6-month Program Research Articles

Evaluation of the feasibility and acceptability of a home-based supervised exercise programme in individuals with spinal cord injuries: SCI-HOME-ACTIVE study protocol

Physical activity is essential to a healthy lifestyle for adults with spinal cord injuries (SCI). Although exercise is recognised as an important tool for improving the well-being and independence of...

Can a 6-Month Exercise Training Program Improve Musculoskeletal Health in Individuals with Systemic Lupus Erythematosus post Glucocorticoid Pulsetherapy? Protocol for a Randomized Controlled Trial

ABSTRACT Background Systemic lupus erythematosus is an autoimmune condition characterized by immune dysregulation, exacerbated systemic inflammation, and tissue damage. Glucocorticoid (GC) pulse therapy is a pharmacological strategy used to manage high activity phases. Although clinically effective, it can lead to adverse effects, including compromised musculoskeletal health. Adjuvant therapies that allow maintenance of the clinical benefits of pulse therapy, while preventing or attenuating these adverse effects, are warranted. Exercise training has the potential to counteract these adverse effects, but the efficacy and viability of this approach has yet to be explored. Hence, this randomized, controlled, parallel-group trial aims to investigate the effects of a home-based, supervised, 6-month exercise training program on a battery of musculoskeletal health parameters in women with systemic lupus erythematosus who recently underwent GC pulse therapy. Methods After baseline assessments, participants will be randomized to either the control or exercise group. Participants in both groups will receive usual care, while those randomized to the exercise group will also undergo a multimodal training program. Outcomes will be examined at baseline and after 3 and 6 months. Primary outcomes include bone mineral density by dual-energy x-ray absorptiometry, bone microarchitecture by high-resolution peripheral quantitative computed tomography, and circulating levels of bone turnover markers (β-CTX and PINP). Secondary outcomes include body composition, muscle strength and function, and aerobic capacity as well as feasibility and acceptability metrics. Conclusion The information gained from this investigation has the potential to inform care and management strategies for this and similarly affected patient groups.

Effects of a 6-month physical activity behavioral intervention in patients following metabolic bariatric surgery: a randomized controlled trial

BackgroundPromoting habitual physical activity (PA) among bariatric patients is crucial for long-term surgery success, yet it poses a significant challenge for healthcare practitioners. ObjectivesThis randomized controlled trial (RCT) aimed to examine the effectiveness of a theory-based behavioral intervention on PA level in post-metabolic bariatric surgery (MBS) patients. SettingUniversity Hospital, Israel MethodsForty-four patients undergoing MBS were randomized to the intervention (n = 22) or control group (n = 22). The intervention group received a 6-month PA counseling program based on self-determination theory (SDT) and the 5 A’s framework, while the control group received usual care. PA level and self-efficacy for exercise (SEE) were assessed pre- (baseline, preintervention) and postoperatively (14 and 28 weeks follow-ups). Anthropometrics, physical function, cardiovascular, and biochemical outcomes were measured at all time points. ResultsThe intervention group showed greater increases in PA levels across time compared to the control group. A significant increase in step counts from baseline to 14 weeks was observed (P = .003). Significant differences favoring the intervention group were observed in self-reported PA changes from baseline to 14- and 28-week follow-ups (P = .020 and P = .024, respectively). Additionally, Physical function, as assessed by the 6-minute walk test (6MWT) and the 5 sit-to-stand (5STS) test, significantly improved in the intervention group throughout the follow-up period (P < .05 for all), However, no between-group differences were observed in SEE, anthropometrics, cardiovascular, or biochemical parameters. ConclusionsA 6-month behavioral intervention post-MBS significantly enhanced patients' PA levels and physical function. Given its theory-based approach and structured protocol, this intervention could be disseminated to support MBS clinicians and centers. Further research with longer follow-up period is warranted to confirm these findings and assess the long-term effects.

