Postgraduate Medical Journal[JOURNAL]
Sun
200 papers
Associations of the neutrophil-to-lymphocyte ratio with all-cause and cardiovascular mortality in patients with chest pain.
Li Z, Wu S, Wu C … +4 more , Yin Y, Fu Y, Li Y, Xia Z
Postgrad Med J · 2026 Apr · PMID 41263757 · Publisher ↗
BACKGROUND: Inflammation is crucial in cardiovascular disease (CVD). While the neutrophil-to-lymphocyte ratio (NLR), a simple inflammatory marker, has been linked to adverse outcomes in various CVD populations, its progn...
BACKGROUND: Inflammation is crucial in cardiovascular disease (CVD). While the neutrophil-to-lymphocyte ratio (NLR), a simple inflammatory marker, has been linked to adverse outcomes in various CVD populations, its prognostic significance in patients with chest pain remains unclear. This study aimed to investigate the associations of the NLR with all-cause and CVD mortality in a large cohort of chest pain patients. METHODS: This retrospective cohort study included 3048 chest pain patients. The NLR was calculated from complete blood counts, and patients were divided into three tertiles. Cox proportional hazards regression models, adjusting for confounders, were used to estimate all-cause and CVD mortality hazard ratios (HRs). Kaplan-Meier survival curves were also created, and sensitivity analyses were performed. RESULTS: A significant positive association was found between the NLR and the risk of both all-cause and CVD mortality. According to the fully adjusted model, a one-unit increase in log10 NLR correlated with a 4.68-fold increase in CVD mortality risk and a 2.37-fold increase in all-cause mortality risk. Compared with the lowest NLR tertile (T1), the highest (T3) was associated with significantly greater all-cause mortality [HR 1.43, 95% confidence interval (CI) 1.14-1.80] and CVD mortality (HR 2.03, 95% CI 1.28-3.22). An NLR ≥ 0.43 (log10) also significantly increased mortality risk. Survival decreased as NLR increased, with these relationships remaining robust in sensitivity analysis. CONCLUSION: Chest pain patients with increased NLRs are at greater risk of all-cause and CVD mortality. NLR can serve as a practical, cost-effective prognostic indicator in this group. Key messages What is already known on this topic: The neutrophil-to-lymphocyte ratio (NLR) is an established marker of systemic inflammation, and its prognostic value has been demonstrated in specific populations with diagnosed cardiovascular disease. However, its utility for risk stratification in the broader, undifferentiated population of patients initially presenting with chest pain remained unclear, warranting further investigation in a large-scale cohort. What this study adds: In this large cohort of over 3000 patients, this study provides robust evidence that an elevated NLR is a significant and independent predictor of both all-cause and cardiovascular mortality. Specifically, after full adjustment, patients in the highest NLR tertile had a 43% higher risk of all-cause mortality (HR 1.43) and a more than 2-fold greater risk of cardiovascular mortality (HR 2.03) compared to those in the lowest tertile. How this study might affect research, practice or policy: These findings support the integration of NLR-a readily available and cost-effective marker from a standard blood count-into the early risk assessment pathways for patients with chest pain. Clinicians can use the NLR to help identify higher-risk individuals who may benefit from more intensive monitoring, further diagnostic workup, or targeted therapeutic interventions upon presentation.
Recent advances in management of Graves' disease: an update.
Singh SK, Singh R, Pandey AK … +3 more , Singh V, Tiwari A, Rai PK
Postgrad Med J · 2026 Mar · PMID 41259222 · Publisher ↗
Treatment of Graves' disease (GD) is complex and controversial. Conventional therapy of GD includes antithyroid drugs (ATDs), surgery, and radio-iodine therapy (RIT) and each has limitations. ATDs are associated with hig...
Treatment of Graves' disease (GD) is complex and controversial. Conventional therapy of GD includes antithyroid drugs (ATDs), surgery, and radio-iodine therapy (RIT) and each has limitations. ATDs are associated with high rates of relapse and side effects. Definitive therapies result in permanent hypothyroidism and increased risk of Graves' ophthalmopathy. With advancements in the understanding of precise autoimmune mechanisms causing GD, novel therapies targeting immune pathways are in the pipeline of development. Newer drugs switch off a part of the immune system that is causing the disease, leaving the rest of the immune system still functioning. Though newer drugs seem to be efficacious, they may elicit higher incidence of infection and other side effects. Other concerns with newer drugs are that they may not be able to cure the disease, do not achieve adequate effectiveness in all patients, and may not achieve remission in all patients. Therefore, additional newer drugs will be needed in future.
