Cybersecurity challenges in blockchain technology : a scoping review
- Mahmood, Samreen, Chadhar, Mehmood, Firmin, Sally
- Authors: Mahmood, Samreen , Chadhar, Mehmood , Firmin, Sally
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Human Behavior and Emerging Technologies Vol. 2022, no. (2022), p.
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- Description: Blockchain technology (BCT) is an emerging technology. Cybersecurity challenges in BCT are being explored to add greater value to business processes and reshape business operations. This scoping review paper was aimed at exploring the current literature's scope and categorizing various types of cybersecurity challenges in BCT. Databases such as Elsevier, ResearchGate, IEEE, ScienceDirect, and ABI/INFORM Collection (ProQuest) were searched using a combination of terms, and after rigorous screening, 51 research studies were found relevant. Data coding was performed following a framework proposed for scoping review. After careful analysis, thirty different types of cybersecurity challenges in BCT were categorized into six standardized classes. Our results show that most of the studies disclose cybersecurity challenges in BCT generally without pointing to any specific industry sector, and to a very little extent, few papers reveal cybersecurity challenges in BCT related to specific industry sectors. Also, prior studies barely investigated the strategies to minimize cybersecurity challenges in BCT. Based on gap identification, future research avenues were proposed for scholars.
- Authors: Mahmood, Samreen , Chadhar, Mehmood , Firmin, Sally
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Human Behavior and Emerging Technologies Vol. 2022, no. (2022), p.
- Full Text:
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- Description: Blockchain technology (BCT) is an emerging technology. Cybersecurity challenges in BCT are being explored to add greater value to business processes and reshape business operations. This scoping review paper was aimed at exploring the current literature's scope and categorizing various types of cybersecurity challenges in BCT. Databases such as Elsevier, ResearchGate, IEEE, ScienceDirect, and ABI/INFORM Collection (ProQuest) were searched using a combination of terms, and after rigorous screening, 51 research studies were found relevant. Data coding was performed following a framework proposed for scoping review. After careful analysis, thirty different types of cybersecurity challenges in BCT were categorized into six standardized classes. Our results show that most of the studies disclose cybersecurity challenges in BCT generally without pointing to any specific industry sector, and to a very little extent, few papers reveal cybersecurity challenges in BCT related to specific industry sectors. Also, prior studies barely investigated the strategies to minimize cybersecurity challenges in BCT. Based on gap identification, future research avenues were proposed for scholars.
Defining timeliness in care for patients with lung cancer : a scoping review
- Ansar, Adnan, Lewis, Virginia, McDonald, Christine, Liu, Chaojie, Rahman, Muhammad Aziz
- Authors: Ansar, Adnan , Lewis, Virginia , McDonald, Christine , Liu, Chaojie , Rahman, Muhammad Aziz
- Date: 2022
- Type: Text , Journal article , Review
- Relation: BMJ Open Vol. 12, no. 4 (2022), p.
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- Description: Objectives Early diagnosis and reducing the time taken to achieve each step of lung cancer care is essential. This scoping review aimed to examine time points and intervals used to measure timeliness and to critically assess how they are defined by existing studies of the care seeking pathway for lung cancer. Methods This scoping review was guided by the methodological framework for scoping reviews by Arksey and O'Malley. MEDLINE, EMBASE, CINAHL and PsycINFO electronic databases were searched for articles published between 1999 and 2019. After duplicate removal, all publications went through title and abstract screening followed by full text review and inclusion of articles in the review against the selection criteria. A narrative synthesis describes the time points, intervals and measurement guidelines used by the included articles. Results A total of 2113 articles were identified from the initial search. Finally, 68 articles were included for data charting process. Eight time points and 14 intervals were identified as the most common events researched by the articles. Eighteen different lung cancer care guidelines were used to benchmark intervals in the included articles; all were developed in Western countries. The British Thoracic Society guideline was the most frequently used guideline (20%). Western guidelines were used by the studies in Asian countries despite differences in the health system structure. Conclusion This review identified substantial variations in definitions of some of the intervals used to describe timeliness of care for lung cancer. The differences in healthcare delivery systems of Asian and Western countries, and between high-income countries and low-income-middle-income countries may suggest different sets of time points and intervals need to be developed. ©
- Authors: Ansar, Adnan , Lewis, Virginia , McDonald, Christine , Liu, Chaojie , Rahman, Muhammad Aziz
- Date: 2022
- Type: Text , Journal article , Review
- Relation: BMJ Open Vol. 12, no. 4 (2022), p.