Cardiac Rehabilitation for Prediabetes and Metabolic Syndrome Remission: Impact of Ultraprocessed Food–Intake Reduction and Time-Restricted Eating in the DIABEPIC-1 Study

BackgroundCardiac rehabilitation programs provide a valuable opportunity to promote the adoption of healthy lifestyle behaviors in patients with atherosclerotic cardiovascular diseases (ASCVDs) and metabolic comorbidities, including metabolic syndrome and prediabetes. However, strategies to reverse these conditions remain to be explored. The DIABEPIC-1 study aimed to assess the feasibility of an enhanced 6-month cardiac rehabilitation program for patients with ASCVD while investigating prediabetes and metabolic syndrome remission. MethodsThe study combined exercise training with a comprehensive nutritional intervention, emphasizing reduction in intake of ultraprocessed foods, adoption of a Mediterranean diet, and implementation of time-restricted eating. Baseline, 3-month, and 6-month assessments included segmental body-composition measurements, blood analysis, maximal exercise testing, nutritional diaries recorded with the Keenoa AI app, and lifestyle questionnaires. Remission criteria included a return to an HbA1c level of < 5.7%, and < 3 National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP-III) criteria for prediabetes and metabolic syndrome, respectively. ResultsA total of 36 participants were recruited. The study demonstrated completion rates of 94.4% at 3 months, and 88.9% at 6 months, and a mean compliance rate of 92.5% for planned clinical appointments. Significant reductions in waist circumference (–9.2 cm, P < 0.001) and weight (–8.0 kg, P < 0.001) were observed. Improvement in glycemic and lipid profiles, insulin-resistance marker levels, and liver health were noted. Participants enhanced their cardiorespiratory fitness, reduced their consumption of ultraprocessed food, and increased their adherence to the Mediterranean diet and time-restricted eating. Notably, 50% achieved prediabetes remission, and 70% with metabolic syndrome at baseline achieved remission. ConclusionsThe study demonstrates the possibility of enhancing cardiac rehabilitation with an intensive nutritional intervention, yielding clinically significant outcomes, including remission of key risk factors in a substantial number of ASCVD patients. Clinical Trial RegistrationClinicalTrials.gov, NCT05459987.

Weight regain after intragastric balloon for pre-surgical weight loss.

Over one-third of Americans carry the diagnosis of obesity, many also with obesity-related comorbidities. This can place patients at increased risk of operative and postoperative complications. The intragastric balloon has been shown to aid in minor weight loss, however its weight recidivism in patients requiring short interval weight loss has not been well studied. To evaluate weight loss, ability to undergo successful elective surgery after intragastric balloon placement, and weight management after balloon removal. This study is a retrospective review of patients in a single academic institution undergoing intragastric balloon placement from 2019-2023 to aid in weight loss prior to undergoing elective surgery. Clinical outcomes including weight loss, duration of balloon placement, successful elective surgery, weight regain post-balloon and post-procedure complications were assessed. Exclusion criteria included those with balloon in place at time of study. Thirty-three patients completed intragastric balloon therapy from 2019-2023 as a bridge to elective surgery. All patients were required to participate in a 12-month weight management program to be eligible for balloon therapy. Elective surgeries included incisional hernia repair, umbilical hernia repair, inguinal hernia repair, and knee and hip replacements. The average age at placement was 53 years ± 11 years, majority (91%) were male. The average duration of intragastric balloon therapy was 186 days ± 41 days. The average weight loss was 14.0 kg ± 7.4 kg and with an average percent excess body weight loss of 30.0% (7.9%-73.6%). Over half of the patients (52.0%) achieved the goal of 30-50 lbs (14-22 kg) weight loss. Twenty-one patients (64%) underwent their intended elective surgery, 2 patients (6%) deferred surgery due to symptom relief with weight loss alone. Twenty-one of the patients (64%) have documented weights in 3 months after balloon removal, in these patients the majority (76%) gained weight after balloon removed. In patients with weight regain at 3 months, they averaged 5.8 kg after balloon removal in the first 3 months, this averaged 58.4% weight regain of the initial weight lost. Intragastric balloon placement is an option for short-term weight management, as a bridge to elective surgery in patients with body mass index (BMI) > 35. Patients lost an average of 14 kg with the balloon, allowing two-thirds of patients to undergo elective surgery at a healthy BMI. However, most patients regained an average of 58% of the original weight lost after balloon removal. The intragastric balloon successfully serves as a tool for rapid weight loss, though patients must be educated on the risks including weight regain.

