INTRODUCTION

The Bachelor of Science in Nursing (BSN) program spans four years and includes general education and professional courses. Student nurses attend lecture hours, clinical duties, and related learning experiences that might be affecting their time in attending to a healthy lifestyle. Health-promoting lifestyle is a multi-dimensional pattern of activities and perceptions that begins with self-motivation and assists in promoting self-improvement and health. The domains of health-promoting lifestyle are essential factors to further improve their way of dealing with daily challenges. Multiple factors can also influence student nurses’ lifestyles, including their separation from family, busy schedules, and dietary choices. A study highlights various factors affecting student nurses' lifestyles, underscoring the need for tailored health promotion strategies and curriculum enhancements. Research into these domains can better equip future healthcare leaders. Gender, year level, and living arrangements influence student nurses' lifestyles, prompting researchers to investigate the extent of health-promoting lifestyles among them and differences based on these factors. By addressing these domains and conducting further research, nursing education and practice can better prepare future healthcare leaders to promote health and lifestyle effectively within their communities.

To determine the extent of health-promoting lifestyle among student nurses and identify the significant differences according to gender, year level, and living arrangement. 

A quantitative, descriptive research design was used with 360 respondents, employing Yamane’s formula and quota sampling. The study adopted the Health-Promoting Lifestyle II questionnaire with a validity of 0.962.

Student nurses often engage in health promoting behaviors (mean=2.56). Male student nurses reported higher scores in health responsibility, physical activity, spiritual growth, and stress management compared to female students (p=0.40). Level IV students engaged in health-promoting activities more frequently than Level I students (p=0.74). Living arrangements did not significantly impact health-promoting lifestyles (p=0.99).

No significant difference in health-promoting lifestyles among student nurses. Respondents demonstrated the least health-promoting lifestyle behaviors in the domains of health responsibility, nutrition, and physical activity. In contrast, spiritual growth, interpersonal relations, and stress management attained the highest mean scores.

Background: Wellness programs can be implemented in a university setting and may include varied elements such as physical activity, occupational balance, and vocal health. However, there is limited information that highlights and synthesizes why and how these programs work. Therefore, this study aimed to understand effective programs on physical activity, occupational balance, and vocal health for university constituents in relation to the implementation contexts, mechanisms, and outcomes (CMO). Methodology: Guided by the Health Belief Model in the context of a realist review design, the researchers conducted an iterative search among seven peer-reviewed electronic databases in the health and education fields using a predetermined set of eligibility criteria. Results: The search identified 6564 records, of which programs from 20 records contributed to data synthesis. Nine CMO statements were created, with physical activity programs accounting for most configurations. Key themes identified were tailored and individualized interventions, medium-term incentivization, lifestyle education programs utilizing information and communications technology, interdisciplinary multi-component programs, use of self-monitoring strategies, social support, and shared experiences among employees and students. Analysis of the mechanisms of these effective university programs revealed processes and structures that were consistent with elements of the Health Belief Model. Conclusion Effective university-based PA programs result from a health-supporting culture among staff and students, utilizing self-based, technological, and social approaches that target and address individual and organizational behaviors in physical activity, occupational balance, and vocal health. This realist review provides practical information that may guide the development of university-based programs and policies targeting these areas of wellness.
Exercise ; Work-Life Balance

INTRODUCTION

COVID-19 is a pandemic that shut down businesses and industries worldwide. The spread of the disease changed social behavior as residents around the world were obliged to endure lockdown and quarantine measures, reducing their physical activity.

To determine the level of physical activity before and during the pandemic among physicians.

A cross-sectional study was carried out on 422 qualified physicians of the Philippine General Hospital, University of the Philippines Manila. The data was obtained from a self-administered questionnaire.

Results of the study revealed a shift of lifestyle from physically active to sedentary in 42.4-57.11% of the respondents during the pandemic. There was no change between the activity levels at work before and during COVID while there was a change in the travel and recreational activities. The results also showed that significant factors including lack of energy, fear of injury, lack of skill, resources, social influences, support seeking activities, and positive alternatives affected their activity levels.

During the pandemic, overall physical activity level decreased. Similarly, factors that motivate health workers to be physically active or sedentary during the COVID-19 pandemic can affect their physical activity levels. Based on this study, the hospital can create guidelines to ensure physical activity among its doctors, especially during a pandemic.

BACKGROUND AND OBJECTIVES

Physical activity (PA) and fitness level are considered key factors in public health promotion, and as such, healthcare workers (HCW) need to be physically well because they are not only responsible for themselves, but of their clients as well. Therefore, we aim to determine the PA and health-related fitness (HRF) level of HCW in a tertiary hospital, disaggregated to age, sex, work assignments, and job tenure.

