Shuyuan Huang

Abstract

Introduction: The aim of this study was to explore the associations among physical activity (PA), inflammatory markers, and quality of life (QoL) from preradiotherapy to 1-year postradiotherapy for patients with head and neck cancer (HNC). Methods: This was an observational longitudinal study. Mixed-effect models incorporating within-subject correlation were used to examine the relationship among the three key variables. Results: Aerobically active patients had significantly lower levels of sTNFR2 (but not other inflammatory markers) than aerobically inactive patients. Being aerobically active and lower inflammation were independently associated with better total QoL scores after adjusting covariates. The trend was similar for patients engaged in strength exercises. Conclusions: Being aerobically active was associated with lower inflammation as represented by sTNFR2 but not with other inflammatory markers. Higher PA (aerobic and strength) and lower inflammation were linked to better QoL. More research is warranted to validate the association among PA, inflammation, and QoL.

Abstract

Background: Pregnant women with gestational diabetes mellitus (GDM) have a higher risk of developing elevated depressive symptoms than women without GDM. The aim of this study was to investigate the sociodemographic (eg, location), clinical (eg, health care–seeking behaviors), and psychological (eg, active coping skills) factors associated with elevated depressive symptoms in Chinese women with GDM. Methods: This was a secondary data analysis of a cross-sectional study among Chinese women with GDM. Data (n = 323) were collected in 2018 from two hospitals in Hunan Province in China. The Center for Epidemiological Survey Depression Scale was used, with a criterion score ≥20 indicative of clinically elevated depressive symptoms. Descriptive, bivariate, and multiple logistic regression analyses were completed. Findings: The women had a mean age of 32.71 (SD = 5.17), and the majority were married (84.2%), college-educated (65.6%), and with Han ethnicity (89.8%). About 68% of women had elevated depressive symptoms. Women with higher active coping scores were less likely (OR = 0.19, 95% CI: 0.10-0.38) to have elevated depressive symptoms. Women from one geographical location (Changde) who had more emergency room visits had higher odds (OR = 3.10, 95% CI: 1.88-5.10) of elevated depressive symptoms. Discussion: There was a high co-occurrence of GDM and elevated depressive symptoms among pregnant women in our sample. Assessment for depressive symptoms in women with GDM is warranted. More research about increasing active coping skills may improve health outcomes in women with GDM.

Abstract

Certain dietary patterns are associated with an increased risk of obesity and its comorbidities. However, these associations vary across populations. The prevalence of obesity has been rising amid a drastic nutrition transition in China during the country’s rapid economic growth. This systematic review and meta-analysis were conducted to summarize how dietary patterns are associated with obesity in the Chinese population. We searched for articles from 1 January 2000 to 1 February 2022 in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus that assessed the relationship between dietary patterns and obesity outcomes. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using a random effects model. From the 2556 articles identified from the search, 23 articles were included in the analysis. We found that the traditional Chinese dietary pattern was associated with a lower risk of overweight/obesity (OR = 0.69, 95% CI: 0.57, 0.84, p < 0.001), whereas the Western dietary pattern was associated with a higher OR of overweight/obesity, but not reaching statistical significance (OR = 1.34, 95% CI: 0.98, 1.84, p = 0.07). There were inconsistent results for other dietary patterns, such as meat/animal protein and plant/vegetarian patterns. In conclusion, the traditional Chinese diet characterized by vegetables, rice, and meat was associated with a lower risk of obesity. The heterogeneity in characterizing dietary patterns contributes to the inconsistency of how dietary patterns are associated with obesity in the Chinese population.

Abstract

Chinese immigrants in the US are disproportionately affected by gestational diabetes mellitus (GDM) and type 2 diabetes (T2D). The aims of this study were to describe their physical activity (PA) and sedentary behaviors (SB) patterns and to identify determinates of objectively-measured PA and SB among Chinese immigrants in the US with prior GDM. We conducted a cross-sectional study among 106 Chinese immigrants with prior GDM across the US. PA and SB were measured by GT9X+ hip accelerometers for 7 consecutive days. Validated questionnaires in English and Chinese were used to assess knowledge and risk perceptions as well as cultural and psychosocial characteristics. Descriptive, bivariate, and multiple regression analyses were performed. Only 27% of participants met the PA guidelines. The median duration of moderate–vigorous-intensity PA (MVPA) per week was 79 (IQR 38–151) minutes. Participants had an average of 9.2 ± 1.4 h of sedentary time per day. Living with parents (who may provide family support) was associated with more MVPA minutes per week, more steps per day, and a greater likelihood of meeting PA guidelines. Higher levels of acculturative stress were associated with fewer MVPA minutes per week. Being employed and having a lower BMI were associated with more SB. Strategies are needed to increase MVPA among this high-risk group, including decreasing acculturative stress and increasing family support. Different strategies are needed to decrease SB among this population.