Reimagining Faculty Development: A 5-Year Journey of Outcomes and Lessons Learned of a Physician Assistant Faculty Fellowship

Introduction Faculty sufficiency remains one of the major bottlenecks in health workforce development. There is a need for effective models for practicing clinicians to successfully transition to academic teaching roles. This article describes outcomes and lessons learned at the 5-year mark for a statewide faculty development workforce initiative for the physician assistant (PA) profession at the PA Leadership and Learning Academy (PALLA) in Maryland. Methods The PALLA PA faculty fellowship is a state-funded workforce initiative that consists of a 10-month training program that includes synchronous workshops, asynchronous learning modules, experiential teaching opportunities, and completion of an individual project in the realm of scholarship/service under longitudinal mentorship. Programmatic outcomes were longitudinally tracked using the Kirkpatrick model of training evaluation to evaluate the faculty training program at 4 levels of criteria: reaction (level 1), learning (level 2), behavior (level 3), and results (level 4). Key performance indicators for the fellowship include the ability for fellow graduates to provide educational support to Maryland PA programs, engage in, and promote scholarship in the PA profession and build an academic portfolio. Results To date, 4 cohorts of PAs (23 individuals) have completed the fellowship. Learner reaction (level 1) evaluated through surveys, and interviews reveal a positive fellowship experience, with fellows noting benefits of the longitudinal nature of the experience and individualized mentorship and fellows self-report high level of achievement of fellowship learning goals (level 2). Local and national PA review of fellow curricular and scholarly products has been positive (level 3). After graduation, 9 fellows are engaged in faculty roles, providing academic support to local PA programs; 11 fellows have had scholarly products accepted; all fellow graduates have generated an academic portfolio; and 2 fellows have provided new service to PA organizations (level 4). Discussion Four years of fellowship data demonstrate positive impact across Kirkpatrick 4 levels of training evaluation. Nearly, all participants have new contributions in teaching, scholarship, or service roles because of the fellowship. Key lessons learned were the benefits of the longitudinal nature of the experience for scaffolding of learning and ongoing, individualized mentorship.

A Controlled Clinical Trial on the Effects of Aquatic Exercise on Cognitive Functions in Community-Dwelling Older Adults.

Several therapies have been developed to reduce cognitive decline associated with aging. Aquatic exercises, which are widely used to enhance functional capacity, may play a role in stimulating cognitive functions. This study investigated the effects of a 3-month aquatic exercise program on cognitive functions in community-dwelling older adults. In this prospective, single-blinded, controlled clinical trial, 31 participants were allocated to either the experimental (aquatic exercises) or control (no-exercise) group. The intervention program consisted of exercises conducted twice a week in a 1.2 m deep indoor pool. The main outcome measures were cognitive functions, assessed using Raven's Progressive Matrices test and the Wisconsin Card Sorting Test. A repeated-measures analysis of variance was used to assess the impact of the exercise program. The effect sizes (η2p) were reported when a level of significance was achieved (p < 0.05). Compared with the control group, the participants who underwent aquatic exercises showed positive outcomes in Raven's Progressive Matrices test (p = 0.046; η2p = 0.131) and the Wisconsin Card Sorting Test (p = 0.001, η2p = 0.589). Complementary analyses of the Wisconsin Card Sorting Test indicated that the benefits of the aquatic exercise were observed in terms of the number of trials (p = 0.001, η2p = 0.478), number of errors (p = 0.001, η2p = 0.458), and number of non-perseverative errors (p = 0.001, η2p = 0.302). The results indicate that a period of three months of aquatic exercise was beneficial for stimulating specific aspects of the cognitive function of community-dwelling older individuals. Aquatic exercise should be prescribed to this population.

Effects of Neuromuscular Training on Muscle Architecture, Isometric Force Production, and Stretch-Shortening Cycle Function in Trained Young Female Gymnasts.

