ABSTRACT
OBJECTIVE: To examine existing research on pulmonary exercise rehabilitation (PR) maintenance interventions. METHODS: Authors conducted a systematic review of PR maintenance interventions. The primary outcome of interest was physical endurance. RESULTS: Eight studies met inclusion criteria. Most showed initial positive intervention effects, which declined to non-significance within 3-12 months after completion of maintenance. Only one of the 8 studies described a theoretical framework underlying the maintenance intervention. CONCLUSIONS: Existing interventions generally fail to maintain benefits derived from PR programs. Future studies should evaluate maintenance interventions that are theoretically-based and seek to impact known maintenance mediators. Evaluation of these interventions should include substantial follow-up periods and adherence measurements.
Subject(s)
Exercise Therapy , Patient Compliance , Pulmonary Disease, Chronic Obstructive/rehabilitation , Bias , Female , Humans , MaleABSTRACT
The benefit of routine prostate cancer screening is currently under debate; however, many experts recommend that men with elevated risk for the disease discuss the potential risks and benefits of screening with their health care team. Psychological factors have been negatively associated with preventive health behaviors such as cancer screenings. The purpose of this study was to investigate the impact of depressive and trauma-related symptoms on prostate cancer screening behaviors and relevant health care perceptions among a sample of U.S. military veterans, as veterans are at higher risk for prostate cancer, depression, and posttraumatic stress disorder than the general population. Participants (n = 350) were a national sample of predominantly Caucasian (84.6%) male U.S. military veterans (60.5 years ± 8.9) who completed an online questionnaire regarding past prostate cancer screening engagement, as well as validated measures of depression, posttraumatic stress disorder, and perceived barriers and benefits to prostate cancer screening. Results indicate that greater depressive symptoms, trauma-related symptoms, and perceived barriers were associated with lower rates of past prostate cancer screening among this veteran sample and that greater depressive and trauma-related symptoms were associated with greater perceived barriers to prostate cancer screening. As prostate cancer screening recommendations continue to evolve, it is important for health care providers not only to discuss pros and cons of screening with high risk men but also to consider the impact of psychological distress on the decision-making process.
Subject(s)
Depression/psychology , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/psychology , Stress Disorders, Post-Traumatic , Veterans/psychology , Adult , Aged , Aged, 80 and over , Health Behavior , Humans , Male , Middle Aged , Surveys and Questionnaires , United StatesABSTRACT
BACKGROUND: Prior studies have documented elevated symptoms of depression among patients undergoing gastric bypass surgery, in addition to significant elevations of inflammatory markers including C-reactive protein (CRP) and interleukin-6 (IL-6). No prior study has examined the relationship of changes in depression with change in inflammation among patients undergoing gastric bypass surgery. This pilot study was designed to examine the relationship of inflammation and depression among gastric bypass patients in a 12-month longitudinal study. METHODS: 13 Caucasian women (mean age 46.9 +/- 5.7 years) who were scheduled to undergo a Roux-en-Y gastric bypass (RYGBP) were recruited prior to surgery for measurement of body mass and blood markers of inflammation, as well as self-report measures of depression, quality of life, and disordered eating. 12 months later, subjects completed the same battery of physiological and psychological measures. Data were analyzed with paired t-tests and Pearson correlations. RESULTS: In addition to significant reductions in BMI (P < .001), participants experienced significant reductions in CRP (P < .001), IL-6 (P = .002), and depressive symptoms (P = .025). Reductions also were observed in binge eating (P = .005). Decreased depression during the 12-month follow-up was highly correlated with reduced CRP (r = .98, P < .001). CONCLUSIONS: Results from this pilot study indicate that RYGBP is associated with significant reductions in inflammatory markers of cardiovascular disease risk (e.g., CRP, IL-6) and depressive symptoms, in addition to reductions in weight. Results suggested that reductions in depression were associated with the observed decreases in inflammation.
