The present study aimed to examine the efficacy of an intervention, based on the Health Belief Model (HBM) and social support, in promoting strength training (ST) among older adults. A two-arm clustered randomized controlled trial (RCT) was conducted among 235 older adults from eight elderly centers in Hong Kong. The intervention group engaged in a 6-month intervention comprising ST sessions, exercise consultations, social gatherings, and a buddy program, while the control group participated in social gatherings. Assessments were conducted at baseline (Month 0), post-intervention (Month 6), and 3-month follow-up (Month 9), with primary outcome being the prevalence of meeting the American College of Sports Medicine (ACSM) recommendations of ST. Results showed that the intervention group reported significantly higher prevalence of meeting ACSM recommendations for ST at both post-intervention and follow-up. Linear mixed models showed significant interaction effect between condition and time on perceived susceptibility of sarcopenia and muscle strength and significant condition effect on self-efficacy for ST, perceived severity of sarcopenia, perceived barriers of ST, and intention to perform ST. Findings suggest that the intervention, guided by HBM and social support, improves older adults' ST participation, muscle strength, perceptions on sarcopenia, and self-efficacy for ST, which offers great potential for broader application in other settings.

Over the past years, France has been rocked not only by violent demonstrations in the banlieues (city outskirts) but also by raging debates regarding the place of “postcolonial studies” in the French archive and in current scholarship. The dispute over postcolonial studies in this European venue is symptomatic of disagreement about the status of French colonial history and the category of race in the construction of contemporary national narratives. The varied and conflicting understandings of both postcolonial studies and the nature of empires entail fierce disagreement over the status of race and immigration in France (if not Europe) today. This introductory essay reviews the arguments presented in the main articles, discussion papers, and Doxa essays included in this special issue. The author enters the debate by arguing against the notion that postcolonial studies can be summarized as a theoretical form. Because postcolonial studies has produced compelling accounts of the epistemological bases for the production of difference and historical forms of regulation, its intellectual force lies in the constant postulation of alternative narratives and counter-histories in a relentless effort to displace the fault lines of power-knowledge. However, to what extent can this contemporary scholarship rid itself of the categories of nineteenth-century academic disciplines? By considering the third languages of the postcolonial world, one can address this predicament of thinking and reasoning in the language of the educator, the statesman, the colonizer, the slaver, the exterminator. In the end, though, an epistemological rupture would entail more than differential languages; it requires that significance no longer be located in historical inscription.

Updating evidence-based nutrient guidance is challenging. One set of recommendations for which a robust evidence base is essential is the DRIs. In the past 10 y, DRI values for 4 essential nutrients have been re-evaluated in 2 groups: vitamin D and calcium, and sodium and potassium. To support the work of the committees tasked with evaluating the available evidence, the federal agencies that sponsor the DRI reviews contracted with the Agency for Healthcare Research and Quality to perform systematic reviews on predefined questions for these nutrient groups. Our aims were to tabulate the studies included in these systematic reviews and then, within the context of prespecified outcomes, summarize the totality of the available evidence and identify areas for consideration to maximize the value of the end products for future DRI committees. For the outcomes of interest, the available studies did not tend to report age data consistent with the current DRI categories. For some life stage categories, particularly pregnancy and lactation, there is a dearth of data. A wide range of study interventions were used, making it challenging to combine data to accurately derive or re-evaluate DRI values. There is also an under-representation of data on race/ethnicity and overweight/obesity, which is of concern, given the shifting demographic in the US and Canadian populations. Moving forward, it may be advantageous to develop a process to prospectively target research funding for studies designed to generate data that will most closely support re-evaluation of DRI values. Statement of Significance: Updating evidence-based nutrient guidance is challenging. Garnered from recent experiences using systematic reviews to update the Dietary Reference Intake values for calcium and vitamin D, and sodium and potassium, are some considerations for the future.