- Full Text:
- Reviewed:
- Description: Objectives Early diagnosis and reducing the time taken to achieve each step of lung cancer care is essential. This scoping review aimed to examine time points and intervals used to measure timeliness and to critically assess how they are defined by existing studies of the care seeking pathway for lung cancer. Methods This scoping review was guided by the methodological framework for scoping reviews by Arksey and O'Malley. MEDLINE, EMBASE, CINAHL and PsycINFO electronic databases were searched for articles published between 1999 and 2019. After duplicate removal, all publications went through title and abstract screening followed by full text review and inclusion of articles in the review against the selection criteria. A narrative synthesis describes the time points, intervals and measurement guidelines used by the included articles. Results A total of 2113 articles were identified from the initial search. Finally, 68 articles were included for data charting process. Eight time points and 14 intervals were identified as the most common events researched by the articles. Eighteen different lung cancer care guidelines were used to benchmark intervals in the included articles; all were developed in Western countries. The British Thoracic Society guideline was the most frequently used guideline (20%). Western guidelines were used by the studies in Asian countries despite differences in the health system structure. Conclusion This review identified substantial variations in definitions of some of the intervals used to describe timeliness of care for lung cancer. The differences in healthcare delivery systems of Asian and Western countries, and between high-income countries and low-income-middle-income countries may suggest different sets of time points and intervals need to be developed. ©
Diet and exercise advice and referrals for cancer survivors : an integrative review of medical and nursing perspectives
- Joseph, Ria, Hart, Nicolas, Bradford, Natalie, Agbejule, Oluwaseyifunmi, Koczwara, Bogda, Chan, Alexandre, Wallen, Matthew, Chan, Raymond
- Authors: Joseph, Ria , Hart, Nicolas , Bradford, Natalie , Agbejule, Oluwaseyifunmi , Koczwara, Bogda , Chan, Alexandre , Wallen, Matthew , Chan, Raymond
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Supportive Care in Cancer Vol. 30, no. 10 (2022), p. 8429-8439
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- Description: Purpose: To examine the perspectives of medical and nursing health professionals concerning their roles and responsibilities in providing dietary and exercise advice to cancer survivors, and referrals to allied health professionals. Methods: An integrative review. PubMed, CINAHL, PsycINFO, Embase, Web of Science databases, and bibliographies of relevant studies were searched from December 2011 to June 2021. All studies were eligible for inclusion. The Mixed-Methods Appraisal Tool (MMAT) was used to critically appraise included studies. Data were extracted and synthesised regarding the perspectives of medical and nursing health professionals on their roles, responsibilities, barriers, and facilitators. Results: Twenty-one studies involving 3401 medical and nursing health professionals and 264 cancer survivors of diverse cancer types were included. Ten quantitative, nine qualitative, and two mixed-methods studies were eligible. All included studies met at least 80% of the quality criteria in the MMAT. Major findings include the following: (1) medical and nursing health professionals were unclear on their roles in providing dietary and exercise advice to cancer survivors but agreed they play a key role in referrals to dietitians and exercise professionals; (2) most cancer survivors valued the involvement of their general practitioner when receiving dietary and exercise advice. Conclusion: Although medical and nursing health professionals understand that referrals to allied health professionals form part of their role, there is a lack of clarity regarding their roles to provide dietary and exercise advice to cancer survivors. Future studies should address barriers and facilitators of dietary and exercise advice and referral by medical and nursing health professionals. © 2022, Crown.
- Authors: Joseph, Ria , Hart, Nicolas , Bradford, Natalie , Agbejule, Oluwaseyifunmi , Koczwara, Bogda , Chan, Alexandre , Wallen, Matthew , Chan, Raymond
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Supportive Care in Cancer Vol. 30, no. 10 (2022), p. 8429-8439
- Full Text:
- Reviewed:
- Description: Purpose: To examine the perspectives of medical and nursing health professionals concerning their roles and responsibilities in providing dietary and exercise advice to cancer survivors, and referrals to allied health professionals. Methods: An integrative review. PubMed, CINAHL, PsycINFO, Embase, Web of Science databases, and bibliographies of relevant studies were searched from December 2011 to June 2021. All studies were eligible for inclusion. The Mixed-Methods Appraisal Tool (MMAT) was used to critically appraise included studies. Data were extracted and synthesised regarding the perspectives of medical and nursing health professionals on their roles, responsibilities, barriers, and facilitators. Results: Twenty-one studies involving 3401 medical and nursing health professionals and 264 cancer survivors of diverse cancer types were included. Ten quantitative, nine qualitative, and two mixed-methods studies were eligible. All included studies met at least 80% of the quality criteria in the MMAT. Major findings include the following: (1) medical and nursing health professionals were unclear on their roles in providing dietary and exercise advice to cancer survivors but agreed they play a key role in referrals to dietitians and exercise professionals; (2) most cancer survivors valued the involvement of their general practitioner when receiving dietary and exercise advice. Conclusion: Although medical and nursing health professionals understand that referrals to allied health professionals form part of their role, there is a lack of clarity regarding their roles to provide dietary and exercise advice to cancer survivors. Future studies should address barriers and facilitators of dietary and exercise advice and referral by medical and nursing health professionals. © 2022, Crown.
Dietary supplements in people with metastatic cancer who are experiencing malnutrition, cachexia, sarcopenia, and frailty : a scoping review
- Johal, Jolyn, Han, Chad, Joseph, Ria, Munn, Zachary, Agbejule, Oluwaseyifunmi, Crawford‐Williams, Fiona, Wallen, Matthew, Chan, Raymond, Hart, Nicolas
- Authors: Johal, Jolyn , Han, Chad , Joseph, Ria , Munn, Zachary , Agbejule, Oluwaseyifunmi , Crawford‐Williams, Fiona , Wallen, Matthew , Chan, Raymond , Hart, Nicolas
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Nutrients Vol. 14, no. 13 (2022), p.
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- Description: Cancer‐associated malnutrition, or cachexia, stemming from cancer or its treatments, is particularly prevalent in metastatic cancers, and is often interrelated with sarcopenia and frailty. Evidence suggests that dietary supplements play a role in managing these conditions. As metastatic cancer cells are associated with notable genomic and phenotypic alterations, response to dietary supplements may differ between metastatic and non‐metastatic cancers. However, research in this area is lacking. This scoping review aims to identify the dietary supplements that have been studied in patients with metastatic cancers and malnutrition‐related conditions, along with their proposed effects, mechanisms, outcome measures, and tools used. A systematic search was conducted across databases, including MEDLINE, EMBASE, CINAHL, and clinical trial registries. Of the initial 6535 records screened, a total of 48 studies were included, covering a range of dietary supplements— vitamins, minerals, antioxidants, proteins, amino acids, fatty acids, fiber, and others. While the types of dietary supplements included varied across cancer types, omega‐3 and carnitine were investigated most often. Proposed relevant attributes of dietary supplements included their antioxidant, anti‐inflammatory, anti‐cancer, and immunomodulatory properties. Overall, there was a paucity of interventional studies, and more randomized controlled trials are warranted. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
- Authors: Johal, Jolyn , Han, Chad , Joseph, Ria , Munn, Zachary , Agbejule, Oluwaseyifunmi , Crawford‐Williams, Fiona , Wallen, Matthew , Chan, Raymond , Hart, Nicolas
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Nutrients Vol. 14, no. 13 (2022), p.