Comparative analysis of lipid and blood glucose profiles and their association with short-term progression of carotid plaque among middle-aged adults.
Sun X, Kang J, Lv H … +2 more , Wu C, Liu X
Postgrad Med J · 2026 Apr · PMID 41224728 · Publisher ↗
BACKGROUND: The progression of carotid atherosclerotic plaques is a significant predictor of cardiovascular events; however, there is a paucity of comparative analyses regarding metabolic biomarkers that can forecast sho...
BACKGROUND: The progression of carotid atherosclerotic plaques is a significant predictor of cardiovascular events; however, there is a paucity of comparative analyses regarding metabolic biomarkers that can forecast short-term carotid plaque progression in middle-aged adults. METHODS: This prospective cohort study included adults without initial carotid abnormalities who underwent serial carotid ultrasounds and metabolic profiling. A total of 11 blood lipid and glucose profiles were examined. Carotid artery plaque progression was defined as the emergence of new plaques within a 2-year period. The association between each metabolic indicator and the outcome was analyzed using Pearson correlation, restricted cubic splines, multivariable logistic regression, and receiver operating characteristic curves. The five indicators with the strongest associations were identified, and a logistic regression model, adjusted for covariates, was utilized to assess the impact of the coexistence of risk factors on the progression of carotid atherosclerosis. RESULTS: A total of 7703 individuals were included in the study, among which 9.52% (n = 733) developed new carotid plaques over the 2-year period. The elevated total cholesterol to high-density lipoprotein cholesterol (HDL-C) ratio [odds ratio (OR) = 1.38, 95% confidence interval (CI) 1.28-1.49], low-density lipoprotein cholesterol to HDL-C ratio (OR = 1.66, 95% CI 1.49-1.85), and triglyceride-glucose index (OR = 1.34, 95% CI 1.17-1.53) demonstrated the strongest correlations with plaque progression. Cumulative risk factor analysis indicated that individuals with five or more risk factors faced a 3-fold increased risk (OR = 3.02, 95% CI 2.28-4.01) relative to those with no risk factors. Subgroup analyses confirmed the robustness of the total cholesterol/HDL-C ratio across various metabolic subgroups, while the triglyceride-glucose index diminished in hypertensive and obese populations. CONCLUSIONS: Both traditional lipid ratios, particularly the total cholesterol/HDL-C ratio, and indices of insulin resistance, such as triglyceride-glucose index, are significant risk factors of carotid plaque progression. A dose-response relationship was observed between the accumulation of identified risk factors and the progression of carotid atherosclerotic plaques. Therefore, risk stratification in health screenings should prioritize these biomarkers to improve early detection and prevention strategies for atherosclerosis. Key messages What is already known on this topic: Existing evidence has established associations between various individual lipid parameters [e.g. low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides (TG)] and glucose metabolism markers with the presence of carotid atherosclerosis. Furthermore, composite ratios like TC/high-density lipoprotein cholesterol (HDL-C) and the triglyceride-glucose index (TyG) index have shown superior predictive capability for cardiovascular risk compared to individual parameters in cross-sectional studies. However, comparative longitudinal analyses of these biomarkers for predicting short-term carotid plaque progression specifically in middle-aged, screening populations are scarce. What this study adds: This prospective cohort study demonstrates that among 11 lipid and glucose profiles, traditional lipid ratios-especially the TC/HDL-C ratio-and the insulin resistance index (TyG) are the strongest independent risk factors for short-term carotid plaque progression in a middle-aged health-screening cohort. We further established a clear dose-response relationship, where the accumulation of identified risk factors (specifically elevated LDL-C, TC/HDL-C, LDL-C/HDL-C, TC, and TG) significantly increased the risk of plaque development. How this study might affect research, practice or policy: Our findings suggest that the TC/HDL-C ratio, a cost-effective and readily available metric, should be prioritized in routine health screenings for better early risk stratification of subclinical atherosclerosis. For clinical practice, this supports integrated risk assessment that considers the cumulative effect of multiple lipid abnormalities. Future research should validate the established cut-off values prospectively and explore whether interventions targeting these key biomarkers can effectively retard plaque progression.