Moeskops, S, Oliver, JL, Radnor, JM, Haff, GG, Myer, GD, Ramachandran, AK, Kember, LS, Pedley, JS, and Lloyd, RS. Effects of neuromuscular training on muscle architecture, isometric force production, and stretch-shortening cycle function in trained young female gymnasts. J Strength Cond Res 38(9): 1640-1650, 2024-This study evaluated the effects of a 10-month neuromuscular training (NMT) intervention on muscle architecture, isometric force production, and stretch-shortening cycle (SSC) function. Thirty-seven girls aged 6-12 years were placed into gymnastics + NMT (gNMT; n = 15), gymnastics only (GYM; n = 10), or maturity-matched control (CON; n = 12) groups. The gNMT group followed a 10-month NMT program in addition to gymnastics training, whereas the GYM group only participated in gymnastics training. Isometric midthigh pull (IMTP) and drop jump (DJ) kinetics were measured, in addition to muscle thickness, fascicle length, and pennation angle of the gastrocnemius medialis at baseline and at 4, 7, and 10 months. A 3 × 4 (group × time) repeated-measures ANCOVA (covariate, % predicted adult height) was used to evaluate within-group changes. Significance level was set at p < 0.05. Significant interaction effects were observed in muscle thickness, absolute (PF abs ) and relative peak force (PF rel ) in the IMTP and various DJ variables. The gNMT group demonstrated improvements in muscle thickness, IMTP PF abs and PF rel , and DJ kinetics, most commonly evidenced from 7 months onward. The GYM group's muscle thickness also significantly improved, accompanied by improvements in some DJ kinetics. The CON group did not experience any desirable changes. Overall, NMT elicited positive changes in muscle thickness, PF abs and PF rel , and SSC function to a greater extent than gymnastics training alone or growth and maturation. As most adaptations took 7 months, longer-term NMT programs should be implemented with youth female gymnasts.

Proposal and validation of a new approach in tele-rehabilitation with 3D human posture estimation: a randomized controlled trial in older individuals with sarcopenia

ObjectiveThrough a randomized controlled trial on older adults with sarcopenia, this study compared the training effects of an AI-based remote training group using deep learning-based 3D human pose estimation technology with those of a face-to-face traditional training group and a general remote training group.MethodsSeventy five older adults with sarcopenia aged 60–75 from community organizations in Changchun city were randomly divided into a face-to-face traditional training group (TRHG), a general remote training group (GTHG), and an AI-based remote training group (AITHG). All groups underwent a 3-month program consisting of 24-form Taichi exercises, with a frequency of 3 sessions per week and each session lasting 40 min. The participants underwent Appendicular Skeletal Muscle Mass Index (ASMI), grip strength, 6-meter walking pace, Timed Up and Go test (TUGT), and quality of life score (QoL) tests before the experiment, during the mid-term, and after the experiment. This study used SPSS26.0 software to perform one-way ANOVA and repeated measures ANOVA tests to compare the differences among the three groups. A significance level of p < 0.05 was defined as having significant difference, while p < 0.01 was defined as having a highly significant difference.Results(1) The comparison between the mid-term and pre-term indicators showed that TRHG experienced significant improvements in ASMI, 6-meter walking pace, and QoL (p < 0.01), and a significant improvement in TUGT timing test (p < 0.05); GTHG experienced extremely significant improvements in 6-meter walking pace and QoL (p < 0.01); AITHG experienced extremely significant improvements in ASMI, 6-meter walking pace, and QoL (p < 0.01), and a significant improvement in TUGT timing test (p < 0.05). (2) The comparison between the post-term and pre-term indicators showed that TRHG experienced extremely significant improvements in TUGT timing test (p < 0.01); GTHG experienced significant improvements in ASMI and TUGT timing test (p < 0.05); and AITHG experienced extremely significant improvements in TUGT timing test (p < 0.01). (3) During the mid-term, there was no significant difference among the groups in all tests (p > 0.05). The same was in post-term tests (p > 0.05).ConclusionCompared to the pre-experiment, there was no significant difference at the post- experiment in the recovery effects on the muscle quality, physical activity ability, and life quality of patients with sarcopenia between the AI-based remote training group and the face-to-face traditional training group. 3D pose estimation is equally as effective as traditional rehabilitation methods in enhancing muscle quality, functionality and life quality in older adults with sarcopenia.Trial registrationThe trial was registered in ClinicalTrials.gov (NCT05767710).

