Weeks Of Intervention Research Articles

Subjective feedback from the EatWellUK-2 study: Insights for personalised nutrition apps

Poor dietary habits are associated with the development of non-communicable diseases(1). Most strategies implemented to enhance population diet quality follow a “one-size-fits-all” standardised approach, often neglecting individual preferences and requirements. Evidence suggests that personalised nutrition (PN) advice, tailored to an individual, can improve dietary intakes(2). This research investigates participants’ subjective feedback from the EatWellUK-2 randomised control trial that compared PN advice versus general dietary guidance, both delivered via eNutri, a web app, developed at the University of Reading. eNutri delivers automated food-based nutrition advice tailored to the user based on their dietary intake recorded by a food frequency questionnaire (FFQ)(3).Participants were disease-free UK adults (>18y) who were randomised to the PN or control group. Participants completed the eNutri FFQ, then automatically received via the app either advice tailored to their dietary intake (PN group) or general population advice based on the UK’s Eatwell Guide (control). Following a 12-week intervention, the FFQ was repeated and participants completed a feedback questionnaire containing open-text and Likert questions assessing agreement with statements (strongly disagree, disagree, neutral, agree and strongly agree). MannWhitney U tests compared the mean ranks between the PN and control groups for each question. Data are presented as percentages of participants who felt positively about each statement based on “agreed” plus “strongly agreed” responses. The study received ethical approval from the University of Reading Research Ethics Committee (08/19) and was registered at ClinicalTrials.gov (NCT03897972).Participants (90% female) had a mean (SD) age of 46 (15) y and BMI of 25.8 (6.1) kg/m2. When asked about the advice received, the responses of the PN group (n = 54) were more positive that “it encouraged me to eat healthily, even if only for short time” (p = 0.045, PN 55.6% vs control 41.8%) and “it was clear what changes I needed to make to improve my diet” (p = 0.011, PN 73.6% vs C 51.8%). When asked to provide an “app review” of eNutri, the control group (n = 55) described their advice as “too general” and “readily available elsewhere”, while the PN group said it contained “varied and realistic examples”, and the advice was “very clear”, “helpful” in relation to choosing “better foods to eat” and allowed people to “assess your own goals”.Participant feedback favoured PN over general population advice as it provided encouragement and clarity about which dietary changes would benefit each individual. Together with the quantitative results from the EatWellUK-2 study, which are still being analysed, these findings will help to assess eNutri’s potential as a useful tool to encourage UK adults to adopt healthier dietary behaviours.

Prediabetes and cardiovascular risk factors: the effectiveness of a guided self-determination counselling approach in primary health care, a randomized controlled trial

BackgroundIdentify individuals who are at risk of Type 2 diabetes, who also are at a greater risk of developing cardiovascular disease is important. The rapid worldwide increase in diabetes prevalence call for Primary Health Care to find feasible prevention strategies, to reduce patient risk factors and promote lifestyle changes. Aim of this randomized controlled trial was to investigate how a nurse-lead Guided Self-Determination counselling approach can assist people at risk of type 2 diabetes to lower their coronary heart disease risk.MethodsIn this randomized controlled study, 81 people at risk of developing type 2 diabetes were assigned into an intervention group (n = 39) receiving Guided Self-Determination counselling from Primary Health Care nurses over three months and a control group (n = 42) that received a diet leaflet only. Measurements included the Finnish Diabetes Risk Score questionnaire and biological measurements of Hemoglobin A1c protein, Body Mass Index, fasting blood glucose, Blood pressure, Cholesterol, High-density lipoprotein, and triglycerides, at baseline (time1), 6 (time2) and 9 months (time 3).ResultsA total of 56 participants, equal number in intervention and control groups, completed all measurements. A significant difference between the intervention and control groups, in coronary heart disease risk was not found at 6 nor 9-months. However, within-group data demonstrated that 55.4% of the participants had lower coronary heart disease risk in the next ten years at the 9-month measurement. Indicating an overall 18% relative risk reduction of coronary heart disease risk by participating in the trial, with the number needed to treat for one to lower their risk to be nine. Within the intervention group a significant difference was found between time 1 and 3 in lower body mass index (p = 0.046), hemoglobin A1c level (p = 0.018) and diastolic blood pressure (p = 0.03).ConclusionsAlthough unable to show significant group differences in change of coronary heart disease risk by this 12-weeks intervention, the process of regular measurements and the guided self-determination counselling seem to be beneficial for within-group measures and the overall reduction of coronary heart disease risk factors.Trial registrationThis study is a part of the registered study ‘Effectiveness of Nurse-coordinated Follow-Up Programme in Primary Care for People at Risk of T2DM’ at www.ClinicalTrials.gov (NCT04688359) (accessed on 30 December 2020).

Can in-store product placement encourage purchases of side salads? A quasiexperimental study in a UK supermarket setting

