The metabolic syndrome (MetS) is defined as the concurrence of obesity-associated cardiovascular risk factors including abdominal obesity, impaired glucose tolerance, hypertriglyceridemia, decreased HDL cholesterol, and/or hypertension. Earlier conceptualizations of the MetS focused on insulin resistance as a core feature, and it is clearly coincident with the above list of features. Each component of the MetS is an independent risk factor for cardiovascular disease and the combination of these risk factors elevates rates and severity of cardiovascular disease, related to a spectrum of cardiovascular conditions including microvascular dysfunction, coronary atherosclerosis and calcification, cardiac dysfunction, myocardial infarction, and heart failure. While advances in understanding the etiology and consequences of this complex disorder have been made, the underlying pathophysiological mechanisms remain incompletely understood, and it is unclear how these concurrent risk factors conspire to produce the variety of obesity-associated adverse cardiovascular diseases. In this review, we highlight current knowledge regarding the pathophysiological consequences of obesity and the MetS on cardiovascular function and disease, including considerations of potential physiological and molecular mechanisms that may contribute to these adverse outcomes.

Cardiovascular consequences of metabolic syndrome

Several forms of virtual reality (VR) have shown promise in treating mental disorders. However, there is a lack of research investigating the use of multicomponent immersive VR. Therefore, this study aimed to evaluate the effectiveness of an immersive virtual reality (IVR) intervention that incorporated Japanese garden aesthetics, relaxation, and elements of Erickson's psychotherapy in alleviating depression and anxiety symptoms among elderly women. Sixty women with depressive symptoms were randomly assigned to one of two treatment groups. Both groups received eight (twice a week for four weeks) low-intensity general fitness training sessions. The IVR group (n = 30) received eight additional VR-based relaxation sessions, whereas the control group (n = 30) received eight group relaxation. As outcome measures, the geriatric depression scale (GDS; primary) and Hospital Anxiety and Depression Scale (HADS; secondary) were administered before and after the interventions. The protocol was registered in the ClinicalTrials.gov PRS database (Registration number: NCT05285501). Patients receiving IVR therapy exhibited a greater significant reduction in the GDS (adjusted mean post-difference of 4.10; 95% CI = 2.27-5.93) and HADS (2.95; 95% CI = 0.98-4.92) scores than those receiving the control intervention. In conclusion, IVR with elements of psychotherapy, relaxation, and garden aesthetics may alleviate the severity of depression and anxiety symptoms in elderly women. 

/pdf/immersive-virtual-reality-as-support-for-the-mental-health-3jhikmsk.pdf

Immersive virtual reality as support for the mental health of elderly women: a randomized controlled trial

The study aims to determine the impact of multimodal therapeutic approach on self-perceived stress in women with high risk of Metabolic Syndrome (MetS). The study involved 43 women aged 60 years and over (mean 68.6 ± 6.5) participating in a Mental Health Promotion Program. Over the 3-month course of the project, all of the participants attended meetings of a support group (60-min sessions twice a week). During these meetings, they took part in general fitness training (20 min), dancing (20 min), as well as health-promoting education and psychoeducation sessions (20 min). Moreover, the participants were encouraged to modify their diet to reduce their daily fat and sugar intake. Stress levels were assessed using the Perception of Stress Questionnaire (PSQ). Mood was measured with the Geriatric Depression Scale (GDS-30). In all of the subjects, a body composition analysis was performed using a Tanita BC-545N analyzer. Abdomen and hip circumference were measured to determine the waist-hip ratio. Weight and height were measured to determine the BMI score. At the beginning of the project, the intensity of stress correlated with the level of depressive symptoms (GDS), Body Mass Index (BDI), and the amount of visceral fat. Three months of participation in the Mental Health Promotion Program resulted in a significant reduction in stress intensity (p < 0.01). At the end of the project, all of the participants expressed their willingness to continue their participation in the classes, which is very important as there is a need to conduct long-term health-promoting activities in the age group in question.

