Exercise intervention is an important non-pharmacological intervention for various diseases, and establishing precise exercise load assessment techniques can improve the quality of exercise intervention and the efficiency of disease prevention and control. Based on data collection from wearable devices, this study conducts nonlinear optimization and empirical verification of the original "Fitness-Fatigue Model". By constructing a time-varying attenuation function and specific coefficients, this study develops an optimized mathematical model that reflects the nonlinear characteristics of training responses. Thirteen participants underwent 12 weeks of moderate-intensity continuous cycling, three times per week. For each training session, external load (actual work done) and internal load (heart rate variability index) data were collected for each individual to conduct a performance comparison between the optimized model and the original model. The results show that the optimized model demonstrates a significantly improved overall goodness of fit and superior predictive ability. In summary, the findings of this study can support dynamic adjustments to participants' training programs and aid in the prevention and control of chronic diseases.
ObjectiveTo systematically review the efficacy of non-pharmacological interventions to reduce fear of childbirth. MethodsThe Cochrane Library, PubMed, EMbase, Web of Science, CNKI, WanFang Data, VIP, and CBM databases were electronically searched to collect randomized controlled trials (RCTs) of the efficacy of non-pharmacological interventions to reduce fear of childbirth from inception to December 2021. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies; then, a network meta-analysis was performed using Stata 15.0 software. ResultsA total of 19 RCTs involving 3 409 patients were included. Ten non-pharmacological interventions (prenatal education, scenario-based health education, psychological guidance, yoga training, hypnosis, mobile learning education, cognitive behavioral therapy, physical relaxation guidance, breathing guidance, and usual care) were included. The results of the reticulated meta-analysis of the Wijma Delivery Expectancy Questionnaire (W-DEQ-A) showed that the rankings of the interventions were as follows: prenatal education > yoga training > cognitive behavioral therapy > situational simulation health education > psychological guidance > physical relaxation guidance > conventional care. The results of the Wijma Experience of Childbirth Questionnaire (W-DEQ-B) mesh meta-analysis showed that the rankings of the interventions were as follows: mobile learning education > prenatal education > scenario-based health education > cognitive behavioral therapy > breathing instruction > hypnosis > psychological instruction > physical relaxation instruction > usual care. ConclusionThe current evidence suggests that prenatal education, mobile learning education, situational simulation health education, and yoga training may be effective interventions in improving maternal fear of childbirth. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To retrieve and summarize evidence of non-pharmacological interventions for sleep disorders in patients with osteoarthritis (OA), and to organize and evaluate the extracted evidence to provide evidence-based interventions for sleep disorders in patients with OA. Methods The relevant literature on non-pharmacological interventions for sleep disorders in patients with OA in BMJ Best Practice, UpToDate, JBI evidence-based healthcare center database, National Institute for Health and Clinical Excellence, Registered Nurses’ Association of Ontario, Guidelines International Network, Medlive guidelines network, Cochrane Library, PubMed, Web of Science, China National Knowledge Infrastructure and Wanfang was systematically searched. The search deadline was June 30th, 2024. The retrieved results were integrated and analyzed to form evidence of non pharmacological interventions for sleep disorders in patients with OA. Results A total of 13 articles were included, including 1 evidence report, 5 guidelines, 2 expert consensus papers, 3 systematic reviews, and 2 randomized controlled trials. The summarized evidence involves six aspects of sleep screening, specialist visits, assessment tools, cognitive behavioral therapy, exercise therapy, and other measures, totaling 20 pieces of evidence. Conclusion Non-pharmacological interventions for sleep disorders of patients with OA include multiple aspects, and this evidence can provide theoretical basis for developing intervention plans for sleep disorder of patients with OA, thereby improving their sleep quality and enhancing quality of life.