Super-Mentors to Train Multiple Neonatal Advanced Practice Providers: Pros and Cons.

Despite available training programs for neonatal advanced practice providers (Neo APP), including neonatal nurse practitioners and physician assistants, it is difficult to meet the demand for these providers. There are no publications regarding training models with greater than 1 Neo APP learner per mentor. To create and measure outcomes of a 12-month program to educate Neo APP "Super-Mentors" able to train 2 Neo APP learners simultaneously. Super-Mentors were selected and attended monthly classes to learn mentorship concepts and receive support. Learners received didactic content and support through a Fellowship program. Quantitative data regarding recruitment and retention, as well as Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS) results were compared pre- and postprogram. Qualitative satisfaction measures via survey from 21 stakeholders were analyzed through a phenomenological approach. Six Super-Mentors trained 14 Neo APPs, as compared to 7 in the previous year. One Neo APP left after training. Summative preprogram MNPJSS scores were better (5.1±0.37) than postprogram (4.7±0.47) ( P <.001). The most important preprogram subscale item was "vacation" versus "quality of assistive personnel" postprogram. Both pre- and postprogram scores reflected positive job satisfaction so differences may not be clinically significant. Qualitative program benefits included faster and increased onboarding, stronger relationships, and dedicated time. Challenges included role clarity among other stakeholders, learning culture, and spacial/technological logistics. Super-Mentors can train twice the number of Neo APP learners, with optimal preparation and support of all stakeholders, adequate space, and appropriate technology.

Six-month post-stroke review provision across southwest England: a service evaluation

Background/Aims Six-month post-stroke reviews are advocated for all stroke survivors. There is no recommended service model, with many variations in practice. The aim of this service evaluation was to describe and evaluate the 6-month post-stroke review service provision across the South West England Integrated Stroke Delivery Networks. Methods A mixed-methods service evaluation for 10 services was undertaken, consisting of: a stakeholder meeting to define the scope and review criteria; a mapping exercise to define core service features and activity data; a 12-month retrospective Sentinel Stroke National Audit Programme clinical data audit plus a 1-month prospective audit detailing identified unmet needs, actions to address needs and patient satisfaction; service provider and user guided discussions; and options appraisal synthesising data from all sources to inform service development. Results Considerable variations in service configuration, processes and outcomes existed across services. Guided discussions with 40 service users and 20 service providers revealed predominantly positive experiences. There was perceived value in the review, a key ingredient being its person-centred nature. However, some felt that the review was generic and more of a tick-box exercise. Many staff appeared unaware of differing 6-month post-stroke review models across the region and rarely used Sentinel Stroke National Audit Programme data to reflect on service outcomes or inform service development. Sharing of good practice across services appeared limited. Conclusions Data did not support a specific preferred service model. Findings suggested 6-month post-stroke reviews should not be a ‘one size fits all’ model, with flexibility in format and timing to optimise value. A knowledge sharing and evidence-based culture should be encouraged to nurture service development.

A mixed-methods assessment of the Australasian Society of Genetic Counselors (ASGC) Mentor Program

PurposeIn Australia and New Zealand, one third of genetic counselors have less than 5 years’ experience. Sharing experienced practitioners’ professional knowledge is needed as the profession grows. Formal mentoring is an important facilitator of career progression and shared knowledge. In 2022, the Australasian Society of Genetic Counselors developed a 6-month mentor program, matching mentees with experienced genetic counselors (>10 years). We aimed to evaluate and assess the overall satisfaction and acceptability of the program, the matching process, and barriers to participation. MethodsWe used an explanatory mixed-method design with cross-sectional surveys deployed at baseline and follow-up and opt-in semi-structured interviews. Interview transcripts were analyzed using codebook thematic analysis, and data were integrated in a narrative approach. ResultsFifteen mentors and 15 mentees (N = 30) from 17 dyads were included in the analysis (response rate 83%). Eighteen completed the postprogram survey, and 12 were interviewed. The majority were female (93%), European (90%), and worked clinically in public hospitals (63%). Mentors’ main reason for participating was “to give back to the next generation,” whereas mentees sought “help with career progression.” Time was a barrier to participating. The majority (89%) achieved their goals, and all participants would recommend the program. Most (61%) found the mentor/mentee matching to be excellent, and 44% believed they would continue the relationship after the program. ConclusionThe Australasian Society of Genetic Counselors Mentor Program filled a gap in professional development within the Australian and New Zealand genetic counseling community and highlighted a general desire to share knowledge with new members of the profession.