Five marks for commitment: implications of the sole-application rule for Internal Medicine Training.
Tan KY, Lim JJ
Postgrad Med J · 2025 Nov · PMID 41212180 · Publisher ↗
Abstract loading — click title to view on PubMed.
Administrative meetings, where minutes go to die: a humorous survival guide for clinicians & academics.
Sharma D
Postgrad Med J · 2025 Nov · PMID 41212177 · Publisher ↗
Abstract loading — click title to view on PubMed.
The vanishing physician-scientist: why Greece is losing its clinician-researchers.
Moris D
Postgrad Med J · 2025 Nov · PMID 41212175 · Publisher ↗
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Correction to: Application of the wireless wearable monitoring system improves the turnaround time in gastrointestinal endoscopy center.
Postgrad Med J · 2026 Mar · PMID 41206367 · Publisher ↗
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Non-linear regression modelling for medical professionals; making curved paths straightforward.
Tingle SJ, Kourounis G, Elliot S … +1 more , Harrison EM
Postgrad Med J · 2026 May · PMID 41182316 · Publisher ↗
Regression models provide information on complex relationships between patient factors, investigations, diagnoses, treatments, and outcomes. These inferences underpin evidence-based medicine. However, by default regressi...
Regression models provide information on complex relationships between patient factors, investigations, diagnoses, treatments, and outcomes. These inferences underpin evidence-based medicine. However, by default regression models assume straight-line relationships, and the common approach of splitting continuous variables into groups has several disadvantages. We discuss pitfalls with these common approaches, and provide an interactive regression model playground, which acts as a point-and-click showcase of these concepts. More flexible regression modelling techniques are available, which allow non-linear relationships between predictors and outcome to be captured. However, they have been shown to be underused in medical research. We feel a major contributor to this is that more flexible non-linear models are typically explained for a statistical audience, creating a barrier for medical professionals. In this article, we introduce non-linear regression for medical researchers. Specifically, we focus on restricted cubic splines (RCS), which allow curved relationships to be fit, within the context of regression models. This has the benefit that the overall structure of the regression model and its outputs, which are familiar to medical researchers, stays the same, with the simple addition of non-linear modelling of specific variables. We implement RCS in a case study, with accompanying example R scripts (available on GitHub). We also launch an R package ("rmsMD") which aims to make this technique approachable to medical researchers, as well as creating publication-ready tables and plots. Overall, this article equips medical researchers with an intuitive understanding of non-linear modelling, which can then be applied with the easy-to-use tools provided.
Investigating factors influencing college students' intention to engage in physical exercise: a theory of planned behavior perspective.
Xia Y, Shi L, Shi Z … +4 more , Yan H, Li T, Fan Y, Wang D
Postgrad Med J · 2026 Mar · PMID 41175088 · Publisher ↗
OBJECTIVE: This study aimed to explore the factors influencing college students' intentions to engage in physical exercise. METHODS: A cross-sectional study was conducted from 15 August 2023 to 25 October 2023. College s...
OBJECTIVE: This study aimed to explore the factors influencing college students' intentions to engage in physical exercise. METHODS: A cross-sectional study was conducted from 15 August 2023 to 25 October 2023. College students in China were recruited to complete a self-designed questionnaire. The hypothetical model was based on the Theory of Planned Behavior (TPB). An online survey was used to measure five constructs: physical exercise behavior intention, attitude (ATT), subjective norms (SN), perceived behavioral control (PBC), and cognition. Structural equation modeling (SEM) was employed to test the hypothesized model. RESULTS: A total of 1997 college students participated in the study, the majority being females (62.0%). The average body mass index (BMI) of 20.98 ± 2.98 (range: 13.86-37.15). The SEM results showed that ATT (β = 0.350, P < 0.001) was the strongest positive predictor of physical exercise intention, followed by PBC (β = 0.171, P < 0.001). Conversely, SN was significantly negatively associated with behavioral intention (β = -0.134, P < 0.001). CONCLUSIONS: College students' ATT and PBC positively predicted their intention to engage in physical exercise, while SN served as a negative predictor. Additionally, cognition was positively associated with attitude toward physical exercise. These findings provide valuable insights for education policymakers and health promotion initiatives aimed at improving college students' physical health. Key messages What is already known on this topic: The Theory of Planned Behavior (TPB) has been widely used to understand factors influencing physical exercise intention, with attitude, subjective norms, and perceived behavioral control being key constructs. Previous studies have shown that these constructs significantly affect physical exercise intention in various populations. However, few studies have specifically examined these factors among Chinese college students, and most have relied on multivariate regression rather than comprehensive model evaluation with structural equation modeling (SEM). What this study adds: This study provides new insights by applying the TPB model with an additional cognition construct to Chinese college students. It reveals that attitude and perceived behavioral control positively predict physical exercise intention, while subjective norms are negatively associated with physical exercise intention, highlighting the strong impact of cognition on attitude and suggesting that enhancing students' understanding of physical exercise can enhance their intention to participate. How this study might affect research, practice, or policy: The findings emphasize the need for targeted interventions that focus on enhancing students' knowledge and intrinsic motivation for physical exercise. This insights could inform the development of educational programs and health promotion strategies to increase physical activity among college students. Additionally, the study's use of SEM to evaluate the TPB model offers a robust methodological approach for future research in this area.