ObjectivesTo evaluate the methodological quality of guidelines for pharmacological intervention of migraine in adults, to compare and analyze the differences in first-line drug recommendations in different regions and quality levels, so as to explore the evidence of drug recommendations, and provide a basis for clinical decision-making.MethodsPubMed, The Cochrane Library, EMbase, SinoMed, CNKI, VIP, and WanFang Data databases, Up To Date, as well as the related books, Yimaitong, Guideline Central, Guidelines International Network (GIN) and National Institute for Health and Clinical Excellence (NICE) were systematically searched to collect pharmacological intervention guidelines of migraine in adults from inception to January 12th, 2020. The methodological quality of the guidelines was evaluated by Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ).ResultsA total of 25 guidelines were included (including 22 evidence-based guidelines), covering 10 countries on 4 continents and World Health Organization (WHO) with a time span of 1997 to 2019. According to AGREE Ⅱ, 5 were A-level guidelines, 18 were B-level guidelines, and 2 were C-level guidelines. Scope and purpose, rigour of development, clarity of presentations and editorial independence obtained high average scores (more than 60%) among all 25 guidelines. The average scores of guidelines in different domains of AGREE Ⅱ varied with regions and countries. Triptans and NSAIDs were the most frequently recommended as first-line drugs for the acute management; beta-blockers and antiepileptic drugs were recommended for the first-line prevention drugs of migraine in adults. There were 2 guidelines that recommended complementary treatments, one recommended traditional Chinese medicine and another recommended herbal butterbur.ConclusionsThe methodological quality of the pharmacological intervention guidelines of migraine in adults is suboptimal among different regions or countries. The quality of evidence-based guidelines is superior to that established by consensus. The consistency of first-line drug recommendations is strong, but there are still regional differences. The therapeutic effect of traditional Chinese medicine requires further verification.
Objective To systematically review simple hypertension guidelines through methods as follows: (a) compare differences and similarities of the recommended drugs; (b) analyze differences of the recommended frequencies in different regions and quality levels; and (c) explore the recommended evidence basis, so as to better understand relevant guidelines. Methods Uncomplicated hypertension guidelines concerning pharmacological interventions were identified (terminated by March 2012) in Ovid, EMbase, Chinese Biomedical Disc (CBM) and WangFang database as well as guideline websites including NGC (National Guideline Clearinghouse), GIN(Guidelines International Network), NICE(National Institute for Health and Clinical Excellence) and CPGN (Clinical Practice Guideline Net, guidelines concerning pharmacological intervention in simple hypertension were included. A total of 6 domains (involving 23 items) in the Appraisal of Guidelines for Research and Evaluation (AGREE) were applied to assess the methodological quality of the guidelines. A comparative study was performed regarding the recommendations in guidelines from different regions as well as of different methodological qualities. Results A total of 27 guidelines concerning pharmacological intervention in simple hypertension were included, involving 6 continents, 13 counties, 3 regions and 3 international organizations. Publication dates ranged from 2003 to 2012. According to the AGREE instrument, 4, 17 and 6 guidelines were graded as Level A, B and C, respectively. There were only 2 domains, “Scope and Purpose” and “Clarity of Presentations”, getting high average scores (more than 60%) among all guidelines. The average scores of guidelines in different domains of AGREE varied with regions. There were 8 evidence-based guidelines which got higher average scores in each domain of AGREE than those of non-evidence-based guidelines. Guidelines varied with the standards of classifying ideal, normal, high normal blood pressure and hypertension. Diuretics were the first agent recommended by all guidelines, and the other recommendations were correlated with age and race. There was a tendency to recommend diuretics as basic drugs in two-drug combination therapy in North America, while calcium channel blockers (CCBs) were the most recommended agents in Asian guidelines. Conclusion The overall methodological quality of simple hypertension guidelines is suboptimal in different countries or regions. The 6 domains involving 23 items in AGREE vary with scores, while the scores of evidence-based guidelines are higher than those of non-evidence-based guidelines. There are differences in the standards of classifying ideal, normal, high normal blood pressure and hypertension. The first-line drug recommendations differ in regions and relate to age and race. Two-drug combination therapy regimens also vary with region.
ObjectiveTo systematically review the efficacy and safety of non-pharmacological interventions for sleep disturbance in dementia, and to provide evidence for clinical practice.MethodsDatabases including CNKI, WanFang Data, VIP, PubMed, EMbase and The Cochrane Library were searched to collect randomized controlled trials (RCTs) on non-pharmacological interventions for sleep disturbance in dementia from inception to May 2020. Two reviewers independently screened literature, extracted data, and assessed risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsA total of 9 RCTs were included, involving 720 patients. Light therapy was the most commonly used treatment, followed by special activity and sleep education program. The results of meta-analysis showed that compared with the control intervention, light therapy could improve sleep efficiency (MD=2.21, 95%CI 1.09 to 3.33, P=0.0001) and the night-time sleep (MD=14.27, 95%CI 5.01 to 23.53, P=0.003) of patients with dementia in the community and nursing institutions, special activity could increase the night-time sleep (MD=29.74, 95%CI 20.44 to 39.04, P<0.00001), and sleep education program could also improve sleep efficiency (MD=6.19, 95%CI 5.22 to 7.16, P<0.00001) and night-time sleep (MD=33.95, 95%CI 25.40 to 42.50, P<0.00001). In addition, it was superior to obtain 120 or 60 minutes of light exposure than 30 minutes to improve the quality of sleep (RR=−2.62, 95%CI −3.56 to −1.68, P<0.001) and reduce daytime sleep (RR=−4.75, 95%CI −5.71 to −3.42, P<0.001). However, there was significant difference in incidence of adverse reactions between groups of 120 minutes and 30 minutes of light exposure (RR=2.57, 95%CI 1.44 to 4.58, P=0.001).ConclusionsThe current evidence shows that non-pharmacological intervention can improve sleep efficiency and night-time sleep in patients with dementia. Due to limited quantity and quality of the included studies, more high quality studies are required to verify above conclusions.