Feasibility of BrainSTORM, a Traumatic Brain Injury Transitional Care Intervention.

To investigate the feasibility, acceptability, and clinical outcome measures of a transitional care intervention for patients with traumatic brain injury (TBI) and their family caregivers. Inpatient and outpatient rehabilitation at a level I trauma center in the Southeastern United States. Patients (ages 18-75) diagnosed with moderate to severe TBI, receiving rehabilitation, and their family caregivers. Quasi-experimental, single-arm, single-center feasibility study with pre- and post-test design. Participants completed a 4-month transitional care program involving monthly education and social support. Feasibility of enrollment, data collection, intervention completion rates, and intervention acceptability. Clinical outcome measures included patient quality of life (QOL) (12-Item Short Form Health Survey (SF-12), primary outcome) and patient and caregiver self-efficacy (Self-Efficacy for Management of Chronic Conditions Scale). Eleven dyads and 1 monad enrolled (N=23, 12 patients, 11 caregivers). All completed baseline data; 91.3% (n=21, 11 patients, 10 caregivers) completed 2-month (intervention midpoint) data; and 86% (n=20, 11 patients, 9 caregivers) completed 4-month (intervention endpoint) data. The intervention completion rate was 91.67%. Participants engaged in a mean of 2.17 (SD=1.34) monthly educational webinars and 2.42 (SD=1.51) social support groups during the intervention period. Approximately 70% of participants (n=16, 9 patients, 7 caregivers) completed acceptability data, indicating positive intervention experiences (patients: mean 9.44/10 [SD=1.01]; caregivers: mean 9.57/10 [SD=0.79]). Patient QOL scores did not statistically improve over time; however, patient self-efficacy scores did statistically significantly improve from baseline (mean=7.03, SD=1.53; P =.0197) to intervention end point (4months) (mean=8.35, SD=1.71). Brain Injury Support To Optimize Recovering Minds (BrainSTORM) is a promising new TBI transitional care intervention that has potential to enhance care standards for patients with TBI and their family caregivers. Further research is needed to determine its efficacy.

Long-term effects of benzodiazepine discontinuation among older adults: potential improvements on depressive symptoms

Objectives To examine how change in benzodiazepine (BZD) use is linked to changes in depressive symptoms intensity, worry intensity, and sleep quality over 16 months. Method Data come from a larger randomised controlled trial (RCT) named the ‘Programme d’Aide du Succès au SEvrage (PASSE-60+)’ study (NCT02281175). Seventy-three participants age 60 years and older took part in a 4-month discontinuation programme and were assessed four times over 16 months. Change in BZD use was defined as the difference in reported mg/day between two assessments. Control variables were RCT discontinuation group; BZD use at T1; and either depressive symptoms, worry intensity, or sleep quality at T1. Hierarchical multiple regressions were used to analyse data. Results In the short term, right after the discontinuation programme, sleep quality worsened with lower BZD use. This link was no longer significant at the 3- and 12-month follow-up. In the long term, depressive symptoms lowered with lower BZD use. No change was found in worry intensity in relation to BZD use at all measurement times. Conclusion Discontinuation may improve depressive symptoms. Our study also questions the long-term effectiveness of BZD use, since long-term discontinuation was not linked with change in worry intensity and sleep quality.