Therapeutic strategy for diabetic patients with cardiovascular-kidney-metabolic syndrome.
Huang J, Zuo PY, Zhang CT … +1 more , Yan JH
Postgrad Med J · 2026 Feb · PMID 41165194 · Publisher ↗
Cardiovascular-kidney-metabolic (CKM) syndrome is a multisystemic condition arising from the intricate interactions among cardiovascular disease, chronic kidney disease, and metabolic risk factors, which together impose...
Cardiovascular-kidney-metabolic (CKM) syndrome is a multisystemic condition arising from the intricate interactions among cardiovascular disease, chronic kidney disease, and metabolic risk factors, which together impose a high burden of morbidity and mortality. Poor CKM health leads to a clinical syndrome with multiorgan dysfunction, with the most significant consequence being a high risk of cardiovascular events and serious renal outcomes. Based on the growing recognition of CKM syndrome, antidiabetic drugs with cardiorenal benefits are considered as first-line therapeutic strategies for patients with type 2 diabetes mellitus. In this review, we summarize several common antidiabetic agents with cardiorenal benefits, and elaborate on their clinical efficacy in addressing cardiovascular events and kidney outcomes in clinical practice, with the aim of developing a holistic CKM management framework and getting a ward-documentation skills among junior doctors. Individualized treatment and precision medicine treatment is also of great importance for CKM health.
Access, bedside assessment, faulty information, and not considering what matters to patients-four impediments to acute medical care that should be addressed.
Kellett J, Holland M
Postgrad Med J · 2026 Feb · PMID 41159618 · Publisher ↗
The growth of medical technology and subspecialization means that most medical care can no longer be provided by single doctors working alone. Notwithstanding its benefits, this transition of care from individuals to tea...
The growth of medical technology and subspecialization means that most medical care can no longer be provided by single doctors working alone. Notwithstanding its benefits, this transition of care from individuals to teams has made healthcare fragmented, with loss of continuity and potentially dangerous hand-overs, which can result in futile cycles of further enquiry before any effective intervention is delivered. These and other unforeseen consequences have, in our opinion, created major challenges for the care of acutely ill patients, which include reduced availability and slow access to acute care, and the impairment of the traditional bedside assessment and diagnostic processes due to faulty or missing information. To correct these issues, essential information, which harms patients if it is incorrect or unavailable, needs to be clearly defined, with systems put in place to ensure it is complete, current, correct, and immediately available. Furthermore, acute care would be focused more on patient needs if quality-of-care outcomes more explicitly measured what matters most to patients.
A narrative review of cancer-related loneliness in those living with and beyond cancer, and their close persons.
Mckeown L, Dempster M, Groarke J … +1 more , Graham-Wisener L
Postgrad Med J · 2026 Feb · PMID 41143719 · Publisher ↗
Cancer-related loneliness is a feeling of social disconnection caused by a diagnosis of cancer, and it is associated with individuals' cancer-related social expectations. It is conceptually distinct when compared with lo...