Multimodal Therapeutic Approach in Women with High Risk of Metabolic Syndrome—A Single Group One Center Pre-Post Study

Background: The complexity of health problems concerning women aged ≥60 years makes it necessary to develop effective, low-cost strategies involving biopsychosocial interventions. The aim of this study is to identify the factors associated with undertaking health-promoting activities by older women at high risk of metabolic syndrome (MetS) with or without depressive symptoms. Methods: The study group consisted of 70 older women (62–84 years old) undertaking regular physical activity. A self-developed questionnaire (used to determine the living situation, selected lifestyle components and health problems), the Perceived Stress Questionnaire (PSQ) and the Geriatric Depression Scale (GDS) were used. Results: In the study group undertaking regular physical activity, 40% had increased symptoms of depression (D group), and 60% were classified as non-depressed (ND group). The D group had a higher general stress level (t = −6.18, p = 0.001). Improving and/or maintaining physical fitness was identified as the greatest motivation in both groups. Willingness to spend time with other people significantly differed between the two groups (χ2 = 4.148, p = 0.042). The sole factor significantly differentiating between both groups was lack of time (χ2 = 8.777, p = 0.003). Conclusions: Motivations and barriers to undertaking health-promoting activities and levels of perceived stress were significantly different between the depressed and non-depressed groups. It is important to encourage primary care physicians to perform screening tests for late-life depression and to provide information on where therapeutic interventions are available for patients with symptoms of MetS and coexisting depressive symptoms.

/pdf/factors-associated-with-undertaking-health-promoting-3mfqmel7.pdf

Factors Associated with Undertaking Health-Promoting Activities by Older Women at High Risk of Metabolic Syndrome

Abstract Background Weight gain after a kidney transplant remains a major problem that can lead to adverse effects on morbidity and mortality. The posttransplant phase provides a window of opportunity to improve the engagement of self-management of care for lifestyle modifications for diet and physical activity. The purpose of our study was to (1) test the feasibility of recruitment, retention, and adherence for using the Technology, Application, Self-Management for Kidney (TASK) intervention in post-kidney transplant recipients (≥ 18 years of age) at baseline, 4, 8, and 12 weeks; and (2) estimate the preliminary effects of the TASK intervention in producing change over time for blood pressure (BP), weight, fruits/vegetable intake, fiber intake, sodium intake, self-efficacy to exercise, and perceived stress. Methods This study used a 12-week pre/posttest design using to test the feasibility of the TASK intervention. We applied paired t -tests and McNemar’s test to compare the outcomes at weeks 4, 8, and 12. Results We met our recruitment goal ( N = 20) and found a 15% attrition rate ( n = 3) at Week 12. Adherence rate among the study completers for recording daily food intake was 83–94% over the 12 weeks and for recording daily physical activity was 17–33% over the 12 weeks. We observed improvements over time for BP, weight, fruits/vegetable intake, fiber intake, and sodium intake; these differences were non-significant, although clinically important. We did find a significant difference from baseline to 12 weeks in weight reduction ( p = 0.02), self-efficacy to exercise ( p = 0.003), and perceived stress ( p = 0.04). Conclusions The data suggest the TASK intervention was feasible for kidney recipients to use and resulted in weight control, increased self-efficacy to exercise, and decreased perceived stress. Trial registration ClinicalTrials.gov #:NCT05151445 

The feasibility of Technology, Application, Self-Management for Kidney (TASK) intervention in post-kidney transplant recipients using a pre/posttest design

The study aims to determine the impact of low-intensity exercise and psychoeducation on depressive symptoms and self-perceived stress in women with metabolic syndrome (MetS). Seventy-four women (mean age 69.35 ± 7.20) were included in the study. Participants were divided into two groups: those with MetS (n = 33) and those without MetS (n = 41). Subjects participated in low-intensity general-fitness exercise sessions combined with psychoeducation distributed regularly over a 12-week period. Participants completed the Geriatric Depression Scale-15 (GDS) and the Stress Level Questionnaire (SLQ) before and after the intervention. All investigated parameters significantly decreased for the participants with metabolic syndrome after the intervention. The level of GDS in this group decreased by approximately 37% (p < 0.01), and SLQ by around 23% (p < 0.01). Our results suggest, that low-intensity exercise combined with psychoeducation could lower depressive symptoms and stress level in women with MetS. However, the intervention does not lower anthropometric parameter scores.

pdf/low-intensity-exercise-as-a-modifier-of-depressive-symptoms-2fsscfdx7h.pdf

Low-Intensity Exercise as a Modifier of Depressive Symptoms and Self-Perceived Stress Level in Women with Metabolic Syndrome.

While much has been achieved in this country to bring about equality for many groups, for refugees it has been a struggle. This chapter explores the state of refugee education in terms of definition and impact for children and families, including coordination constraints. It provides a program-model for working with refugee students and their families within a culturally responsive partnership at Washington Elementary School District, Arizona, USA. In addition, challenges are addressed leading to constant adapting, changing, and improving the program model over time based on the needs of the refugee students and their families.

Refugee children and parental involvement in school education: A field model

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Low-Intensity Exercise as a Modifier of Depressive Symptoms and Self-Perceived Stress Level in Women with Metabolic Syndrome.

Refugee children and parental involvement in school education: A field model