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Determinants of physical activity and exercise in individuals with mental illness: results from a large cross-sectional online survey

Por: Koepl · K. L. · Wambsganz · A. · Roell · L. · Schwaiger · R. · Fischer · T. · Falkai · P. · Hasan · A. · Schmitt · A. · Maurus · I.
Objective

Regular exercise significantly benefits mental health, yet its therapeutic potential in psychiatric care remains underutilised. Understanding the factors influencing physical activity in individuals with mental illness is crucial to realising its full therapeutic potential. Our study seeks to explore motivational and socio-demographic determinants affecting exercise habits in individuals with mental illness and compare them to those without mental illness.

Design and setting

Distribution of the link to a cross-sectional online survey at psychiatric clinics, practices, university events and sports clubs, via self-help group email lists and on social media.

Methods

An online survey using validated questionnaires supplemented with self-developed items was conducted. Statistical analysis encompassed unpaired t-tests and 2 tests to compare individuals with and without mental illness, as well as multiple linear regression to investigate the relationship between childhood exercise experience, psychometrics and current physical activity behaviour in individuals with mental illness.

Participants

1564 individuals (66.5% female) including 417 diagnosed with any kind of mental illness.

Results

In comparison with mentally healthy participants, individuals diagnosed with mental illness displayed notably lower activity levels (eg, engaging in regular physical activity 55.6% vs 69.3%, x2(1, n=1458) = 26.03, p

Conclusion

There is a dire need for professionally supervised, small group exercise programmes for people with mental illness incorporating cognitive-behavioural elements, to better address their individual needs and to positively influence previously mentioned psychometric determinants. Furthermore, the importance of sport and physical activity in childhood, and especially in adolescence, was reaffirmed, underlining the paramount importance of youth sport programmes in long-term health promotion from a public health perspective.

Canakinumab for the treatment of postprandial hypoglycaemia: study protocol for a randomised, placebo-controlled, parallel-group, double-blind, multicentric, superiority trial--the CanpHy study

Por: Hepprich · M. · Fischer · J. · Cattaneo · M. · Ferreira · A. · Herzig · D. · Bally · L. · Donath · M.
Introduction

Postbariatric hypoglycaemia (PBH) is a complex medical condition with a significant impact on patients’ quality of life. The underlying mechanisms remain to be elucidated. We have shown that food ingestion increases IL-1β and subsequently stimulates insulin secretion. We therefore hypothesised that overactivation of the IL-1β pathway could lead to PBH by promoting excessive insulin secretion after a meal. In a proof-of-concept study, we have shown that acute treatment with the IL-1 receptor antagonist anakinra can attenuate PBH after a single liquid mixed meal. This study aims to validate this therapeutic approach over a longer period of time using the long-acting anti-IL-1β antibody canakinumab.

Methods and analysis

In this prospective, randomised, double-blind, placebo-controlled, multicentre trial, we plan to enrol 62 adult patients after bariatric surgery with frequent, postprandial hypoglycaemia (ie,

Ethics and dissemination

The trial was approved by the Cantonal Ethics Committee ‘Ethikkommission Nordwest- und Zentralschweiz’ in January 2022 (#2021–02325), as well as by Swissmedic in April 2022 (#701280). Current, approved protocol version 1.3 of 28.03.2023. The study is actively recruiting. Results will be published in a relevant scientific journal and communicated to participants and relevant institutions through dissemination activities. Individual data are accessible on request.

Trial registration

The study is registered with the www.clinicaltrials.gov registry (NCT05401578) and the Swiss National Clinical Trials Portal (SNCTP) on www.kofam.ch (SNCTP000004838).

Telemedicine-supported hospital-at-home for acutely admitted patients at Nordsjaellands Hospital, Denmark: a study protocol for a randomised controlled trial

Por: Larsen · M. N. · Dreisig · T. S. · Rasmussen · M. K. · Christensen · M. L. · Bjerregaard · D. · von Sydow · C. D. · Nielsen · T. L. · Fischer · T.
Introduction

The combination of a reduction in the Danish hospital bed count, the shortage of hospital staff and demographic changes challenges the Danish hospital capacity. This was further highlighted during the COVID-19 pandemic when hospitals worldwide were overwhelmed by infected patients requiring acute hospital care. To address these challenges, a hospital-at-home (HaH) programme offers an alternative to conventional in-hospital admission. Furthermore, HaH has the potential to improve patient outcomes, reduce costs and increase patient satisfaction. However, few studies have evaluated HaH in a Scandinavian setting, and this article describes the protocol for a randomised controlled trial (RCT) comparing an HaH model with continued conventional in-hospital admission. The main aim of the trial is to evaluate physical activity level and mental wellbeing in patients admitted at home compared with conventionally admitted patients.