Cancer-related loneliness is a feeling of social disconnection caused by a diagnosis of cancer, and it is associated with individuals' cancer-related social expectations. It is conceptually distinct when compared with loneliness in a general population due to the unique challenges of cancer. Cancer-related loneliness also impacts close persons including caregivers and dependent youth, with both these populations reporting experiences of loneliness. Given that loneliness is related to a range of harmful psychological and physical outcomes, and there is a paucity of interventions to address cancer-related loneliness in patients and close persons, it is vital for healthcare professionals to be aware of loneliness in these populations. This review provides key takeaways for healthcare professionals to best support patients and close persons experiencing cancer-related loneliness and provides recommendations for future research directions.
A personal view of some aspects of assurances, reassurances, advices, and communications with patients.
Welsby PD
Postgrad Med J · 2025 Oct · PMID 41143718 · Publisher ↗
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Systemic inflammatory markers and epicardial fat volume as predictors of cardiometabolic risk in type 2 diabetes.
Cosgun M, Cosgun Z, Kalfaoglu ME … +1 more , Aktas G
Postgrad Med J · 2026 Mar · PMID 41143714 · Publisher ↗
BACKGROUND: This study aims to examine the relationship between markers indicating systemic inflammatory response and epicardial fat volume (EFV) detected by computed tomography (CT) in type 2 diabetes mellitus (T2DM) pa...
BACKGROUND: This study aims to examine the relationship between markers indicating systemic inflammatory response and epicardial fat volume (EFV) detected by computed tomography (CT) in type 2 diabetes mellitus (T2DM) patients. METHODS: A total of 165 patients (92 patients with diabetes and 73 control group) who underwent thoracic CT examination were included in the study. Hemogram parameters, lipid profiles, HbA1c, glucose, C-reactive protein, and uric acid levels were recorded. The systemic inflammatory response was calculated using the formula P × N/L. CT images were analysed by an experienced radiologist using 3D Slicer software. RESULTS: EFV and surface area were significantly higher in T2DM patients compared to the control group (P < .001). Additionally, the uric acid to HDL ratio (UHR) and systemic inflammatory index (SII) values of T2DM patients were significantly higher than those of control subjects (P = .04 for UHR and P = .035 for SII). Receiver operating characteristic analysis showed that EFV was >15.5 in T2DM patients with a sensitivity of 92% and a specificity of 37%. CONCLUSIONS: This study reveals that EFV is higher in T2DM patients and shows a positive correlation SII. Evaluating EFV, SII, and UHR together may be significant in assessing the inflammatory burden and cardiac risk of T2DM. The ease and cost-effectiveness of these markers increase their usability in clinical practice. Key messages What is already known on this topic: Epicardial fat volume (EFV) and systemic inflammatory index (SII) have been reported to be associated with type 2 diabetes mellitus (T2DM). What this study adds: Besides correlated with SII, EFV was further associated with T2DM and high sensitivity in detecting diabetic subjects. How this study might affect research, practice, or policy: The results of the present study may guide clinicians in personalizing preventive strategies, such as, identifying patients at higher cardiometabolic risk who could benefit from intensive lifestyle or pharmacological interventions.
It's not all in the name-how the misnomer 'endometriosis' stifles understanding and research.
Fatima O, Shams A
Postgrad Med J · 2025 Oct · PMID 41124082 · Publisher ↗
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Netrin-1: pioneering new Frontiers in peripheral nerve injury treatment.
Qin C, Zhang S, Hua G … +4 more , Kong L, Cao J, Tan X, Xu S
Postgrad Med J · 2026 Jan · PMID 41124081 · Publisher ↗
BACKGROUND: The incidence of peripheral nerve injury has increased annually and it has become a common traumatic disease in clinical practice. METHODS: Netrin-1 is a crucial extracellular matrix protein that plays a sign...
BACKGROUND: The incidence of peripheral nerve injury has increased annually and it has become a common traumatic disease in clinical practice. METHODS: Netrin-1 is a crucial extracellular matrix protein that plays a significant role in nerve development and regeneration, and is involved in the construction of a local neurological injury regional regeneration and repair microenvironment to support axon and myelin repair growth. RESULTS: Recent studies have highlighted its important roles in the repair of peripheral nerve injuries. CONCLUSION: This review clarifies how Netrin-1 in fluences neuronal survival, promotes axonal regeneration, and modulates neuro-inflammation.
Plagiarism checks in medical postgraduate theses: context, challenges, and recommendations.