Abstract

Objective: To examine the characteristics and effectiveness of lifestyle interventions for gestational diabetes mellitus (GDM) in pregnancy and the postpartum period to prevent Type 2 diabetes. Data Sources: We conducted searches in seven databases, including Ovid MEDLINE, CINAHL, Ovid Embase, Cochrane Central, Web of Science, Ovid PsycInfo, and ProQuest Dissertations and Theses for articles published from inception to January 2021. Study Selection: We included articles on controlled intervention studies in which researchers evaluated a lifestyle intervention provided during pregnancy and the postpartum period for women with or at risk for GDM that were published in English. Data Extraction: Twelve articles that were reports of seven studies met the inclusion criteria. In some cases, more than one article was selected from the same study. For example, articles reported different outcomes from the same study. We extracted data with the use of a data collection form and compared and synthesized data on study design, purpose, sample, intervention characteristics, recruitment and retention, and outcomes. Data Synthesis: All seven studies focused on weight management and/or healthy lifestyle behaviors (diet and physical activity). Outcomes included glucose regulation, weight, lifestyle behaviors, and knowledge. The interventions varied in duration/dosage, strategies, and modes of delivery. In four studies, researchers reported interventions that had significant effects on improving glucose regulation and/or weight change. Some characteristics from the four effective interventions included goal setting, individualized care, and good retention rates. In the other three studies, limitations included low rates of participant retention, lack of personalized interventions, and limited population diversity or lack of culturally sensitive care. Conclusion: Lifestyle interventions provided during and after pregnancy to reduce the risk associated with GDM have the potential to improve outcomes. Health care counseling to promote healthy lifestyle behaviors related to the prevention of Type 2 diabetes is needed at different stages of maternity care for women with GDM. Additional high-quality studies are needed to address the limitations of current studies.

Abstract

Although parental HIV disclosure has benefits for parents and children, the disclosure rate among parents remains low. This study aims to qualitatively examine parental concerns regarding disclosure of their HIV status to their children. Eighty parents were enrolled in a randomized controlled trial of a three-session disclosure-support intervention, with forty receiving the intervention and forty receiving treatment as usual. Intervention sessions were audio recorded, and transcriptions were qualitatively coded for content related to concerns of disclosure. Four themes emerged: Intention to disclose, disclosure approach, indicators for disclosure, and fears about disclosure. These themes reveal struggles that parents experience when considering HIV disclosure suggesting that an effective disclosure intervention must help parents assess pros and cons, discuss the emotions of the children after the disclosure, and monitor the impact on children’s lives after disclosure over time. Future research is needed to implement interventions supporting HIV-positive parents’ disclosure decision-making and actions.

Abstract

Aim: The objective of this systematic review was to summarize the ecological momentary assessment (EMA) methodology and associations between EMA-measured psychosocial, contextual factors and diabetes self-management. Methods: The inclusion criteria were: research of EMA and diabetes self-management behaviors such as glucose checks, administration of insulin and eating-and dietary intake behaviors among persons with diabetes. A comprehensive search of several databases was conducted across all dates until July 2020. Results: A modified Checklist for Reporting EMA Studies was used to assess the quality of studies. Among the ten included studies, participants were predominantly White adolescents with type 1 diabetes (T1D) and type 2 diabetes was studied in two studies. Time-varying, psychosocial contexts such as negative affect or negative social interaction were associated with missed insulin injection and poor adherence to glucose check. More preceding psychological stress was associated with more calorie intake from snacks or binge eating behaviors. Mornings were the most challenging time of day for adherence to diabetes self-management among adolescents with T1D. Intentional insulin withholding was more common in the afternoon in adults with T1D. Conclusions: EMA has potential clinical utility in the assessment of diabetes self-management and in the development of timely and individualized diabetes interventions.

Abstract

Objective: The purpose of this systematic review is to explore the effect of interventions involving social networks on self-management and quality of life in adults with diabetes. Introduction: There is growing evidence that interventions involving social networks have a positive impact on people with diabetes through social support and social participation. However, the existing literature or protocols relate to only one type of diabetes, a certain population, or one type of intervention involving social networks. This study will comprehensively assess the impact of interventions involving social networks on self-management and quality of life for all types of diabetes. Inclusion criteria: This study will consider studies that compare interventions involving the social networks (families, friends and peers) of adults with all types of diabetes with interventions that do not involve social networks. Methods: We plan to collect relevant randomized and non-randomized controlled trials for systematic evaluation and meta-analysis by searching PubMed, Embase, Web of Science, CINAHL Complete, Cochrane Central Register of Controlled Trials, ProQuest Dissertations and Theses, and Google Scholar. Studies published in English from database inception to the present will be included. After the search, two researchers will independently screen the literature according to inclusion and exclusion criteria, evaluate the selected literature critically and extract the relevant data required, then meta-analysis will be performed using Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information. Systematic review registration number: PROSPERO CRD42019135949.