Methods and analysis

110 clinically stable patients from two internal medical wards at Nordsjaellands Hospital in Denmark will be included and randomised in a ratio of 1:1 to either continued conventional in-hospital admission (control group) or virtual HaH model (intervention group). The control group will receive standard hospital treatment, and the intervention group will be transferred home for continued treatment (eg, intravenous antibiotics or oxygen treatment). The primary outcome measures are physical activity assessed using daily step count (during the first 24 hours after inclusion, as an intermediary indicator of the risk of adverse events) and treatment satisfaction (assessed using a patient satisfaction survey). Secondary outcome measures are adverse events of special interest, escalation of care, readmission rate postdischarge (30 days and 90 days), mortality (associated and 7 days, 30 days and 90 days postdischarge), process data (eg, the number of teleconsultations) and a health economic evaluation.

Ethics and dissemination

The study was approved by the Danish Research Ethics Committees (no. 2303051) and the Danish Medicines Agency (CIV-23-03-042542) and will be monitored by the Copenhagen University Hospital Good Clinical Practice unit. Results will be published in peer-reviewed journals and presented at relevant national and international conferences. We also plan to communicate the results to relevant stakeholders in the Danish healthcare system.

Trial registration number

NCT05920304.

Ten sessions of hyperbaric oxygen versus sham treatment in patients with long covid (HOT-LoCO): a randomised, placebo-controlled, double-blind, phase II trial

Por: Kjellberg · A. · Hassler · A. · Boström · E. · El Gharbi · S. · Al-Ezerjawi · S. · Schening · A. · Fischer · K. · Kowalski · J. H. · Rodriguez-Wallberg · K. A. · Bruchfeld · J. · Stahlberg · M. · Nygren-Bonnier · M. · Runold · M. · Lindholm · P.
Objectives

To evaluate if 10 sessions of hyperbaric oxygen treatments (HBOTs) improve short- and long-term health related quality of life, symptoms and physical performance in long covid patients compared with placebo.

Design

Parallel, randomised, placebo-controlled, double-blind trial.

Setting

Single-centre, university hospital, Sweden.

Participants

Previously healthy subjects aged 18–60 years, diagnosed with long covid were included. We excluded pregnant women, patients with RAND-36 (role limitations due to physical health (RP) and physical functioning (PF)) above 70, diabetes, hypertension and contraindications for HBOT.

Interventions

Subjects were randomly assigned to 10 sessions of HBOT or sham (placebo) treatments over 6 weeks. HBOT involved 100% oxygen, 2.4 bar, 90 min, placebo medical air, 1.34–1.2 bar. Randomisation (1:1) was done electronically, in blocks stratified by sex and disease severity. Subjects and investigators were blinded to allocation.

Primary and secondary outcome measures

Primary endpoints were changes from baseline in RAND-36 PF and RP at 13 weeks. Efficacy was analysed on an intention-to-treat basis. Harms were evaluated according to the actual treatment given.

Results

Between 15 September 2021 and 20 June 2023, 80 subjects (65 women, 15 men) were enrolled and randomised (40 in each group). The trial is completed. The primary endpoint analysis included 79 subjects (40 in HBOT and 39 in control). At 13 weeks, both groups showed improvement, with no significant difference between HBOT and placebo in PF (least square mean difference between groups (LSD), 0.63 (95% CI –7.04 to 8.29), p=0.87) and RP (LSD, 2.35 (95% CI –5.95 to 10.66), p=0.57). Harms: 43 adverse events (AEs), most commonly cough and chest pain/discomfort, occurred in 19 subjects (49%) of the HBOT group and 38 AEs in 18 subjects (44%) of the placebo group, one serious AE in HBOT and one death in the placebo group.

Conclusions

10 HBOT sessions did not show more short-term benefits than placebo for long covid patients. Both groups improved, with a notable sex difference. HBOT has a favourable harm profile.

Trial registration number

ClinicalTrials.gov (NCT04842448), EudraCT (2021-000764-30). The trial was funded by Vetenskapsrådet (2022-00834), Region Stockholm (2020-0731, 2022-0674), Hjärt-Lungfonden and OuraHealth Oy.

Impact of antibiotics, iron oxide, and sodium sulfate on microbial community composition in laboratory-built municipal solid waste microcosms

by Judy Malas, Sarah C. Khoury, Michael Tanzillo, Gracie A. Fischer, Jean E. Bogner, D’Arcy R. Meyer-Dombard

Municipal solid waste (MSW) landfills represent underexplored microbial ecosystems. Landfills contain variable amounts of antibiotic and construction and demolition (C&D) wastes, which have the potential to alter microbial metabolism due to biocidal or redox active components, and these effects are largely underexplored. To circumvent the challenge of MSW heterogeneity, we conducted a 65-day time series study on simulated MSW microcosms to assess microbiome changes using 16S rRNA sequencing in response to 1) Fe(OH)3 and 2) Na2SO4 to represent redox active components of C&D waste as well as 3) antibiotics. The addition of Fe(OH)3 altered the overall community composition and increased Shannon diversity and Chao1 richness. The addition of a mixture of seven antibiotics (1000 ng/L each) altered the community composition without affecting diversity metrics. Sulfate addition had little effect on microbial community composition or diversity. These results suggest that the microbial community composition in fresh MSW may be significantly impacted by influxes of iron waste and a single application of antibiotics.
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