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- Description: Cancer‐associated malnutrition, or cachexia, stemming from cancer or its treatments, is particularly prevalent in metastatic cancers, and is often interrelated with sarcopenia and frailty. Evidence suggests that dietary supplements play a role in managing these conditions. As metastatic cancer cells are associated with notable genomic and phenotypic alterations, response to dietary supplements may differ between metastatic and non‐metastatic cancers. However, research in this area is lacking. This scoping review aims to identify the dietary supplements that have been studied in patients with metastatic cancers and malnutrition‐related conditions, along with their proposed effects, mechanisms, outcome measures, and tools used. A systematic search was conducted across databases, including MEDLINE, EMBASE, CINAHL, and clinical trial registries. Of the initial 6535 records screened, a total of 48 studies were included, covering a range of dietary supplements— vitamins, minerals, antioxidants, proteins, amino acids, fatty acids, fiber, and others. While the types of dietary supplements included varied across cancer types, omega‐3 and carnitine were investigated most often. Proposed relevant attributes of dietary supplements included their antioxidant, anti‐inflammatory, anti‐cancer, and immunomodulatory properties. Overall, there was a paucity of interventional studies, and more randomized controlled trials are warranted. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
- Thangavelu, Dhivya, Tan, Apphia, Cant, Robyn, Chua, Wei, Liaw, Sok
- Authors: Thangavelu, Dhivya , Tan, Apphia , Cant, Robyn , Chua, Wei , Liaw, Sok
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Nurse Education Today Vol. 113, no. (2022), p.
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- Description: Objective: This review aimed to synthesise evidence from experimental studies of the application of digital serious games in developing nursing clinical competence. Design: Systematic review and meta-analysis. Data sources: Eight databases were searched for randomized controlled trials and quasi-experimental studies published in English from 2000 to 2021. Review methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were adopted in this review. Quality appraisal was conducted using Cochrane's Risk of Bias tool and the Joanna Brigg's Institute Critical Appraisal Tool for Quasi-Experimental Designs. A narrative synthesis of studies, and a meta-analysis and subgroup analysis, was performed on the study outcomes. Results: 22 experimental studies including 13 randomized controlled trials and nine quasi-experimental studies were included. Of these, 19 studies examined nursing students and three examined qualified nurses. These studies applied serious games to develop nursing competencies in management of nursing care, clinical reasoning skills, procedural skills, legal practice and quality improvement. Compared with control groups, serious games improved knowledge (SMD = 1.30, 95% CI [0.75, 1.86]) and skills (SMD = 0.38, 95% CI [0.17, 0.60]). Subgroup analysis for both knowledge and skills outcomes demonstrated that serious games were more effective than control groups with either no intervention or other educational interventions. A large effect size (SMD = 1.13, 95% CI [0.91, 1.34]) was found in favour of serious games for improving knowledge scores in management of nursing care. Conclusion: The reviewed studies identified a broad application of digital serious games for developing nursing competencies. The knowledge and skills performance outcomes supported the use of serious games, which were found to be superior to conventional educational interventions. More serious games are required to be incorporated into undergraduate and continuing nursing education for workplace training, with more rigorous studies examining the effect of serious games in improving the quality and safety of clinical nursing practice. © 2022 Elsevier Ltd
Educational anomaly analytics : features, methods, and challenges
- Guo, Teng, Bai, Xiaomei, Tian, Xue, Firmin, Sally, Xia, Feng
- Authors: Guo, Teng , Bai, Xiaomei , Tian, Xue , Firmin, Sally , Xia, Feng
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Frontiers in Big Data Vol. 4, no. (2022), p.
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- Description: Anomalies in education affect the personal careers of students and universities' retention rates. Understanding the laws behind educational anomalies promotes the development of individual students and improves the overall quality of education. However, the inaccessibility of educational data hinders the development of the field. Previous research in this field used questionnaires, which are time- and cost-consuming and hardly applicable to large-scale student cohorts. With the popularity of educational management systems and the rise of online education during the prevalence of COVID-19, a large amount of educational data is available online and offline, providing an unprecedented opportunity to explore educational anomalies from a data-driven perspective. As an emerging field, educational anomaly analytics rapidly attracts scholars from a variety of fields, including education, psychology, sociology, and computer science. This paper intends to provide a comprehensive review of data-driven analytics of educational anomalies from a methodological standpoint. We focus on the following five types of research that received the most attention: course failure prediction, dropout prediction, mental health problems detection, prediction of difficulty in graduation, and prediction of difficulty in employment. Then, we discuss the challenges of current related research. This study aims to provide references for educational policymaking while promoting the development of educational anomaly analytics as a growing field. Copyright © 2022 Guo, Bai, Tian, Firmin and Xia.
- Authors: Guo, Teng , Bai, Xiaomei , Tian, Xue , Firmin, Sally , Xia, Feng
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Frontiers in Big Data Vol. 4, no. (2022), p.
- Full Text:
- Reviewed:
- Description: Anomalies in education affect the personal careers of students and universities' retention rates. Understanding the laws behind educational anomalies promotes the development of individual students and improves the overall quality of education. However, the inaccessibility of educational data hinders the development of the field. Previous research in this field used questionnaires, which are time- and cost-consuming and hardly applicable to large-scale student cohorts. With the popularity of educational management systems and the rise of online education during the prevalence of COVID-19, a large amount of educational data is available online and offline, providing an unprecedented opportunity to explore educational anomalies from a data-driven perspective. As an emerging field, educational anomaly analytics rapidly attracts scholars from a variety of fields, including education, psychology, sociology, and computer science. This paper intends to provide a comprehensive review of data-driven analytics of educational anomalies from a methodological standpoint. We focus on the following five types of research that received the most attention: course failure prediction, dropout prediction, mental health problems detection, prediction of difficulty in graduation, and prediction of difficulty in employment. Then, we discuss the challenges of current related research. This study aims to provide references for educational policymaking while promoting the development of educational anomaly analytics as a growing field. Copyright © 2022 Guo, Bai, Tian, Firmin and Xia.
