Physical activity monitors to enhance the daily amount of physical activity in elderly-a protocol for a systematic review and meta-analysis

Abstract Background To investigate the use of physical activity monitors (PAMs) for the elderly, the scientific literature should be systematically reviewed and the effect quantified, as the evidence seems inconclusive. Methods and design Randomized controlled trials and randomized crossover trials, with participants with a mean age above 65 years, comparing any PAM intervention with other control interventions or no intervention, will be included. This protocol is detailed according to the recommendations of the Cochrane Handbook, and it is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols statement. Results We will present results from the search in a flow diagram. The results from the analyses will include regular meta-analyses, stratified analyses, and meta-regressions. The results on each outcome of interest will be presented in a summary of findings table. Discussion This paper will explore and analyze the heterogeneity of the results and try to identify variables that will enhance the effect of PAMs in elderly. The results will be useful to researchers working with elderly and/or PAMs, health care professionals working with elderly, and relatives together with the elderly themselves. Systematic review registration PROSPERO CRD42018083648

Physical activity monitors to enhance amount of physical activity in older adults - a systematic review and meta-analysis

Figure S6. Subgroup analysis on effect of the interventions on physical activity sorted on type of physical activity monitor, diagnoses, feedback frequency, risk of bias judgement and type of physical activity measure. Results are from random effects model using Hedges g. K: Number of studies; SMD: standardized mean difference; PAM: physical activity monitor; COPD: chronic obstructive pulmonary disease. For each analysis, the diamond represents the standardized mean difference of the pooled intervention effect with the horizontal line representing 95% confidence intervals. Figure S7. Subgroup analysis on effect of the interventions on moderate to vigorous physical activity, sorted on type of physical activity monitor, diagnoses, feedback frequency, and risk of bias judgement. Results are from random effects model using Hedges g. K: Number of studies; SMD: standardized mean difference; PAM: physical activity monitor; COPD: chronic obstructive pulmonary disease. For each analysis, the diamond represents the standardized mean difference of the pooled intervention effect with the horizontal line representing 95% confidence intervals. Figure S8. Subgroup analysis on effect of the interventions on physical capacity, sorted on type of physical activity monitor, diagnoses, feedback frequency, and risk of bias judgement. Results are from random effects model using Hedges g. K: Number of studies; SMD: standardized mean difference; PAM: physical activity monitor; COPD: chronic obstructive pulmonary disease. For each analysis, the diamond represents the standardized mean difference of the pooled intervention effect with the horizontal line representing 95% confidence intervals. Figure S9. Subgroup analysis on effect of the interventions on body mass index, sorted on type of physical activity monitor, diagnoses, feedback frequency, and risk of bias judgement. Results are from random effects model using Hedges g. K: Number of studies; SMD: standardized mean difference; PAM: physical activity monitor; COPD: chronic obstructive pulmonary disease. For each analysis, the diamond represents the standardized mean difference of the pooled intervention effect with the horizontal line representing 95% confidence intervals. Figure S10. Subgroup analysis on effect of the interventions on health-related qualify of life, sorted on type of physical activity monitor, diagnoses, feedback frequency, and risk of bias judgement. Results are from random effects model using Hedges g. K: Number of studies; SMD: standardized mean difference; PAM: physical activity monitor; COPD: chronic obstructive pulmonary disease; HRQoL: Health-related quality of life. For each analysis, the diamond represents the standardized mean difference of the pooled intervention effect with the horizontal line representing 95% confidence intervals. Positive values favor the intervention. Figure S11. Funnel plot with Eggers line illustrating risk of publication bias in the analysis of effect of the interventions on physical activity. SMD: standardized mean difference. Figure S12. Random effects meta-analysis on withdrawals due to illness and adverse events. For each study, the diamond represents the specific relative risk of withdrawing with the horizontal line representing 95% confidence intervals. Results are from random effects model with relative risks. RR: Relative risk. The large diamond represents the pooled relative risk. Values below one equals more events in the intervention groups. Figure S13. Explorative subgroup analyses of effect of interventions on physical activity sorted on control intervention. For each study, the diamond represents the standardized mean difference of the intervention effect with the horizontal line representing 95% confidence intervals. Results are from random effects model using standardized mean difference (SMD) adjusted to Hedges g. PA: physical activity. The large diamonds represent the pooled standardized mean difference between the intervention groups and the control groups. Positive values favor the intervention. Figure S14. Explorative subgroup analyses of effect of interventions on physical activity sorted on additional intervention content. Results are from random effects model using standardized mean difference (SMD) adjusted to Hedges g. For each study, the diamond represents the standardized mean difference of the intervention effect with the horizontal line representing 95% confidence intervals. The large diamonds represent the pooled standardized mean difference between the intervention groups and the control groups. Positive values favor the intervention. Figure S15. Figure S15. Explorative subgroup analyses of effect of interventions on physical activity sorted on active control intervention or non-active control intervention. Results are from random effects model using standardized mean difference (SMD) adjusted to Hedges g. For each study, the diamond represents the standardized mean difference of the intervention effect with the horizontal line representing 95% confidence intervals. The large diamonds represent the pooled standardized mean difference between the intervention groups and the control groups. Table S1. Characteristics of included studies. Table S2. Univariate meta-regressions between standardized mean differences from all outcomes and age, gender distribution, number of participants with walking aids, intervention length, baseline physical activity and body mass index. Table S3. Citations and reasons for exclusion from full text screening. (DOCX 4040 kb