Objective To evaluate and summarize the evidence related to non-pharmacological interventions in community-dwelling elderly with sarcopenia and to provide an evidence-based basis for guiding community health professionals to effectively manage older patients with sarcopenia. Methods We searched all evidence about non-pharmacological interventions in community-dwelling elderly with sarcopenia from BMJ Best Practice, UpToDate, Guidelines International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses' Association of Ontario, Canadian Medical Association Clinical Practice Guidelines Infobase, American Society for Nutrition, Australian JBI Evidence-Based Health Care Centre Database, CINAHL, PubMed, Cochrane Library, Web of Science, CBM, CNKI, WanFang Data and VIP Databases. The types of literature included guidelines, expert consensus, systematic reviews, evidence summaries and meta-analyses. The retrieval time ranged from January 1, 2019 to May 31, 2024. Results A total of 14 publications were included, including 2 guidelines, 3 expert consensuses, and 9 systematic reviews. Twenty-four pieces of evidence were summarized in 3 areas, including screening, assessment, and non-pharmacological interventions for sarcopenia. Conclusion We summarize the best evidence for initial screening, systematic assessment, and comprehensive non-pharmacological interventions for elderly patients with sarcopenia in the community, and provide a guidance and reference for community medical staff to efficiently manage elderly patients with sarcopenia.
ObjectiveTo evaluate the efficacy of different non-pharmacological interventions on cognitive function in elderly patients with mild cognitive impairment by the network meta-analysis. MethodsThe PubMed, Embase, Cochrane Library, CINAHL, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect randomized controlled trials (RCTs) related to the objectives from inception to November 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. The network meta-analysis was then performed by using Stata 16.0 and Open BUGS 3.2.3 software. ResultsA total of 43 RCTs involving 2 986 patients were included, which involved 8 non-drug intervention methods. The best probability ranking results of the network meta-analysis showed that on the simple mental state scale (MMSE) scores: rTMS > acupressure > acupuncture therapy > exercise therapy > cognitive training > multicomponent intervention > VR > conventional care > health education, and on the Montreal cognitive assessment scale (MoCA) scores: VR > exercise therapy > rTMS > acupuncture therapy > acupressure > cognitive training > health education > conventional care. Conclusion Current evidence shows that rTMS, acupressure, VR, exercise therapy and acupuncture may be effective interventions to improve cognitive function in elderly patients with mild cognitive impairment. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To explore the clinical comprehensive therapy of Peutz-Jeghers syndrome. Methods From January 2000 to December 2010，71 cases of Peutz-Jeghers syndrome underwent endoscopic polyp resection firstly，and those with unresectable lesions or with severe complications underwent rescue laparotomy. After endoscopic or surgical treatment，the patients took Celecoxib capsules voluntarily for 6 to 9 months under informed consents. All cases were followed up from 6 months to 8 years. Results Twenty-nine patients had familial history of Peutz-Jeghers syndrome among the 71 patients （41 males and 30 females）. Sixty-two cases underwent 94 surgeries and intussusception was the most common cause of laparotomy. Sixty-five patients underwent 169 double-balloon endoscopy （DBE） therapies，and a total of 1 714 polyps were resected by DBE polypectomy. The largest major axis of small-bowel polyp was 8 cm. No severe complications occurred after DBE polypectomy except for 3 cases of intestinal perforation. Eight patients took Celecoxib capsule，3 of them were treated more than 6 months，and DBE examination showed the gastrointestinal polyps reduced in number and size. Conclusion The comprehensive treatment （including of endoscopic therapy，operation，and drug intervention） is a safe and effective clinical model to treat Peutz-Jeghers syndrome．