A cross-sectional research design was utilized to assess HCW from the administrative, medical, nursing, and paramedical cohorts. ALPHA-FIT Test Battery was used to assess cardiorespiratory fitness, muscular strength, lower extremity power and strength, upper body muscle endurance, balance, and body composition.

Our study concurred with the results of previous studies on HCW yielding lower PA levels compared with the general population. We tested 282 participants (administrative: 97; medical: 36; nursing: 55; paramedical: 94), mean age 37.4 years, 64.54% females, 52.13% perceived average health status. Ninety percent of the HCW had PA levels below the World Health Organization’s recommended levels. The ALPHA-FIT mean score per category revealed: one-legged stance, 2.67/3; figure-of-8 run, 2.45/3; shoulder-neck mobility, 4.58/5; modified push-up, 2.05/4; hand-grip strength, 2.5/5; jump and reach, 4/4; dynamic sit-up, 2.62/3; six-minute walk test, 475.38 meters covered. There were no significant differences in PA and HRF levels across cohorts except for modified sit-ups (p < 0.001) and figure-of-8 run (p = 0.012). The results showed significant inverse correlation between balance and shoulder-neck mobility and age (p < 0.001), and modified push ups (p = 0.004). Males had significantly higher sit-up scores (p < 0.001), one-legged stance scores (p = 0.001), and faster figure-of-8 run (p = 0.011), while females had better jump and reach scores (p < 0.001).

Physical activity levels of HCW did not meet the World Health Organization’s recommended PA levels. Healthcare professionals who are expected to be aware of the benefits of PA and HRF have shown low to midfit levels of grip strength, upper extremity endurance, core strength, and cardiorespiratory endurance. Information on PA and HRF may aid in policy making on employee wellness that could highly impact health service delivery.

BACKGROUND AND OBJECTIVES

The built environment or physical environment consists of surroundings and conditions constructed by human activity. It includes urban design, neighborhoods, transportation, and smaller scale structures like the design and layout of rooms within buildings. The built environment can affect the physical, social, and functional wellbeing of older adults, both within their own homes and in the neighborhoods in which they live, and additionally plays a part in promoting healthy aging. This narrative review of the literature aims to present the ways in which the built environment can influence the functional ability of community-dwelling older adults, and affect their ability to live independently and age in place.

Narrative literature review and inductive thematic analysis.

Forty-five full-text, English language publications from peer-reviewed sources were selected for this review, with the majority (35) presenting quantitative research findings and originating from North America (28). Older adults in rural and developing countries were underrepresented in the literature, despite acknowledgement that health of the aging population is a worldwide problem. Three major themes emerged. First, the built environment affects older adults in the most fundamental way at home through design considerations, modifications, and technological advances promoting aging in place and accessibility. Secondly, built environments outside the home can affect older adults’ physical activity and overall function with regard to mobility, transportation, and activities of daily living. The majority (22 of 45 publications) focused on this theme. Finally, the built environment in neighborhoods can affect older adults’ perception of social support, their social participation, and quality of life.

As the built environment is created by humans and can be substantially modified, it possesses considerable potential for enhancing functional ability, social participation, and overall quality of life in community-dwelling older adults. It is possible to design a better person-environment fit, promoting safety, independence, optimal health, and quality of life. In order to support healthy aging, improvements in the built environment need to be accompanied by appropriate health and social policies, systems, and services. These changes require political will, as well as material resources that may not be readily available especially in the global South. A socioecological approach with adequate resources directed to older adults’ health and healthcare is necessary in order to achieve the ultimate goal of healthy aging in this population.

OBJECTIVES

To compare the effectiveness of different exercise interventions on improving adiposity-related inflammatory markers of metabolically healthy obese (MHO) adults.

This is a systematic review with meta-analysis of randomized controlled trials (RCTs) and quasi-experimental studies on the effects of exercise interventions in the inflammatory markers of sedentary adults with MHO phenotype. Systematic searches were performed in PubMed, Cochrane, CINAHL, and OVID from January 2021 to January 2022. The included studies were from 2000 to 2021. The inclusion criteria included: a) adults with obese phenotype, b) has physical activity or exercise as intervention, and c) inflammatory markers as outcome measure. Exclusion criteria included: a) pregnant women, b) adults with cardiovascular conditions or taking medications, c) participants having central obesity. The review was registered on PROSPERO (CRD42021249661). Risk of bias (RoB) assessment was performed using Revised Cochrane RoB tool for RCTs, and ROBINS-I tool for quasi-experimental studies. A metaanalysis was performed for inflammatory markers and body composition measurements using random effects model with forest plots presenting mean differences (MD) of outcome measures with 95% CI.