Energy harvesting in underwater acoustic wireless sensor networks : design, taxonomy, applications, challenges and future directions
- Khan, Anwar, Imran, Muhammad, Alharbi, Abdullah, Mohamed, Ehab, Fouda, Mostafa
- Authors: Khan, Anwar , Imran, Muhammad , Alharbi, Abdullah , Mohamed, Ehab , Fouda, Mostafa
- Date: 2022
- Type: Text , Journal article , Review
- Relation: IEEE Access Vol. 10, no. (2022), p. 134606-134622
- Full Text:
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- Description: In underwater acoustic wireless sensor networks (UAWSNs), energy harvesting either enhances the lifetime of a network by increasing the battery power of sensor nodes or ensures battery-less operation of nodes. This, in effect, results in sustainable and reliable operation of the network deployed for various underwater applications. This work provides a survey of the energy harvesting techniques for UAWSNs. Our work is unique than the existing work on underwater energy harvesting in that it includes state-of-the art techniques designed in the last decade. It analyzes every harvesting scheme in terms of its main idea, merits, demerits and the extent of the harvested power (energy). The description of the merits results in selection of the suitable scheme for the suitable underwater applications. The demerits of the addressed schemes provide an insight to their future enhancement and improvement. Moreover, the harvested techniques are classified into various categories depending upon the involved energy harvesting mechanism and compared based on the maximum and minimum amount of harvested power, which helps in selection of the suitable category keeping in view the power budget of an underwater network before deployment. The challenges in energy harvesting and in UAWSNs are described to provide an insight to them and to address them for further enhancement in the harvested extent. Finally, research directions are specified for future investigation. © 2013 IEEE.
- Authors: Khan, Anwar , Imran, Muhammad , Alharbi, Abdullah , Mohamed, Ehab , Fouda, Mostafa
- Date: 2022
- Type: Text , Journal article , Review
- Relation: IEEE Access Vol. 10, no. (2022), p. 134606-134622
- Full Text:
- Reviewed:
- Description: In underwater acoustic wireless sensor networks (UAWSNs), energy harvesting either enhances the lifetime of a network by increasing the battery power of sensor nodes or ensures battery-less operation of nodes. This, in effect, results in sustainable and reliable operation of the network deployed for various underwater applications. This work provides a survey of the energy harvesting techniques for UAWSNs. Our work is unique than the existing work on underwater energy harvesting in that it includes state-of-the art techniques designed in the last decade. It analyzes every harvesting scheme in terms of its main idea, merits, demerits and the extent of the harvested power (energy). The description of the merits results in selection of the suitable scheme for the suitable underwater applications. The demerits of the addressed schemes provide an insight to their future enhancement and improvement. Moreover, the harvested techniques are classified into various categories depending upon the involved energy harvesting mechanism and compared based on the maximum and minimum amount of harvested power, which helps in selection of the suitable category keeping in view the power budget of an underwater network before deployment. The challenges in energy harvesting and in UAWSNs are described to provide an insight to them and to address them for further enhancement in the harvested extent. Finally, research directions are specified for future investigation. © 2013 IEEE.
Ever and cumulative occupational exposure and lung function decline in longitudinal population-based studies : a systematic review and meta-analysis
- Rabbani, Golam, Nimmi, Naima, Benke, Geza, Dharmage, Shyamali, Bui, Dinh, Sim, Malcolm, Abramson, Michael, Alif, Sheikh
- Authors: Rabbani, Golam , Nimmi, Naima , Benke, Geza , Dharmage, Shyamali , Bui, Dinh , Sim, Malcolm , Abramson, Michael , Alif, Sheikh
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Occupational and Environmental Medicine Vol. 80, no. 1 (2022), p. 51-60
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- Description: Objectives Adverse occupational exposures can accelerate age-related lung function decline. Some longitudinal population-based studies have investigated this association. This study aims to examine this association using findings reported by longitudinal population-based studies. Methods Ovid Medline, PubMed, Embase, and Web of Science were searched using keywords and text words related to occupational exposures and lung function and 12 longitudinal population-based studies were identified using predefined inclusion criteria. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Lung function decline was defined as annual loss of forced expiratory volume in 1 s (FEV 1), forced vital capacity (FVC) or the ratio (FEV 1 /FVC). Fixed and random-effects meta-analyses were conducted to calculate pooled estimates for ever and cumulative exposures. Heterogeneity was assessed using the I 2 test, and publication bias was evaluated using funnel plots. Results Ever exposures to gases/fumes, vapours, gases, dusts, fumes (VGDF) and aromatic solvents were significantly associated with FEV 1 decline in meta-analyses. Cumulative exposures for these three occupational agents observed a similar trend of FEV 1 decline. Ever exposures to fungicides and cumulative exposures to biological dust, fungicides and insecticides were associated with FEV 1 decline in fixed-effect models only. No statistically significant association was observed between mineral dust, herbicides and metals and FEV 1 decline in meta-analyses. Conclusion Pooled estimates from the longitudinal population-based studies have provided evidence that occupational exposures are associated with FEV 1 decline. Specific exposure control and respiratory health surveillance are required to protect the lung health of the workers. © 2023 Author(s). Published by BMJ.
- Authors: Rabbani, Golam , Nimmi, Naima , Benke, Geza , Dharmage, Shyamali , Bui, Dinh , Sim, Malcolm , Abramson, Michael , Alif, Sheikh
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Occupational and Environmental Medicine Vol. 80, no. 1 (2022), p. 51-60
- Full Text:
- Reviewed:
- Description: Objectives Adverse occupational exposures can accelerate age-related lung function decline. Some longitudinal population-based studies have investigated this association. This study aims to examine this association using findings reported by longitudinal population-based studies. Methods Ovid Medline, PubMed, Embase, and Web of Science were searched using keywords and text words related to occupational exposures and lung function and 12 longitudinal population-based studies were identified using predefined inclusion criteria. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Lung function decline was defined as annual loss of forced expiratory volume in 1 s (FEV 1), forced vital capacity (FVC) or the ratio (FEV 1 /FVC). Fixed and random-effects meta-analyses were conducted to calculate pooled estimates for ever and cumulative exposures. Heterogeneity was assessed using the I 2 test, and publication bias was evaluated using funnel plots. Results Ever exposures to gases/fumes, vapours, gases, dusts, fumes (VGDF) and aromatic solvents were significantly associated with FEV 1 decline in meta-analyses. Cumulative exposures for these three occupational agents observed a similar trend of FEV 1 decline. Ever exposures to fungicides and cumulative exposures to biological dust, fungicides and insecticides were associated with FEV 1 decline in fixed-effect models only. No statistically significant association was observed between mineral dust, herbicides and metals and FEV 1 decline in meta-analyses. Conclusion Pooled estimates from the longitudinal population-based studies have provided evidence that occupational exposures are associated with FEV 1 decline. Specific exposure control and respiratory health surveillance are required to protect the lung health of the workers. © 2023 Author(s). Published by BMJ.
