence interval 1.08-10.69).
CONCLUSION: This study suggests that the risk of dental caries is higher for adolescents who have high salivary cotinine levels attributable to second-hand smoke exposure.
METHODS: This qualitative study used vignettes and think-aloud methods. We recruited patients from a primary care clinic who were at least 18 years old, had high cardiovascular risk and had previously sought OHI. Participants were given two statin-related vignettes: Vignette 1 (low-quality information) and Vignette 2 (high-quality information). Participants voiced their thoughts aloud when reading the vignettes and determined the trust level for each vignette using a 5-point Likert scale. This was followed by a semi-structured interview which was audio-recorded and transcribed verbatim. The transcripts were coded and analysed using thematic analysis.
RESULTS: A total of 20 participants were recruited, with age ranging from 38-74 years. Among all the high cardiovascular-risk participants, eight had pre-existing cardiovascular diseases. For Vignette 1 (low-quality information), five participants trusted it while nine participants were unsure of their trust. 17 participants (85%) trusted Vignette 2 (high-quality information). Five themes emerged from the analysis of how patients evaluated OHI: (1) logical content, (2) neutral stance and tone of OHI content, (3) credibility of the information source, (4) consistent with prior knowledge and experience, and (5) corroboration with information from other sources.
CONCLUSION: Patients with high cardiovascular risks focused on the content, source credibility and information consistency when evaluating and determining their trust in statin-related OHI. Doctors should adopt a more personalised approach when discussing statin-related online misinformation with patients by considering their prior knowledge, beliefs and experience of statin use.
METHODS: A total of 48 adolescents with mild to moderate mental disabilities were recruited. The participants were randomly divided into four groups: control group (C), Traditional Chinese Medicine acupuncture group (M), moderate-intensity aerobic exercise group (E) and exercise and acupuncture combined intervention group (J). Before and after the experimental intervention, the participant's height, weight and attention ability were measured.
RESULTS: The improved range of attention total duration of the J group after the intervention was significantly higher than that of the E and M groups (0.05), whereas that of the latter groups was significantly higher compared to that of the C group ( 0.05). The J group showed significantly higher ( 0.05) attention span values after the intervention compared to the E, M and C groups. The C group did not show a significant difference in attention transfer at 12 weeks compared to before intervention (0.05), whereas the E, M and J groups increased significantly ( 0.05) after intervention than the C group.
CONCLUSIONS: Moderate-intensity aerobic exercise combined with acupuncture can more effectively improve the attention concentration and attention span of mentally-retarded adolescents than aerobic exercise or acupuncture alone.
METHODS: A total of 32 obese women were selected as subjects and administered the interventions of low-intensity combination exercise (Q2), moderate-intensity combination exercise (Q3), and high-intensity combination exercise (Q4). ELISA was used to measure irisin and IL-6 levels in all samples. Statistical analysis used one-way ANOVA and Turkey's-Honest Significant Difference (HSD) post hoc test.
RESULTS: The mean Δ IL-6 levels in the control groups (Q1), Q2, Q3, and Q4 were 0.27 ± 2.54, 2.07 ± 2.55, 5.99 ± 6.25, and 7.98 ± 2.82 pg/mL with (p=0.015). The mean Δ irisin levels were 0.06 ± 0.81 ng/mL in Q1, 0.59 ± 0.67 ng/mL in Q2, 1.99 ± 1.65 ng/mL in Q3, 4.63 ± 3.57 ng/mL in Q4 with (p=0.001).
CONCLUSIONS: This study proved that all three types of combined exercise intensity increased myokine levels, such as irisin and IL-6. However, high-intensity combination exercise provided the most optimal improvement in myokine levels in obese women. Future studies are needed to design long-term exercise programs specifically for obese adolescent women using the findings from this study.
METHODS: This study aimed to compile and synthesize the existing studies on the effects of PT on healthy athletes' technical skill performance. A comprehensive search of SCOPUS, PubMed, Web of Science Core Collection, and SPORTDiscus databases was performed on 3rd May 2023. PICOS was employed to establish the inclusion criteria: 1) healthy athletes; 2) a PT program; 3) compared a plyometric intervention to an active control group; 4) tested at least one measure of athletes' technical skill performance; and 5) randomized control designs. The methodological quality of each individual study was evaluated using the PEDro scale. The random-effects model was used to compute the meta-analyses. Subgroup analyses were performed (participant age, gender, PT length, session duration, frequency, and number of sessions). Certainty or confidence in the body of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).
RESULTS: Thirty-two moderate-high-quality studies involving 1078 athletes aged 10-40 years met the inclusion criteria. The PT intervention lasted for 4 to 16 weeks, with one to three exercise sessions per week. Small-to-moderate effect sizes were found for performance of throwing velocity (i.e., handball, baseball, water polo) (ES = 0.78; p < 0.001), kicking velocity and distance (i.e., soccer) (ES = 0.37-0.44; all p < 0.005), and speed dribbling (i.e., handball, basketball, soccer) (ES = 0.85; p = 0.014), while no significant effects on stride rate (i.e., running) were noted (ES = 0.32; p = 0.137). Sub-analyses of moderator factors included 16 data sets. Only training length significantly modulated PT effects on throwing velocity (> 7 weeks, ES = 1.05; ≤ 7 weeks, ES = 0.29; p = 0.011). The level of certainty of the evidence for the meta-analyzed outcomes ranged from low to moderate.
CONCLUSION: Our findings have shown that PT can be effective in enhancing technical skills measures in youth and adult athletes. Sub-group analyses suggest that PT longer (> 7 weeks) lengths appear to be more effective for improving throwing velocity. However, to fully determine the effectiveness of PT in improving sport-specific technical skill outcomes and ultimately enhancing competition performance, further high-quality research covering a wider range of sports is required.