The metabolic syndrome (MetS) has been well linked with coronary heart disease (CHD) in the general population, but studies have rarely explored their association among patients with stroke. We examine prevalence of MetS and its association with CHD in patients with first-ever ischemic stroke. This hospital-based study included 1851 patients with first-ever ischemic stroke (mean age 61.2 years, 36.5% women) who were hospitalized into two university hospitals in Shandong, China (January 2016–February 2017). Data were collected through interviews, physical examinations, and laboratory tests. MetS was defined following the National Cholesterol Education Program (NCEP) criteria, the International Diabetes Federation (IDF) criteria, and the Chinese Diabetes Society (CDS) criteria. CHD was defined following clinical criteria. Data were analyzed using binary logistic regression models. The overall prevalence of MetS was 33.4% by NECP criteria, 47.2% by IDF criteria, and 32.5% by CDS criteria, with the prevalence being decreased with age and higher in women than in men (p < 0.05). High blood pressure, high triglycerides, and low HDL-C were significantly associated with CHD (multi-adjusted odds ratio [OR] range 1.27–1.38, p < 0.05). The multi-adjusted OR of CHD associated with MetS defined by the NECP criteria, IDF criteria, and CDS criteria (vs. no MetS) was 1.27 (95% confidence interval 1.03–1.57), 1.44 (1.18–1.76), and 1.27 (1.03–1.57), respectively. In addition, having 1–2 abnormal components (vs. none) of MetS was associated with CHD (multi-adjusted OR range 1.66–1.72, p < 0.05). MetS affects over one-third of patients with first-ever ischemic stroke. MetS is associated with an increased likelihood of CHD in stroke patients.

We explored the predictors and predictive models of loss to follow-up (LTFU) during the first year of anti-retroviral therapy (ART). LTFU was defined as the failure to visit the clinic for antiretroviral drugs for ≥ 90 days after the last missed scheduled visit. Based on the electronic medical records of 5953 patients who were HIV positive and began ART between 2016 and 2019 in China, the LTFU rate was 7.24 (95% confidence interval 6.49–7.97) per 100 person-years during the first year of ART. ART baseline factors were associated with LTFU, but were non-optimal predictors. A model including ART process-related factors such as follow-up behaviors and physical health status had an area under the receiver operating characteristic curve of 73.4% for predicting LTFU. Therefore, the medical records of follow-up visits can be used to identify patients with a high risk of LTFU and allow interventions to be implemented proactively.

Background: In 2019, there has been a large number of sustained street protests against government policies worldwide, with many involved extensive use of crowd control weapons (CCWs) such as teargas by law enforcement forces against civilians. Previous studies on the health impact of CCWs are sparse, and little evidence exists on the consequences of repeated, intensive exposure, especially in densely-populated cities like Hong Kong, where large-scale protests have been ongoing since June 2019.Methods: During October-November 2019, we recruited 230 journalists in Hong Kong, for a baseline survey to assess their past exposure to CCWs(e.g. teargas, kinetic impact projectiles [KIPs]), symptoms and injuries experienced, use of protective equipment, and mental health condition (using the Depression Anxiety Stress Scale-21). Subsequent resurveys were conducted one, three and six months after the baseline to capture the temporal variations in exposure and health outcomes.Results: Of the 230 journalists (57% female; mean [SD] age = 21.9 [15.5] years), 94% have been exposed to any CCWs before the baseline survey, with two-third exposed ≥once/ week since June 2019. About 95% participants had been exposed to teargas; ~50% had been exposed to pepper spray and water cannon; and ~40% had been exposed to at least one type of KIPs, including 43 and 35 being shot by teargas canisters and rubber bullets, respectively. Most (>80%) participants used respirators with chemical filters, but respiratory symptoms (e.g.cough, burning throat, breathing difficulties) remained common (20-30%). There were also surprisingly high prevalences of gastrointestinal (diarrhoea [27%], vomit [6%], dysentery [3%]), mental (moderate or severe depression [47%] and anxiety [23%]), and female reproductive (23% disrupted menstrual cycle) problems.Discussion: Despite the independent role of journalists in mass protests, the sample had frequent exposure to CCWs and experienced a wide range of health problems across multiple body systems.

Systematic reviews ("reviews") underpin health decisionmaking. The Systematic Review Data Repository (SRDR), developed by our team in 2012, is a widely-used, free, online, open-access system for extracting, managing, and archiving primary study data gathered during reviews. To make review data, including outcomes, query-able and more readily accessible to decisionmakers, we are developing "SRDR 2.0", a platform for sharing summary review data digitally and interactively. Our objective in this presentation is to describe the development of SRDR 2.0 and to demonstrate its use. To determine the structured information ("structured elements") that would be of interest to decisionmakers, we followed two steps. Step 1: We identified potential structured elements from common items reported in 10 published reviews. Step 2: We engaged 21 international academic and non-academic stakeholders representing diverse perspectives. Through iterative discussion, we developed the final list of structured elements. During Step 1, we identified 68 potential structured elements. During Step 2, through elimination and consolidation, we finalized 44 structured elements. We organized elements into three categories: Category 1 (related to the entire systematic review), Category 2 (related to specific populations, interventions/exposures, comparators, outcomes, study design, and settings of interest), and Category 3 (related to results for specific outcomes). By applying various filtering options (e.g., participant age or sex, intervention dose, outcomes), the user can visualize the number of relevant studies, outcomes, and results, such as meta-analyses. SRDR 2.0 will display information through interactive, user-friendly formats such as accordion-style headings, where the user clicks on headings to reveal underlying information, and mouse-overs, where underlying information is revealed only once the user hovers the mouse over a heading. SRDR 2.0 will serve as a new platform for sharing outcomes and other summary systematic review data with diverse users. SRDR 2.0 has the potential to greatly facilitate evidence-based decision-making.