- Haeffner, Melissa, Hames, Fern, Barbour, Margaret, Reeves, Jessica, Platell, Ghislaine, Grover, Samantha
- Authors: Haeffner, Melissa , Hames, Fern , Barbour, Margaret , Reeves, Jessica , Platell, Ghislaine , Grover, Samantha
- Date: 2022
- Type: Text , Journal article , Review
- Relation: One Earth Vol. 5, no. 2 (2022), p. 157-167
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- Description: Wicked problems such as climate change and the COVID-19 pandemic require authentically transdisciplinary approaches to achieving effective collaboration. There exist several research approaches for identifying the components and interactions of complex problems; however, collaborative autoethnography provides an empirical way to collect and analyze self-reflection that leads to transformative change. Here, we present a case study of collaborative autoethnography, applied as a tool to transform research practice among a group of natural and social scientists, by constructively revealing and resolving deep, often unseen, disciplinary divides. We ask, “How can natural and social scientists genuinely accept, respect, and share one another's approaches to work on the wicked problems that need to be solved?” This study demonstrates how disciplinary divisions can be successfully bridged by open-minded and committed collaborators who are prepared to recognize the academic bias they bring to their research and use this as a platform of strength. © 2022 Elsevier Inc.
- Hungerford, Catherine, Hills, Sharon, Richards, Catelyn, Robinson, Tracy, Hills, Danny
- Authors: Hungerford, Catherine , Hills, Sharon , Richards, Catelyn , Robinson, Tracy , Hills, Danny
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Issues in Mental Health Nursing Vol. 43, no. 11 (2022), p. 1014-1021
- Full Text: false
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- Description: The origins of mindfulness go back some 25 centuries to Eastern teachings, including Buddhism and Hinduism. Mindfulness-based interventions gained credence in Western mental health settings in the late 1970s through the work of medical researcher Kabat-Zinn, whose interest in Eastern meditation led him to develop a program for stress reduction. Since then, mindfulness-based interventions have been utilized for various populations, including older people with anxiety. Group mindfulness-based interventions have demonstrated benefits for older people with anxiety living in residential aged care and the community. In primary care settings, innovative delivery models for group mindfulness-based interventions could be facilitated by nurses to support older people with anxiety to age in place with dignity. The benefits of mindfulness-based interventions suggest the value of integrating ancient Eastern techniques with modern Western strategies to achieve better health outcomes for older people with mental health concerns. © 2022 Taylor & Francis Group, LLC.
- Gomez, Rapson, Stavropoulos, Vasileios, Brown, Taylor, Griffiths, Mark
- Authors: Gomez, Rapson , Stavropoulos, Vasileios , Brown, Taylor , Griffiths, Mark
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Psychiatry Research Vol. 313, no. (2022), p.
- Full Text: false
- Reviewed:
- Description: Over the past two decades, many problematic/excessive behaviours have increasingly been conceptualized as addictions due to their similarity with more traditional psychoactive substance addictions. The primary aim of the present study was to simultaneously examine the factor structure of three psychoactive substance addictions (alcohol use, cigarette smoking, and substance use) and seven behavioural addictions (sex, social media use, shopping, exercise, online gambling, internet gaming, and internet use), using exploratory factor analysis (EFA; N = 481) and confirmatory factor analysis (CFA; N = 487). A total of 968 participants completed an online survey including ten psychometric scales assessing the ten different potentially addictive behaviours. EFA supported a two-factor solution, with different factors for the psychoactive substance and behavioural addictions (excluding exercise addiction). CFA supported the two-factor model in a separate sample. There was good support for the concurrent and discriminant validities of the CFA latent factors and the reliability of the behavioural latent factor in the two-factor CFA model. While there was support for the concurrent and discriminant validities of the psychoactive substance latent factor, there was insufficient support for its reliability. The taxonomic, theoretical, and clinical implications of the findings are discussed. © 2022
Factors influencing the transition and retention of mental health nurses during the initial years of practice : scoping review
- Joseph, Bindu, Jacob, Sini, Lam, Louisa, Rahman, Muhammad Aziz
- Authors: Joseph, Bindu , Jacob, Sini , Lam, Louisa , Rahman, Muhammad Aziz
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Journal of Nursing Management Vol. 30, no. 8 (2022), p. 4274-4284
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- Description: Aim: This review aims to identify the factors influencing the transition and retention of mental health nurses during the initial years of practice, recognize gaps in the literature and propose evidence-based strategies. Background: Mental health is a challenging specialty; recruitment, transition and retention of mental health nurses are known issues of concern. Evaluation: The present study undertakes a scoping review to identify factors influencing the transition and retention of mental health nurses during the initial years of practice and the gaps in that research domain. A literature search was conducted using electronic databases. To gain an understanding of the topic of interest, the review of the literature extended from 2000 to 2022. Key issues: Existing evidence focuses on specific perspectives of transition. There is limited literature on factors influencing transition and retention among mental health nurses. Findings suggested that personal and professional factors could influence the transition and retention of mental health nurses during the initial years of practice. The main themes identified were personal attributes and professional factors with a number of subthemes. Conclusion: The scoping review identified only a few studies, which showed personal and professional factors related to the transition and retention of mental health nurses at the early stages of their career. Implications for nursing management: Potential benefits of effective transition and support with the understanding of factors influencing transition and retention of early career mental health nurses will enhance staff morale, sustainability of the workforce and better patient outcomes. Additionally, a few recommendations for nurse managers and leaders to improve transitional experiences and retention of early career nurses are highlighted. © 2022 The Authors. Journal of Nursing Management published by John Wiley & Sons Ltd.
