Elmwood Academy of Biomedicine

08/01/2024

Setting Korea’s National Health Insurance Service mother-child linked database, 2008-21.

Participants All children live born between 2009 and 2020, followed up until 2021 to compare those with and without antibiotic exposure during pregnancy or early infancy (first six months of life).

Main outcomes measures Autism spectrum disorder, intellectual disorder, language disorder, and epilepsy in children. After 1:1 propensity score matching based on many potential confounders, hazard ratios with 95% confidence interval were estimated using Cox proportional hazard models. A sibling analysis additionally accounted for unmeasured familial factors.

Results After propensity score matching, 1 961 744 children were identified for the pregnancy analysis and 1 609 774 children were identified for the early infancy analysis. Although antibiotic exposure during pregnancy was associated with increased risks of all four neurodevelopmental disorders in the overall cohort, these estimates were attenuated towards the null in the sibling analyses (hazard ratio for autism spectrum disorder 1.06, 95% confidence interval 1.01 to 1.12; intellectual disorder 1.00, 0.93 to 1.07; language disorder 1.05, 1.02 to 1.09; and epilepsy 1.03, 0.98 to 1.08). Likewise, no association was observed between antibiotic exposure during early infancy and autism spectrum disorder (hazard ratio 1.00, 0.96 to 1.03), intellectual disorder (1.07, 0.98 to 1.15), and language disorder (1.04, 1.00 to 1.08) in the sibling analyses; however, a small increased risk of epilepsy was observed (1.13, 1.09 to 1.18). The results generally remained consistent across several subgroup and sensitivity analyses, except for slightly elevated risks observed among children who used antibiotics during very early life and those who used antibiotics for more than 15 days.

Conclusions In this large cohort study, antibiotic exposure during pregnancy or early infancy was not associated with an increased risk of autism spectrum disorder, intellectual disorder, or language disorder in children. However, elevated risks were observed in several subgroups such as children using antibiotics during very early life and those with long term antibiotic use, which warrants attention and further investigation. Moreover, antibiotic use during infancy was modestly associated with epilepsy, even after control for indications and familial factors. When prescribing antibiotics to pregnant women and infants, clinicians should carefully balance the benefits of use against potential risks.

07/25/2024

Study selection A search of seven databases for randomised controlled trials published from inception to 1 March 2023 comparing a behavioural intervention including motivational interviewing with a comparator without motivational interviewing on physical activity outcomes in adults. Outcomes of interest were differences in change in quantitative measures of total physical activity, moderate to vigorous physical activity (MVPA), and sedentary time.

Data extraction and synthesis Two reviewers extracted data and assessed risk of bias. Population characteristics, intervention components, comparison groups, and outcomes of studies were summarised. For overall main effects, random effects meta-analyses were used to report standardised mean differences (SMDs) and 95% confidence intervals (CIs). Differential effects based on duration of follow-up, comparator type, intervention duration, and disease or health condition of participants were also examined.

Results 129 papers reporting 97 randomised controlled trials totalling 27 811 participants and 105 comparisons were included. Interventions including motivational interviewing were superior to comparators for increases in total physical activity (SMD 0.45, 95% CI 0.33 to 0.65, equivalent to 1323 extra steps/day; low certainty evidence) and MVPA (0.45, 0.19 to 0.71, equivalent to 95 extra min/week; very low certainty evidence) and for reductions in sedentary time (−0.58, −1.03 to −0.14, equivalent to −51 min/day; very low certainty evidence). Evidence for a difference in any outcome compared with comparators of similar intensity was lacking. The magnitude of effect diminished over time, and evidence of an effect of motivational interviewing beyond one year was lacking. Most interventions involved patients with a specific health condition, and evidence of an effect of motivational interviewing to increase MVPA or decrease sedentary time was lacking in general population samples.

Conclusions Certainty of the evidence using motivational interviewing as part of complex behavioural interventions for promoting total physical activity in adults was low, and for MVPA and sedentary time was very low. The totality of evidence suggests that although interventions with motivational interviewing increase physical activity and decrease sedentary behaviour, no difference was found in studies where the effect of motivational interviewing could be isolated. Effectiveness waned over time, with no evidence of a benefit of motivational interviewing to increase physical activity beyond one year.

07/19/2024

The purpose of my study is to explore the importance of the role of the nurse in promoting healthy lifestyles in adolescents.
To achieve this goal, the following tasks were set: 1) to analyze modern scientific approaches to healthy lifestyle; 2) to identify the main directions of the nurse's activity in the formation of a healthy lifestyle:
Healthy lifestyle is an image based on the principles of morality, positivity, diligence and at the same time protects from negative environmental, psychological and physical health. At all times, physical and psychological health has become an enduring value of man and society for all people in the world. Even in ancient times it was understood by doctors and philosophers as the main condition of free human life activity. One can literally realize that the process of rational management of habits is the management of one's own behavior.
Nursing process is a scientific method of organizing research on the systematic care of patients, aimed at meeting the needs related to human health. Nursing process involves discussing with the help of solutions all possible problems within the nurse's capabilities.
The work of the nurse with adolescents on the formation of healthy lifestyle is a complex process of education of responsibility for their own health, the development of critical thinking and the formation of a positive attitude to a healthy lifestyle.
The nurse should identify factors that can adversely affect the health of adolescents: improper nutrition, lack of physical activity, stress, bad habits, etc.
It is necessary to analyze the information that adolescents receive from different sources (Internet, television, social networks), to identify false or harmful information and prepare counterarguments.
The main directions of the nurse's activity in the formation of a healthy lifestyle:
Individual conversations: The nurse can have a conversation with the patient about his or her lifestyle, identifying risk factors and offering recommendations to reduce them. The nurse can develop and distribute informational booklets, posters, and videos about healthy lifestyles. The nurse can create a blog or a page in social networks with useful materials about a healthy lifestyle. [2, с. 280]
Motivation and support: The nurse can create an atmosphere of trust and support by encouraging the patient to make lifestyle changes, can help the patient set realistic goals and develop a plan to achieve them. And it is important to monitor the patient's progress and evaluate the effectiveness of the measures taken. Psychological support
It is important for the nurse to participate in preventive measures such as immunizations, disease screening, and preventive examinations. The nurse can help the patient to find out the risk factors for diseases and take measures to reduce them.
The nurse should conduct regular counseling sessions with adolescents, answering their questions, providing guidance, and supporting them in their pursuit of HEA.
Conclusion
The nurse plays a key role in the formation of a healthy lifestyle of the population. She not only informs about the importance of healthy lifestyle but also helps people to change their habits, increase motivation and make changes in their lives. Through her actions, the nurse not only preserves the health of patients, but also improves the quality of life of the entire community.
Building a healthy lifestyle is an investment in the future. It is an investment in one's own health, happiness and well-being, as well as the health and well-being of the entire community. A healthy lifestyle is not just a fashion trend, but a necessary foundation for creating a happy and prosperous future.

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