Effects of urodilatin on natriuresis in cirrhosis patients with sodium retention

BACKGROUND: Sodium retention and ascites are serious clinical problems in cirrhosis. Urodilatin (URO) is a peptide with paracrine effects in decreasing sodium reabsorption in the distal nephron. Our aim was to investigate the renal potency of synthetic URO on urine sodium excretion in cirrhosis patients with sodium retention and ascites. METHODS: Seven cirrhosis patients with diuretics-resistant sodium retention received a short-term (90 min) infusion of URO in a single-blind, placebo-controlled cross-over study. In the basal state after rehydration the patients had urine sodium excretion < 50 mmol/24 h. RESULTS: URO transiently increased urine sodium excretion from 22 ± 16 μmol/min (mean ± SD) to 78 ± 41 μmol/min (P < 0.05) and there was no effect of placebo (29 ± 14 to 44 ± 32). The increase of URO's second messenger after the receptor, cGMP, was normal. URO had no effect on urine flow or on blood pressure. Most of the patients had highly elevated plasma levels of renin, angiotensin II and aldosterone and URO did not change these. CONCLUSION: The short-term low-dose URO infusion increased the sodium excretion of the patients. The increase was small but systematic and potentially clinically important for such patients. The small response contrasts the preserved responsiveness of the URO receptors. The markedly activated systemic pressor hormones in cirrhosis evidently antagonized the local tubular effects of URO

Genome-wide meta-analysis of 241,258 adults accounting for smoking behaviour identifies novel loci for obesity traits

Few genome-wide association studies (GWAS) account for environmental exposures, like smoking, potentially impacting the overall trait variance when investigating the genetic contribution to obesity-related traits. Here, we use GWAS data from 51,080 current smokers and 190,178 nonsmokers (87% European descent) to identify loci influencing BMI and central adiposity, measured as waist circumference and waist-to-hip ratio both adjusted for BMI. We identify 23 novel genetic loci, and 9 loci with convincing evidence of gene-smoking interaction (GxSMK) on obesity-related traits. We show consistent direction of effect for all identified loci and significance for 18 novel and for 5 interaction loci in an independent study sample. These loci highlight novel biological functions, including response to oxidative stress, addictive behaviour, and regulatory functions emphasizing the importance of accounting for environment in genetic analyses. Our results suggest that tobacco smoking may alter the genetic susceptibility to overall adiposity and body fat distribution.Peer reviewe

Dissecting the Shared Genetic Architecture of Suicide Attempt, Psychiatric Disorders, and Known Risk Factors