- Authors: Joseph, Bindu , Jacob, Sini , Lam, Louisa , Rahman, Muhammad Aziz
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Journal of Nursing Management Vol. 30, no. 8 (2022), p. 4274-4284
- Full Text:
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- Description: Aim: This review aims to identify the factors influencing the transition and retention of mental health nurses during the initial years of practice, recognize gaps in the literature and propose evidence-based strategies. Background: Mental health is a challenging specialty; recruitment, transition and retention of mental health nurses are known issues of concern. Evaluation: The present study undertakes a scoping review to identify factors influencing the transition and retention of mental health nurses during the initial years of practice and the gaps in that research domain. A literature search was conducted using electronic databases. To gain an understanding of the topic of interest, the review of the literature extended from 2000 to 2022. Key issues: Existing evidence focuses on specific perspectives of transition. There is limited literature on factors influencing transition and retention among mental health nurses. Findings suggested that personal and professional factors could influence the transition and retention of mental health nurses during the initial years of practice. The main themes identified were personal attributes and professional factors with a number of subthemes. Conclusion: The scoping review identified only a few studies, which showed personal and professional factors related to the transition and retention of mental health nurses at the early stages of their career. Implications for nursing management: Potential benefits of effective transition and support with the understanding of factors influencing transition and retention of early career mental health nurses will enhance staff morale, sustainability of the workforce and better patient outcomes. Additionally, a few recommendations for nurse managers and leaders to improve transitional experiences and retention of early career nurses are highlighted. © 2022 The Authors. Journal of Nursing Management published by John Wiley & Sons Ltd.
Few-shot image classification : current status and research trends
- Liu, Ying, Zhang, Hengchang, Zhang, Weidong, Lu, Guojun, Tian, Qi, Ling, Nam
- Authors: Liu, Ying , Zhang, Hengchang , Zhang, Weidong , Lu, Guojun , Tian, Qi , Ling, Nam
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Electronics (Switzerland) Vol. 11, no. 11 (2022), p.
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- Description: Conventional image classification methods usually require a large number of training samples for the training model. However, in practical scenarios, the amount of available sample data is often insufficient, which easily leads to overfitting in network construction. Few-shot learning provides an effective solution to this problem and has been a hot research topic. This paper provides an intensive survey on the state-of-the-art techniques in image classification based on few-shot learning. According to the different deep learning mechanisms, the existing algorithms are di-vided into four categories: transfer learning based, meta-learning based, data augmentation based, and multimodal based methods. Transfer learning based methods transfer useful prior knowledge from the source domain to the target domain. Meta-learning based methods employ past prior knowledge to guide the learning of new tasks. Data augmentation based methods expand the amount of sample data with auxiliary information. Multimodal based methods use the information of the auxiliary modal to facilitate the implementation of image classification tasks. This paper also summarizes the few-shot image datasets available in the literature, and experimental results tested by some representative algorithms are provided to compare their performance and analyze their pros and cons. In addition, the application of existing research outcomes on few-shot image classification in different practical fields are discussed. Finally, a few future research directions are iden-tified. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
- Authors: Liu, Ying , Zhang, Hengchang , Zhang, Weidong , Lu, Guojun , Tian, Qi , Ling, Nam
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Electronics (Switzerland) Vol. 11, no. 11 (2022), p.
- Full Text:
- Reviewed:
- Description: Conventional image classification methods usually require a large number of training samples for the training model. However, in practical scenarios, the amount of available sample data is often insufficient, which easily leads to overfitting in network construction. Few-shot learning provides an effective solution to this problem and has been a hot research topic. This paper provides an intensive survey on the state-of-the-art techniques in image classification based on few-shot learning. According to the different deep learning mechanisms, the existing algorithms are di-vided into four categories: transfer learning based, meta-learning based, data augmentation based, and multimodal based methods. Transfer learning based methods transfer useful prior knowledge from the source domain to the target domain. Meta-learning based methods employ past prior knowledge to guide the learning of new tasks. Data augmentation based methods expand the amount of sample data with auxiliary information. Multimodal based methods use the information of the auxiliary modal to facilitate the implementation of image classification tasks. This paper also summarizes the few-shot image datasets available in the literature, and experimental results tested by some representative algorithms are provided to compare their performance and analyze their pros and cons. In addition, the application of existing research outcomes on few-shot image classification in different practical fields are discussed. Finally, a few future research directions are iden-tified. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
Gambling disorder in the UK : key research priorities and the urgent need for independent research funding
- Bowden-Jones, Henrietta, Hook, Roxanne, Grant, Jon, Ioannidis, Konstantinos, Corazza, Ornella, Fineberg, Naomi, Singer, Bryan, Roberts, Amanda, Bethlehem, Richard, Dymond, Simon, Romero-Garcia, Rafa, Robbins, Trevor, Cortese, Samuele, Thomas, Shane, Sahakian, Barbara, Dowling, Nicki, Chamberlain, Samuel
- Authors: Bowden-Jones, Henrietta , Hook, Roxanne , Grant, Jon , Ioannidis, Konstantinos , Corazza, Ornella , Fineberg, Naomi , Singer, Bryan , Roberts, Amanda , Bethlehem, Richard , Dymond, Simon , Romero-Garcia, Rafa , Robbins, Trevor , Cortese, Samuele , Thomas, Shane , Sahakian, Barbara , Dowling, Nicki , Chamberlain, Samuel
- Date: 2022
- Type: Text , Journal article , Review
- Relation: The Lancet Psychiatry Vol. 9, no. 4 (2022), p. 321-329