Twenty-one RCTs and seven quasi-experimental studies with 1,117 participants were included in the review. For short-term intervention, aerobic exercises showed an increased trend in IL-6 levels, and both resistance and aerobic exercises reduced TNF-alpha and CRP levels, respectively. For long-term exercises, aerobic exercises showed a significant reduction in CRP (MD= -0.33, 95%CI, -0.57 to -0.09, p=0.006). Long-term concurrent training also showed a significant reduction in TNF-alpha (MD= -2.65, 95%CI, -4.13 to -1.18; p=0.0004). Meta-regression also found no direct association between body weight and fat mass, and changes in inflammatory markers.

Concurrent and aerobic exercises were both effective in reducing pro-inflammatory markers. Concurrent training was more effective in reducing BMI, body fat composition, and CRP compared to aerobic and resistance exercises. Furthermore, middle-aged women benefited from aerobic exercises to reduce IL-6 levels. These results indicate the need for both resistance and aerobic exercise in improving inflammatory levels of the body. This review has limitations in terms of degree of heterogeneity brought by different exercise protocol and assessment of inflammatory markers. More research is needed to identify possible outcome measures that can predict chronic inflammation in MHO people.

Background and Objective: Hypertension is a major health issue worldwide, with primary schoolteachers possessing several lifestyle risks of the disease. There have not been any health promotion programs yet for primary schoolteachers in Indonesia, especially for blood pressure control. A school-based model of workplace wellness program for teachers was developed. It focused on using screening as feedback in controlling blood pressure by eating a healthy diet, doing physical activity, and having regular checks. This study aimed to assess its clinical and behavioral effects. Methods: This trial was a one group pre- and post-test study design without control. It was implemented purposively in three public primary school locations in Jakarta to 44 eligible teachers for approximately three months from January to March 2022. The workplace wellness program included on-site screening (blood pressure, body mass index/BMI, spot urine sodium-creatinine ratio), knowledge, motivation, and ongoing health behavior (physical activity and the dietary approach to stop hypertension/DASH), online education/training, consultation/counseling sessions with a family doctor, and self-monitoring. All screening measurements were repeated at the end of the program. A paired t-test or Wilcoxon analysis was performed using SPSS 20.0. Results: Both systolic and diastolic blood pressure decreased by 5.05 mmHg (p = 0.018) and 6.41 mmHg (p < 0.001), respectively. The spot urine sodium-creatinine ratio and BMI decreased slightly but not significant (p = 0.707; p = 0.761). Knowledge and motivation increased slightly but not significant (p = 0.529; p = 0.175). The DASH behavior significantly increased by 25% (p < 0.001). Though the overall physical activity did not change, the walking activity increased twofold significantly (p = 0.006). This study also showed that the outcome would be achieved when the participant followed the recommendations obediently. Conclusion This school-based workplace wellness program was found to have a potential effect on controlling blood pressure by changing health behaviors. A randomized controlled trial is recommended to provide stronger evidence on its effectiveness before doing a large-scale implementation in primary schools in Indonesia.
Health Promotion ; Hypertension ; Exercise ; DASH diet ; Dietary Approaches To Stop Hypertension

Parkinson disease （PD） is a neurodegenerative disease caused by the degeneration and loss of dopaminergic neurons and is characterized by bradykinesia， myotonia， resting tremor， and abnormal gait and posture. Medication has been the main therapy for PD in clinical practice； however， long-term medication can cause motor fluctuations and dopamine dysregulation syndrome. Exercise， as an adjuvant therapy for PD that runs through the whole process of PD treatment， can not only improve the motor and non-motor symptoms of PD patients， but also reduce the dose and adverse reactions of drugs for PD. In recent years， exercise has become a hot topic in PD treatment in China and globally， including tai chi， Baduanjin exercise， virtual reality， dance， yoga， progressive resistance training， hydrotherapy， and aerobic treadmill exercise. This article reviews the effect of the above exercises on PD.
Parkinson Disease ; Exercise