Kumar M, Aparnavi P
Postgrad Med J · 2026 May · PMID 41104679 · Publisher ↗
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Pan-immune-inflammation value and systemic immune-inflammation index predict the clinical efficacy of biological agents in Crohn's disease.
Liu B, Liu D, Qi C … +1 more , Sunggip C
Postgrad Med J · 2026 Mar · PMID 41092350 · Publisher ↗
BACKGROUND: It remains unclear whether pan-immune-inflammation value (PIV) and systemic immune-inflammation index (SII) can predict treatment outcomes in Crohn's disease (CD) patients receiving infliximab. This study exp...
BACKGROUND: It remains unclear whether pan-immune-inflammation value (PIV) and systemic immune-inflammation index (SII) can predict treatment outcomes in Crohn's disease (CD) patients receiving infliximab. This study explored the role of PIV and SII in predicting treatment response and prognosis in CD patients receiving biologics. METHODS: Clinical data of 160 patients with CD were retrospectively collected from Anqing First People's Hospital in China. Patients were classified into effective and ineffective groups based on therapeutic response. Additionally, 60 healthy controls were enrolled. Serum levels of PIV and SII were measured in all participants. The effectiveness of infliximab was evaluated based on Crohn's Disease Activity Index. Clinical remission was defined as a Crohn's Disease Activity Index score <150, while a reduction of ≥70 points from baseline indicated clinical response. RESULTS: The effective group included 125 patients (mean age, 34.5 ± 10.2 years; 68 men [54.4%]), and the ineffective group included 35 patients (mean age, 36.1 ± 9.8 years; 18 men [51.4%]). The healthy control group covered 60 individuals (mean age, 33.8 ± 11.1 years; 32 men [53.3%]). Patients in the high SII group demonstrated a markedly elevated hazard ratio (HR = 20.786, P < .001). A higher PIV was associated with better prognosis (HR = 0.386, 95% confidence interval: 0.228-1.655, P = .011). Conversely, a higher SII was associated with worse prognosis (HR = 20.786, 95% confidence interval: 9.412-45.902, P < .001). CONCLUSIONS: Both PIV and the SII are useful in predicting efficacy of CD patients treated with biologics. Compared with SII, PIV is a better choice. Key messages What is already known on this topic: Infliximab is the most efficacious and widely used biologic for inducing remission in moderate-to-severe Crohn's disease. SII and PIV have been validated as prognostic indicators in many diseases. What this study adds: Higher PIV and SII both have positive effects on predicting the prognosis of patients with Crohn's disease. Compared with the SII, the PIV holds greater significance in predicting the clinical outcomes for patients with Crohn's disease. How this study might affect research, practice or policy: PIV and SII may aid in risk stratification and individualized treatment planning in Crohn's disease.
Healthcare workers' knowledge, attitudes, and practices towards cardiovascular disease prevention: a multi-national cross-sectional study.
Heng KJQ, Loong SSE, Chew JHS … +15 more , Yap J, Cader FA, Prajapati D, Lee D, Raja Shariff ER, Cuenza L, Honda S, Tan JWC, Keong YK, Wang W, Foo R, Keong PK, Razavi AC, Nicholls SJ, Dalakoti M
Postgrad Med J · 2026 Mar · PMID 41075282 · Publisher ↗
AIMS: We sought to understand healthcare workers' (HCW) cardiovascular disease (CVD) prevention knowledge, attitudes, and practices to help inform future healthcare policies and optimize preventive cardiology care. METHO...