Adherence to physical exercise program in patients with hypertension

The study aims to assess adherence to a physical exercise program in patients with hyper-tension. 120 hypertensive patients were included in a 3-month physical exercise program (first 2 weeks, 10 daily sessions, under the supervision of a physical therapist in a rehabili-tation center, continued at home, 5 sessions per week). After the 3-month exercise program 108 patients completed an adherence questionnaire. All patients considered the physical exercise program important for their physical health; 82% of them also considered the program important for their mental health. 94% of patients admitted as necessary to con-tinue the physical exercise program after the end of the study. The lowest percentages of patients (47%) admitted the fitting of the physical exercise sessions performed in a rehabil-itation center with their daily program. Adherence to a 3-month physical exercise was beneficial for physical and mental health status of patients with hypertension. The pro-moting factors for a good adherence to rehabilitation were involvement and availability of patients, living in the city or nearby villages, free of charge exercise sessions and quality of physical therapy. The assessment of adherence by an easy-to-use tool can provide im-portant data for adapting the rehabilitation program to patients’ need and expectations. Keywords: hypertension; physical exercise; adherence.

Improving the Jump Shots of U12 Junior Basketball Players by Implementing a Combined Program of Plyometric and Coordination Exercises Using MyVert Technology.

The aim of this study was to investigate the impact of the implementation of an experimental program with combined plyometric and coordination exercises for a time interval of 6 months aimed at improving the jump shots of U12 junior players through the use of information technologies. One hundred seventeen female basketball players, aged between 10 and 12 years (U12), participated in this study. The study subjects were divided into two groups: the experimental group (EG), with 60 (51.3%) subjects, and the control group (CG), with 57 subjects (48.7%). The 6-month experiment program implemented in the experimental group included exercises that combined coordination exercises with plyometric exercises in the execution of throwing skills and skills specific to the basketball game by using the MyVert portable smart sensor. This study included an initial test and a final test, in which three motor tests adapted to the specifics of the basketball game were applied in order to evaluate jump shots: a throw-after-step test, a standing shot test and a shot-after-dribbling test. Only the results of the experimental group showed statistically significant progress (p < 0.05) between the final and initial testing in all three motor tests for the following parameters: maximum jump height (cm), average jump height (cm), power (watts/kg) and successful shots (no). The gains of the control group were not statistically significant in any test. It should be noted that the number of throws scored in the basket of the experimental group increased significantly, a fact highlighted by the very large size of Cohen's value > 3 in all the tests of this study. The results of the experimental group as a result of the implementation of the experimental training program using MyVert technology were superior to the results of the control group. The practical implications of the present study will contribute to the optimization of the athletes' training methodology in order to improve the physical and technical levels in relation to the peculiarities of age and training level.

Feasibility of the flipped classroom approach for health education in a clinical weight loss program

AimTo assess the feasibility of the flipped classroom pedagogy in a clinical weight loss program and its impact on 6-month weight change. MethodsAdults with overweight/obesity enrolled in a 6-month program with a structured diet (portion-controlled meals and fruits/vegetables) and exercise plan (≥150mins/week), plus weekly, 1-h group education sessions. Sessions used a flipped classroom approach: educational content was delivered beforehand via podcast/video and book readings and session time involved application-based activities (e.g., case studies, games). Satisfaction surveys were completed at 3 months. Weight change was assessed using paired t-tests (SAS 9.4, significance 0.05). ResultsEighteen participants completed 6 months (retention 94%). Participants maintained diet adherence and exercise at 3 months (∼84% diet adherence, ∼153mins exercise/week) and 6 months (∼83% diet adherence, ∼158mins exercise/week), as well as attendance to behavioral sessions (3 months: 77%; 6mo: 71%). Satisfaction surveys showed high program enjoyment (∼8.1/10). Mean weight change at 3 and 6 months was −6.5 ± 4.2% and − 9.3 ± 5.0% (both p < 0.01), respectively. ConclusionThe flipped classroom pedagogy was feasible for delivery in a clinical weight loss program and supported significant 6-month weight loss. InnovationThis is the first evaluation of the flipped classroom in a clinical setting and supports the investigation of this pedagogy in weight management.

An investigation of a novel milk allergy-friendly food supplement program.