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- Description: Gambling in the modern era is pervasive owing to the variety of gambling opportunities available, including those that use technology (eg, online applications on smartphones). Although many people gamble recreationally without undue negative effects, a sizeable subset of individuals develop disordered gambling, which is associated with marked functional impairment including other mental health problems, relationship problems, bankruptcy, suicidality, and criminality. The National UK Research Network for Behavioural Addictions (NUK-BA) was established to promote understanding of, research into, and treatments for behavioural addictions including gambling disorder, which is the only formally recognised behavioural addiction. In this Health Policy paper, we outline the status of research and treatment for disordered gambling in the UK (including funding issues) and key research that should be conducted to establish the magnitude of the problem, vulnerability and resilience factors, the underlying neurobiology, long-term consequences, and treatment opportunities. In particular, we emphasise the need to: (1) conduct independent longitudinal research into the prevalence of disordered gambling (including gambling disorder and at-risk gambling), and gambling harms, including in vulnerable and minoritised groups; (2) select and refine the most suitable pragmatic measurement tools; (3) identify predictors (eg, vulnerability and resilience markers) of disordered gambling in people who gamble recreationally, including in vulnerable and minoritised groups; (4) conduct randomised controlled trials on psychological interventions and pharmacotherapy for gambling disorder; (5) improve understanding of the neurobiological basis of gambling disorder, including impulsivity and compulsivity, genetics, and biomarkers; and (6) develop clinical guidelines based on the best contemporary research evidence to guide effective clinical interventions. We also highlight the need to consider what can be learnt from approaches towards mitigating gambling-related harm in other countries. © 2022 Elsevier Ltd
- Authors: Bowden-Jones, Henrietta , Hook, Roxanne , Grant, Jon , Ioannidis, Konstantinos , Corazza, Ornella , Fineberg, Naomi , Singer, Bryan , Roberts, Amanda , Bethlehem, Richard , Dymond, Simon , Romero-Garcia, Rafa , Robbins, Trevor , Cortese, Samuele , Thomas, Shane , Sahakian, Barbara , Dowling, Nicki , Chamberlain, Samuel
- Date: 2022
- Type: Text , Journal article , Review
- Relation: The Lancet Psychiatry Vol. 9, no. 4 (2022), p. 321-329
- Full Text:
- Reviewed:
- Description: Gambling in the modern era is pervasive owing to the variety of gambling opportunities available, including those that use technology (eg, online applications on smartphones). Although many people gamble recreationally without undue negative effects, a sizeable subset of individuals develop disordered gambling, which is associated with marked functional impairment including other mental health problems, relationship problems, bankruptcy, suicidality, and criminality. The National UK Research Network for Behavioural Addictions (NUK-BA) was established to promote understanding of, research into, and treatments for behavioural addictions including gambling disorder, which is the only formally recognised behavioural addiction. In this Health Policy paper, we outline the status of research and treatment for disordered gambling in the UK (including funding issues) and key research that should be conducted to establish the magnitude of the problem, vulnerability and resilience factors, the underlying neurobiology, long-term consequences, and treatment opportunities. In particular, we emphasise the need to: (1) conduct independent longitudinal research into the prevalence of disordered gambling (including gambling disorder and at-risk gambling), and gambling harms, including in vulnerable and minoritised groups; (2) select and refine the most suitable pragmatic measurement tools; (3) identify predictors (eg, vulnerability and resilience markers) of disordered gambling in people who gamble recreationally, including in vulnerable and minoritised groups; (4) conduct randomised controlled trials on psychological interventions and pharmacotherapy for gambling disorder; (5) improve understanding of the neurobiological basis of gambling disorder, including impulsivity and compulsivity, genetics, and biomarkers; and (6) develop clinical guidelines based on the best contemporary research evidence to guide effective clinical interventions. We also highlight the need to consider what can be learnt from approaches towards mitigating gambling-related harm in other countries. © 2022 Elsevier Ltd
Home-based work and ergonomics : physical and psychosocial considerations
- Reznik, Jacqueline, Hungerford, Catherine, Kornhaber, Rachel, Cleary, Michelle
- Authors: Reznik, Jacqueline , Hungerford, Catherine , Kornhaber, Rachel , Cleary, Michelle
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Issues in Mental Health Nursing Vol. 43, no. 10 (2022), p. 975-979
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- Authors: Reznik, Jacqueline , Hungerford, Catherine , Kornhaber, Rachel , Cleary, Michelle
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Issues in Mental Health Nursing Vol. 43, no. 10 (2022), p. 975-979
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- Rantung, Gilny, Griffiths, Debra, Plummer, Virginia, Moss, Cheryle
- Authors: Rantung, Gilny , Griffiths, Debra , Plummer, Virginia , Moss, Cheryle
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Journal of Clinical Nursing Vol. 31, no. 7-8 (2022), p. 843-859
- Full Text: false
- Reviewed:
- Description: Aims and objectives: The aim of this integrative review was to assess how emergency nurses cope and motivate themselves to sustain their caring work. Background: The need to enhance sustainability of the workforce creates a demand to consolidate contemporary evidence related to emergency nurses’ motivations, how they cope and sustain themselves for caring work. Design and methods: The integrative literature review informed by Whittemore and Knafl involved searching four databases, which yielded 977 published research papers (2008–2021). A total of 33 studies met the inclusion and quality assessment criteria. The PRISMA checklist for review was followed. Results: No studies addressing all three areas (motivations, coping and caring sustainability) together were identified. Integration of evidence from quantitative and qualitative research was achieved in three categories: (1) emergency nurses’ motivations to sustain their work, (2) emergency nurses’ coping strategies and (3) sustaining care as emergency nurses. Conclusion: To sustain themselves in caring work, emergency nurses need to be intrinsically and extrinsically motivated and know how to cope effectively with stressors and work demands. There is need for research examining the relationships between these aspects of emergency nursing work. Relevance to clinical practice: To ensure the sustainability of emergency nurses’ work and careers understanding of the factors that influence and sustain their motivations and coping strategies is important for nurses and their clinical leaders and managers. © 2021 John Wiley & Sons Ltd.
- Cleary, Michelle, West, Sancia, Hunt, Glenn, McLean, Loyola, Hungerford, Catherine, Kornhaber, Rachel
- Authors: Cleary, Michelle , West, Sancia , Hunt, Glenn , McLean, Loyola , Hungerford, Catherine , Kornhaber, Rachel
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Issues in Mental Health Nursing Vol. 43, no. 12 (2022), p. 1093-1106
- Full Text: false
- Reviewed:
- Description: For people with autism spectrum disorder (ASD), the risk of mental illness, including suicidality, has a higher prevalence than the general population. This scoping review explored how people with ASD access suicide hotlines/crisis support services; and current approaches to delivering mental health services (MHS) to people with ASD. A search identified 28 studies meeting the selection criteria with analysis revealing four key findings. The support received by the person with ASD influenced how they accessed MHS; people often encounter barriers to accessing MHS; a separation exists between autism and MHS; and no studies on accessing or delivering MHS through crisis hotlines. The presence of such autism-specific crisis hotlines and the dearth of studies suggest a void in the existing research. © 2022 Taylor & Francis Group, LLC.