Background Conducting systematic reviews (“reviews”) requires a great deal of effort and resources. Making data extracted during reviews available publicly could offer many benefits, including reducing unnecessary duplication of effort, standardizing data, supporting analyses to address secondary research questions, and facilitating methodologic research. Funded by the US Agency for Healthcare Research and Quality (AHRQ), the Systematic Review Data Repository (SRDR) is a free, web-based, open-source, data management and archival platform for reviews. Our specific objectives in this paper are to describe (1) the current extent of usage of SRDR and (2) the characteristics of all projects with publicly available data on the SRDR website. Methods We examined all projects with data made publicly available through SRDR as of November 12, 2019. We extracted information about the characteristics of these projects. Two investigators extracted and verified the data. Results SRDR has had 2552 individual user accounts belonging to users from 80 countries. Since SRDR’s launch in 2012, data have been made available publicly for 152 of the 735 projects in SRDR (21%), at a rate of 24.5 projects per year, on average. Most projects are in clinical fields (144/152 projects; 95%); most have evaluated interventions (therapeutic or preventive) (109/152; 72%). The most frequent health areas addressed are mental and behavioral disorders (31/152; 20%) and diseases of the eye and ocular adnexa (23/152; 15%). Two-thirds of the projects (104/152; 67%) were funded by AHRQ, and one-sixth (23/152; 15%) are Cochrane reviews. The 152 projects each address a median of 3 research questions (IQR 1–5) and include a median of 70 studies (IQR 20–130). Conclusions Until we arrive at a future in which the systematic review and broader research communities are comfortable with the accuracy of automated data extraction, re-use of data extracted by humans has the potential to help reduce redundancy and costs. The 152 projects with publicly available data through SRDR, and the more than 15,000 studies therein, are freely available to researchers and the general public who might be working on similar reviews or updates of reviews or who want access to the data for decision-making, meta-research, or other purposes.

Objectives: Data Abstraction Assistant (DAA) is a software for linking items abstracted into a data collection form for a systematic review to their locations in a study report. We conducted a randomized cross-over trial that compared DAA-facilitated single-data abstraction plus verification ("DAA verification''), single data abstraction plus verification ("regular verification''), and independent dual data abstraction plus adjudication ("independent abstraction''). Study Design and Setting: This study is an online randomized cross-over trial with 26 pairs of data abstractors. Each pair abstracted data from six articles, two per approach. Outcomes were the proportion of errors and time taken. Results: Overall proportion of errors was 17% for DAA verification, 16% for regular verification, and 15% for independent abstraction. DAA verification was associated with higher odds of errors when compared with regular verification (adjusted odds ratio [OR] 5 1.08; 95% confidence interval [CI]: 0.99-1.17) or independent abstraction (adjusted OR 5 1.12; 95% CI: 1.03-1.22). For each article, DAA verification took 20 minutes (95% CI: 1-40) longer than regular verification, but 46 minutes (95% CI: 26 to 66) shorter than independent abstraction. Conclusion: Independent abstraction may only be necessary for complex data items. DAA provides an audit trail that is crucial for reproducible research. (C) 2019 The Authors. Published by Elsevier Inc.

This is a response to a Letter. Data abstraction is a time-consuming and error-prone systematic review task. Shokraneh and Adams categorize available techniques for tracking data during data abstraction into three methods: simple annotation, descriptive addressing, and Cartesian coordinate system. While we agree with the categorization of the techniques, we disagree with the authors’ statement that descriptive addressing is a PDF-independent method, i.e., any sort of descriptive addressing must reference a specific version of PDF file and not just any PDF of said report. Different versions of PDFs of the same report might place text and tables on different locations of the same page and/or on different pages. Consequently, it is our opinion that any kind of source location information should be accompanied by the source or linked by an intermediary service such as the Data Abstraction Assistant (DAA).