Compared to households not managing food allergy, households managing food allergy are faced with greater direct and indirect costs. To address these cost burdens, we developed and piloted a milk allergy-friendly food supplement program for lower- and middle-income households managing a dairy allergy in a child age <6 years. Herein, we aimed to evaluate to the impact of this program on food costs, food security, and caregiver mental health using a longitudinal design. Participants living in or near the city of Winnipeg, in Manitoba, Canada were recruited from January to February 2022 via social media, word-of-mouth, and a database maintained by the principal investigator. Consenting participants took part in a 6-month allergen-friendly food supplement program that provided them with biweekly deliveries of allergen-friendly foods free of charge. To evaluate the impact of the program on food costs, food security, and well-being, participants completed a series of questionnaires at baseline, mid-point, and at the end of the program. Changes in these variables were assessed via a series of Friedman tests. The final sample was comprised of 8 households. Relative to baseline, participants reported higher total direct food costs at midpoint (+5.6%) and endpoint (+13.5%), but these changes did not reach statistical significance. In contrast, total indirect food costs decreased over the course of the study relative to baseline (midpoint = -28.2%; endpoint = -18.5%), but the changes were not found to be statistically significant. Participants did, however, report a statistically significant decrease in costs related to lost time from work or school as a result of their child's food allergy at endpoint relative to baseline (-100%). Few changes in food security, caregiver well-being, or child food allergy quality of life were noted. The provision of allergen-friendly foods helped keep grocery costs below the pace of inflation. Participants also reported reduced costs associated with missed time from work or school as a result of their child's food allergy. Despite these encouraging findings, a relatively high proportion of the current sample reported experiencing food insecurity throughout the study period, suggesting that additional financial support for families is needed.

The impact of State of Surrender on the relationship between engagement in substance use treatment and meaning in life presence: a pilot study.

The current study examined the construct of State of Surrender (SoS)-defined as a willingness to accept, without resistance, what is to come-and investigated SoS as a statistical mediator of the relationship between engagement in substance use treatment and meaning in life (MIL). Using a cross-sectional design, participants were 123 people involved with the legal system participating in a 6-month residential treatment program for substance use. Results showed that measures of treatment engagement, including treatment participation, counselor rapport, and peer support, were all positively associated with SoS scores (R 2s ≥ 21.16). Moreover, while controlling for time spent in treatment, SoS statistically mediated the positive association between aspects of treatment engagement and MIL. State of Surrender may be a targetable process in substance use treatment that aids in recovery by orienting clients toward what they find meaningful in life. Future directions and practical considerations are discussed.

Evaluating usability of and satisfaction with mHealth app in rural and remote areas-Germany GIZ collaboration in Bosnia-Herzegovina to optimize type 1 diabetes care.

Type 1 diabetes mellitus (T1DM) management in children and adolescents requires intensive supervision and monitoring to prevent acute and late diabetes complications and to improve quality of life. Digital health interventions, in particular diabetes mobile health apps (mHealth apps) can facilitate specialized T1DM care in this population. This study evaluated the initial usability of and satisfaction with the m-Health intervention Diabetes: M app, and the ease of use of various app features in supporting T1DM care in rural and remote areas of Bosnia-Herzegovina with limited access to specialized diabetes care. This cross-sectional study, performed in February-March 2023, evaluated T1DM pediatric patients who used the Diabetes: M app in a 3-month mHealth-based T1DM management program, along with their parents and healthcare providers (HCPs). All participants completed self-administered online questionnaires at the end of the 3-month period. Data were analyzed by descriptive statistics. The study population included 50 T1DM patients (children/parents and adolescents) and nine HCPs. The mean ± SD age of the T1DM patients was 14 ± 4.54 years, with 26 (52%) being female. The mean ± SD age of the HCPs was 43.4 ± 7.76 years; all (100%) were women, with a mean ± SD professional experience of 17.8 ± 8.81 years. The app was reported usable in the domains of ease-of-use and satisfaction by the T1DM children/parents (5.82/7.0), T1DM adolescents/young adults (5.68/7.0), and HCPs (5.22/7.0). Various app features, as well as the overall app experience, were rated positively by the participants. The results strongly support the usability of mHealth-based interventions in T1DM care, especially in overcoming care shortage and improving diabetes management and communications between HCPs and patients. Further studies are needed to compare the effectiveness of apps used to support T1DM management with routine care.