Background Suicide is a leading cause of death worldwide, and nonfatal suicide attempts, which occur far more frequently, are a major source of disability and social and economic burden. Both have substantial genetic etiology, which is partially shared and partially distinct from that of related psychiatric disorders. Methods We conducted a genome-wide association study (GWAS) of 29,782 suicide attempt (SA) cases and 519,961 controls in the International Suicide Genetics Consortium (ISGC). The GWAS of SA was conditioned on psychiatric disorders using GWAS summary statistics via multitrait-based conditional and joint analysis, to remove genetic effects on SA mediated by psychiatric disorders. We investigated the shared and divergent genetic architectures of SA, psychiatric disorders, and other known risk factors. Results Two loci reached genome-wide significance for SA: the major histocompatibility complex and an intergenic locus on chromosome 7, the latter of which remained associated with SA after conditioning on psychiatric disorders and replicated in an independent cohort from the Million Veteran Program. This locus has been implicated in risk-taking behavior, smoking, and insomnia. SA showed strong genetic correlation with psychiatric disorders, particularly major depression, and also with smoking, pain, risk-taking behavior, sleep disturbances, lower educational attainment, reproductive traits, lower socioeconomic status, and poorer general health. After conditioning on psychiatric disorders, the genetic correlations between SA and psychiatric disorders decreased, whereas those with nonpsychiatric traits remained largely unchanged. Conclusions Our results identify a risk locus that contributes more strongly to SA than other phenotypes and suggest a shared underlying biology between SA and known risk factors that is not mediated by psychiatric disorders.Peer reviewe

Kullmiler. Tofstad, 121/3, Kongsberg, Buskerud.

Den 16. juni 1997 fikk Oldsaksamlingen melding frå Buskerud fylkeskommune om funn av kulturminner (kullholdige strukturer) ved anlegg av golfbane i dyrket mark. Etter befaring fremstod det som sannsynlig at det kunne dreie seg om fornminner, og det ble besluttet å foreta en mindre utgravning. Denne ble foretatt 16. juli samme år, Felt 1 inneholdt noe skjørbrent stein, felt 2 bare kull. Strukturene inneholdt til dels uforkullet treverk og er i ettertid vurdert å ha sammenheng med etterreformatorisk kullbrenning (brenning av kullmiler), og materialet er kassert. Strukturene var grunne, til dels runde, dels pølseformete. De små mengdene skjørbrent stein antas å ha sammenheng med den høye temperaturen ved milebrenningen

Jernvinneanlegg. Berge, 101/, Vang, Oppland.

Siden Hauge foretok sine undersøkelser, er det gjort mange utgravninger av jernvinneanlegg og kullgroper i Valdres, og disse er knyttet er hovedsakelig fra middelalderen. Av anlegg fra eldre jernalder er det bare datert ett, hvor det ble tatt ut prøver i 1991. Denne våren var det spesielle forhold under snøsmeltingen. Det var sol og vind og forholdsvis kaldt slik at snøen fordampet, og det ble lite vann i de regulerte kraftmagasinene, slik det også er i 2018. En maidag kom jeg i forbindelse med andre oppdrag kjørende seterveien på vestsiden av Øyangen fra Vestre Slidre over Uvildsete til Beito. Vannet var lavt, og på Stølsbakke i Vang fikk jeg øye på en utvasket morenehaug som var helt brun, noe som vanskelig kunne være annet enn slagg. Fra tidligere visste jeg at det var funnet mye slagg langs strendene av Øyangen, blant annet fra Harald Jacobsens registreringer ved utløpsosen. Jeg bega meg nedover i bjerkelia, og anstrengelsen var kronet med hell. Ved kraft-regulering kan fornminnene ofte bli sterkt skadet, for eksempel ved at isen legger seg ned på fornminnet under nedtapping av magasinet. Om våren kan isen skli, og en slagghaug kan bli spredt utover et stort område

Kokegroper. Stor Hove, 184/55, Lillehammer, Oppland.

Under graving av grøfter for kabel og informasjonsskilt ved midlertidig nedkjørsel til Oppland distriktshøgskole var det kommet for dagen kokegroper og kullkonsentrasjoner. Undersøkelse ble foretatt24.-25. september, 5 strukturer fra gammel bosetning ble dokumentert. Tre C14-dateringer ga AD265-650. Pga manglende innmåling er restmaterialet kassert