AIMS: We sought to understand healthcare workers' (HCW) cardiovascular disease (CVD) prevention knowledge, attitudes, and practices to help inform future healthcare policies and optimize preventive cardiology care. METHODS: Data was collected via an anonymous, online questionnaire which consisted of pre-validated CVD prevention and smoking cessation scales adapted from the Preventive Medicine Attitudes and Activities Questionnaire. RESULTS: Six hundred sixty-eight HCWs (60.5% doctors, 27.8% nurses, 11.7% medical students) from 25 nations responded to the survey. Overall, 74.9% of HCWs routinely assessed patients' cardiovascular risk profiles in clinical practice. About 65.7% of HCWs counselled patients who were asymptomatic for CVD on tangible lifestyle changes to improve their cardiovascular risk profiles, while 68.2% of HCWs did so when patients were overweight. Of note, only 51.3% of HCWs implemented comprehensive smoking cessation interventions for their patients. Practising HCWs demonstrated higher levels of CVD prevention promotion than medical students in all aspects, except for self-reported importance of CVD risk factor counselling (Tukey honestly significant difference diff: 0.31, P-value: .051). Among practising HCWs, there were no significant differences in their CVD prevention practices across varying lengths of clinical practice. HCWs from higher income nations tended to fare worse than their lower income counterparts. CONCLUSION: A large multi-national survey reveals significant gaps in the promotion of CVD prevention by HCWs. Significant differences between medical students and practising HCWs' CVD prevention behaviours, highlight the role of education for the promotion of long-term positive CVD prevention practices. Further efforts should target the medical education of early-career HCWs, especially in higher income nations. Key message What is already known on this topic: The importance of lifestyle modification for the primordial prevention (risk factor prevention) and primary prevention (risk factor management) of cardiovascular disease (CVD) is indisputable. Studies have shown that physicians and other healthcare workers (HCWs) may be best placed to encourage tangible lifestyle changes and enact meaningful modification in patients' cardiovascular health-related behaviours. What this study adds: However, in practice, the role of HCWs in monitoring and encouraging patients' health behaviours is complicated by the challenges of real-life clinical practice, such as time constraints or lack of manpower. Hence, this large multi-national survey sought to understand HCWs' CVD prevention knowledge, attitudes, and practices to help inform future healthcare policies and optimize preventive cardiology care. How this study might affect research, practice, or policy: This study reveals significant gaps in the promotion of CVD prevention by HCWs, highlighting key differences in CVD prevention practices based on profession, level of training, subspecialty, and national income status. Nurses, cardiology subspecialists, and HCWs from lower middle-income nations were found to be more proficient in promoting CVD prevention compared to their counterparts. Further efforts should target the medical education of undergraduate HCWs, especially in higher income nations, as established clinical practices learned during clinical education typically persist and are resistant to change over time.
The impact of community-based Tai Chi exercise on intrinsic capacity improvement in the elderly: a meta-analysis of randomized controlled trials.
Lan Y, Salvador JT, Zhang S … +1 more , Wu M
Postgrad Med J · 2026 Mar · PMID 41075277 · Publisher ↗
BACKGROUND: With global population aging, the decline in intrinsic capacity-crucial for health and independence of older adults-has become a major concern. OBJECTIVE: With global population aging, the decline in intrinsi...
BACKGROUND: With global population aging, the decline in intrinsic capacity-crucial for health and independence of older adults-has become a major concern. OBJECTIVE: With global population aging, the decline in intrinsic capacity-crucial for health and independence of older adults-has become a major concern. To evaluate the effects of community-based Tai Chi on intrinsic capacity in elderly populations. METHODS: A meta-analysis of 26 randomized controlled trials (RCTs) including 3275 participants aged ≥60 years was conducted. Intervention durations ranged from 6 to 72 weeks. Outcomes assessed included activities of daily living, cognitive function, motor function, and depressive symptoms. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. RESULTS: Tai Chi interventions significantly improved activities of daily living (SMD = 1.11), cognitive function (SMD = 0.44), motor function (SMD = -0.50), and depressive symptoms (SMD = -0.79). The intervention was consistently effective across various program lengths and settings. CONCLUSION: Community-based Tai Chi is a low-cost, low-risk intervention that enhances intrinsic capacity, particularly motor, cognitive, and psychological domains, in older adults. It should be considered in managing age-related decline. Further large-scale, long-term RCTs are warranted to confirm these findings and clarify underlying mechanisms. Key message What is already known on this topic: Decline in intrinsic capacity threatens independence and well-being in older adults. Tai Chi has been reported to improve balance, cognition, and mood, but evidence on its overall effect across multiple domains of intrinsic capacity has been inconsistent. What this study adds: This meta-analysis of 26 RCTs demonstrates that community-based Tai Chi significantly improves activities of daily living, cognitive function, motor function, and depressive symptoms in elderly populations. How this study might affect research, practice or policy: Findings support the integration of Tai Chi into community-based aging programs as a safe, low-cost strategy to preserve intrinsic capacity. Future large-scale, long-term studies could refine protocols and inform public health policy on healthy aging.
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