OBJECTIVE: To observe the effect of acupuncture exercise therapy synchronizing isokinetic muscle strength training on the motor function, stability and proprioception of knee joint, as well as the anxiety emotion in patients after meniscectomy under arthroscopy. METHODS: A total of 70 patients after meniscectomy under arthroscopy were randomized into an observation group (35 cases, 2 cases were eliminated， 2 cases dropped off) and a control group (35 cases, 2 cases were eliminated, 1 case dropped off). Acupuncture was applied at Chize (LU 5), Neixiyan (EX-LE 4), Dubi (ST 35),Yanglingquan (GB 34), etc. on the affective side in the two groups. After 30 min, the needles of the knee joint area were withdrew, while the needle at elbow was continuously retained, the observation group was given acupuncture exercise therapy synchronizing isokinetic muscle strength training, and the control group was given conventional acupuncture exercise therapy. The treatment was given once a day, 7-day treatment was taken as one course, and totally 4 courses were required in the two groups. Before and after treatment, the knee joint Lysholm score, the knee joint isokinetic muscle strength flexion/extension ratio (H/Q), joint position sense measurement (JPS) and Hamilton anxiety scale (HAMA) score were compared in the two groups. RESULTS: After treatment, the knee joint Lysholm scores and H/Q were increased compared with those before treatment in the two groups (P<0.001), and the knee joint Lysholm score and H/Q in the observation group were higher than those in the control group (P<0.001); the JPS and HAMA scores were decreased compared with those before treatment in the two groups (P<0.001), the JPS and HAMA score in the observation group were lower than those in the control group (P<0.05). CONCLUSION Acupuncture exercise therapy synchronizing isokinetic muscle strength training can effectively improve the motor function, stability and proprioception of knee joint, as well as the anxiety emotion in patients after meniscectomy under arthroscopy.
Humans ; Arthroscopy ; Meniscectomy ; Resistance Training ; Treatment Outcome ; Osteoarthritis, Knee/therapy* ; Acupuncture Therapy ; Exercise Therapy ; Muscles ; Muscle Strength ; Acupuncture Points

OBJECTIVES: To compare the effects of electroacupuncture (EA) with different time intervals on corticospinal excitability of the primary motor cortex (M1) and the upper limb motor function in healthy subjects and observe the after-effect rule of acupuncture. METHODS: Self-comparison before and after intervention design was adopted. Fifteen healthy subjects were included and all of them received three stages of trial observation, namely EA₀ group (received one session of EA), EA_6h group (received two sessions of EA within 1 day, with an interval of 6 h) and EA_48h group (received two sessions of EA within 3 days, with an interval of 48 h). The washout period among stages was 1 week. In each group, the needles were inserted perpendicularly at Hegu (LI 4) on the left side, 23 mm in depth and at a non-acupoint, 0.5 cm nearby to the left side of Hegu (LI 4), separately. Han's acupoint nerve stimulator (HANS-200A) was attached to these two needles, with continuous wave and the frequency of 2 Hz. The stimulation intensity was exerted higher than the exercise threshold (local muscle twitching was visible, and pain was tolerable by healthy subjects, 1-2 mA ). The needles were retained for 30 min. Using the single pulse mode of transcranial magnetic stimulation (TMS) technique, before the first session of EA (T0) and at the moment (T1), in 2 h (T2) and 24 h (T3) after the end of the last session of EA, on the left first dorsal interosseous muscle, the amplitude, latency (LAT), resting motor threshold (rMT) of motor evoked potentials (MEPs) and the completion time of grooved pegboard test (GPT) were detected. Besides, in the EA_6h group, TMS was adopted to detect the excitability of M1 (amplitude, LAT and rMT of MEPs) before the last session of EA (T0*). RESULTS: The amplitude of MEPs at T1 and T2 in the EA₀ group, at T0* in the EA_6h group and at T1, T2 and T3 in the EA_48h group was higher when compared with the value at T0 in each group separately (P<0.001). At T1, the amplitude of MEPs in the EA₀ group and the EA_48h group was higher than that in the EA_6h group (P<0.001, P<0.01); at T2, it was higher in the EA₀ group when compared with that in the EA_6h group (P<0.01); at T3, the amplitude in the EA₀ group and the EA_6h group was lower than that of the EA_48h group (P<0.001). The LAT at T1 was shorter than that at T0 in the three groups (P<0.05), and the changes were not obvious at the rest time points compared with that at T0 (P > 0.05). The GPT completion time of healthy subjects in the EA₀ group and the EA_48h group at T1, T2 and T3 was reduced in comparison with that at T0 (P<0.001). The completion time at T3 was shorter than that at T0 in the EA_6h group (P<0.05); at T2, it was reduced in the EA_48h group when compared with that of the EA_6h group (P<0.05). There were no significant differences in rMT among the three groups and within each group (P>0.05). CONCLUSIONS Under physiological conditions, EA has obvious after-effect on corticospinal excitability and upper limb motor function. The short-term interval protocol (6 h) blocks the after-effect of EA to a certain extent, while the long-term interval protocol (48 h) prolongs the after-effect of EA.
Humans ; Electroacupuncture ; Motor Cortex/physiology* ; Transcranial Magnetic Stimulation/methods* ; Upper Extremity ; Exercise ; Muscle, Skeletal/physiology*