Impact of dementia literacy interventions for non-health-professionals: systematic review and meta-analysis
- Nguyen, Hoang, Phan, Hoang, Terry, Daniel, Doherty, Kathleen, McInerney, Fran
- Authors: Nguyen, Hoang , Phan, Hoang , Terry, Daniel , Doherty, Kathleen , McInerney, Fran
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Aging and Mental Health Vol. 26, no. 3 (2022), p. 442-456
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- Description: Objectives: To assess evidence regarding the effects of interventions aimed at improving dementia literacy for different groups of non-health-professionals. Methods: A systematic search for relevant interventions was conducted using a range of online databases (e.g. CINAHL, Embase, Medline, ProQuest, and PsycINFO) and hand-searching of reference lists. Eligible interventions were identified based on predefined inclusion/exclusion criteria and methodological quality criteria. Meta analyses were performed using a random-effects model. Results: The final review included 14 interventions, which were either randomised controlled trials or non-randomised controlled trials. The interventions had varied contents, approaches, settings, and outcome measures. Evidence of improved dementia literacy in various aspects was found, and the intervention effects were strongest on knowledge of dementia. Discussion: There is evidence for the positive impact of dementia literacy interventions on different groups of non-health-professionals. Best practices in intervention contents, approaches, and outcome measures should be examined to guide future interventions. © 2021 Informa UK Limited, trading as Taylor & Francis Group.
- Authors: Nguyen, Hoang , Phan, Hoang , Terry, Daniel , Doherty, Kathleen , McInerney, Fran
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Aging and Mental Health Vol. 26, no. 3 (2022), p. 442-456
- Full Text:
- Reviewed:
- Description: Objectives: To assess evidence regarding the effects of interventions aimed at improving dementia literacy for different groups of non-health-professionals. Methods: A systematic search for relevant interventions was conducted using a range of online databases (e.g. CINAHL, Embase, Medline, ProQuest, and PsycINFO) and hand-searching of reference lists. Eligible interventions were identified based on predefined inclusion/exclusion criteria and methodological quality criteria. Meta analyses were performed using a random-effects model. Results: The final review included 14 interventions, which were either randomised controlled trials or non-randomised controlled trials. The interventions had varied contents, approaches, settings, and outcome measures. Evidence of improved dementia literacy in various aspects was found, and the intervention effects were strongest on knowledge of dementia. Discussion: There is evidence for the positive impact of dementia literacy interventions on different groups of non-health-professionals. Best practices in intervention contents, approaches, and outcome measures should be examined to guide future interventions. © 2021 Informa UK Limited, trading as Taylor & Francis Group.
- Vigo, Cristian, Myller, Kyle, Sánchez, Adriano, Ayan, Carlos
- Authors: Vigo, Cristian , Myller, Kyle , Sánchez, Adriano , Ayan, Carlos
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Archivos de Medicina del Deporte Vol. 39, no. 1 (2022), p. 50-61
- Full Text: false
- Reviewed:
- Description: Flexibility is recognized as a strong marker of physical health in children. Scientific research has indicated that there is a worldwide decline in children's physical fitness, including a reduction in flexibility levels. It has been suggested that a lack of flexibility in youth may be responsible for several health complications, including back pain, injury risk, and posture problems. Physical education (PE) classes are part of the school curriculum, which are an ideal setting to improve children physical fitness levels. The purpose of this systematic review and meta-analysis was to investigate whether incorporating a stretching component during regular PE classes can improve flexibility in school children. Three electronic databases were searched systematically until June 2019 for studies analysing the effects of interventions performed during PE classes aimed to improve the flexibility levels of school children (6-18 years). The critical appraisal was carried using PEDro and MINORS scales and a meta-analysis was performed. Seventeen studies of moderate-to-high methodological quality were included in the review and 14 in the meta-analysis, pooling 874 participants. The interventions showed significant improvements in the flexibility of the children, although the relative influence of genre could not be further analysed, due to the fact that insufficient data was reported. The meta-analysis for the hamstring flexibility resulted in a significant moderate effect. Flexibility levels can be improved through the incorporation of stretching interventions during PE classes, since flexibility is a key health-related physical fitness componentFurther research is needed on the effects of such interventions on trunk and upper body flexibility. © 2022 Authors. All rights reserved.
- Kemel, Paul, Porter, Joanne, Coombs, Nicole
- Authors: Kemel, Paul , Porter, Joanne , Coombs, Nicole
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Health Promotion Journal of Australia Vol. 33, no. 3 (2022), p. 590-601
- Full Text: false
- Reviewed:
- Description: Background: Across various parts of the world there is an increasing trend in adolescent and young adult physical inactivity, which has been linked to a multitude of illnesses throughout the lifespan. To further understand the link between physical inactivity and illness, it is important to determine the effect that physical activity has various components of wellbeing. The primary aim of this review was to compile and synthesise the recent evidence on physical activity and its effect on physical, mental and social wellbeing across younger populations. The secondary aim was to determine whether there is relationship between the amount, type and intensity of exercise, and changes in wellbeing outcomes. Methods: Main databases were searched using MeSH terms for the population of interest (young adult, adolescent), intervention (physical activity) and outcome (wellbeing). Upon screening papers of eligibility, quality appraisal was completed through the Critical Appraisals Skills Programme (CASP). Results: Nineteen studies were included in this review. The majority of studies found an associated link between the participation of physical activity and improvements in physical, mental and social wellbeing outcomes. There was evidence to suggest that lower levels of physical intensity produced similar results in mental and social outcomes when compared to higher levels of physical intensity. Conclusion: This review supports the encouragement of adolescent and young adult physical activity, noting the improvements seen across the physical, mental and social wellbeing outcomes. Future research is still required to further understand the benefits of lower intensity exercise within the adolescent and young adult population. © 2021 Australian Health Promotion Association.