Fruits and vegetables are rich in dietary fibre, vitamins and minerals making them beneficial for health. The UK’s Eatwell Guide (EWG)(1) recommends fruits and vegetables make up 40% of the diet (by weight), but on average they contribute less than 29% to the UK diet(2). Prominent product placement can boost sales. We explored the effect of placing salads next to ready meals in a retail setting, on salad and total fruit and vegetable sales.In a 12-week intervention (July – October 2021), four bagged salad products were shelved above Italian ready meals in 23 stores. Salads displayed a ‘healthy’ on-pack symbol and shelf signposting encouraging customers to ‘add salad to their baskets for a balanced meal’.Two matched control store groups were identified, based on store area demographics (n = 23 stores) and store-level pre-intervention bagged salad and Italian ready meal sales (n = 21 stores), accounting for external sales influences, e.g. weather, supply chain shocks and Covid-19 lockdown behaviours. Transactions were shared by the retailer for 2 years before, 3 months during, and 9 months post-intervention.Two years of pre-trial transactions (units and weight) were aggregated to the store level to produce an interrupted time series model quantifying changes in store-level daily sales of promoted salads, versus a predicted counterfactual. Analysis was repeated in control stores.Within-group change in mean basket proportion (by weight) by EWG segment was examined via the Wilcoxon signed-rank test for difference, comparing the intervention period with two timematched baseline (BL) periods (BL1 = July – October 2019, and BL2 = July – October 2020).In the first three weeks of the intervention, unit sales of promoted salads increased by 35.74% (CI 25.91 - 45.72, p<0.001) vs counterfactual in the intervention stores. However, over the whole 12weeks, unit sales were down 18.34% (CI -26.17%, -10.35%, p<0.001) vs counterfactual. A similar trend was observed across control groups, indicating changes were independent of the intervention.In intervention stores, fruits and vegetables made up 38.75% of baskets at BL1, but declined significantly over time, down 4.12 (p<0.001) percentage points in the intervention period vs BL1 and 1.43 (p<0.001) vs BL2. The proportion of composite (multi-ingredient) dishes rose; up 0.74(p<0.001) percentage points vs BL1 and 1.35 (p<0.001) vs BL2, as did discretionary items; up 0.91 (p<0.001) percentage points vs BL1 and 0.45 (p<0.001) vs BL2. Similar patterns were observed in control stores.Salad sales increased at the start of the intervention relative to predicted sales, but the same change was observed in control stores meaning it cannot be attributed to the trial. Pre-intervention fruit and vegetable purchases with the retailer aligned with the EWG, indicating shoppers already had healthy purchase patterns which may have limited intervention effectiveness.

The Effect of the Continuous Care Model on Oral Health, Self-Efficacy, and Self-Care in Patients With Head and Neck Cancer Undergoing Radiotherapy: A Study Protocol for a Quasi-Experimental Study.

Head and neck cancer, with its unique challenges, often involves radiotherapy as a primary treatment. This can lead to complications affecting patients' well-being. A continuous care model offers potential benefits, but its effectiveness requires validation through rigorous studies. This protocol aims to evaluate its impact on patients undergoing head and neck cancer radiotherapy, contributing to improved care strategies and well-being. The study is a double-arm and parallel-group quasi experimental study in which a 4-week intervention will be compared with usual care. A total of 70 eligible patients with head and neck cancer who are undergoing radiotherapy will be recruited to the intervention or control group. The patients in the intervention group will receive a continues care model designed for head and neck cancer patients in four phases of Orientation, Sensitization, Control, and Evaluation. The primary outcomes include dental plaque and gingival index, which will be measured by an approved dentist using The Gingival and Quigley-Hein index. The secondary outcomes are Oral hygiene self-efficacy and Dental and Oral Health Self-Care Behavior which will be assessed by the Oral and Dental Health Self-Efficacy and Dental and Oral Health Self-Care Behavior Questionnaires. Descriptive statistics will be used to describe variables. According to the types of variables, appropriate statistical tests, including two-sample t-tests, Χ 2, analysis of covariance, or linear regression will be performed. In conclusion, this study aims to evaluate the impact of a continuous care model on head and neck cancer patients undergoing radiotherapy. Findings will contribute to enhancing care strategies and well-being in this population. The trial has been approved by the Research Ethics Committees of Zahedan University Of Medical Sciences. In this study, written consent will be obtained from all participants. The results will be presented to representative groups and published in peer-reviewed journals.

Improvement of sleep quality and sub-health conditions through pasteurized fermented milk consumption: A human intervention study

The sub-health state refers to a transitional condition between optimal health and disease, impacting physical, psychological, and social well-being. In this 42-day human intervention trial, we investigated the effects of two pasteurized fermented milks on sub-health symptoms. These pasteurized fermented milks shared the same starter culture and probiotic strains (Lacticaseibacillus paracasei PC-01, Lactiplantibacillus plantarun Lp-6, Lactobacillus helveticus H9, and Bifidobacterium animalis subsp. lactis Probio-M8), differing only in the presence of inulin. Qualified subjects were randomly assigned to the probiotic group (received milk without inulin; n = 49 or synbiotic group (received milk with inulin; n = 51). Outcome measures included Sub-Health Measurement Scale (SHMS) and Pittsburgh Sleep Quality Index (PSQI) scores, fecal metagenomes, metabolomes, and short-chain fatty acids, and serum neurotransmitter levels at baseline, after a 4-week intervention (day 28), and a 2-week-follow-up period (day 42). Our results showed that both pasteurized fermented milks improved sleep quality and alleviated sub-health symptoms, with no significant added benefit from inulin. Fecal metagenome analysis revealed post-interventional changes in gut microbial composition, including increased Bifidobacterium longum and decreased potentially pro-inflammatory bacteria (Blautia sp. and Dorea sp.). Changes in Blautia sp. and B. longum correlated significantly with SHMS and PSQI scores, respectively. Fecal and serum metabolite analysis showed post-interventional modulation of fecal short-chain fatty acids, anti-inflammatory bioactive metabolites, and serum neurotransmitters such as gamma-aminobutyric and serotonin hydrochloride. In conclusion, pasteurized fermented milk intake alleviated sub-health symptoms, affected the gut microbiome, metabolome, and serum metabolites. These findings highlight the potential of pasteurized fermented milk for mitigating sub-health conditions.

Autism Transition to Adulthood Groups (ATAG): protocol for a feasibility RCT of a new peer-group intervention to promote successful transition to adulthood for autistic young people

IntroductionAutism is a lifelong neurodevelopmental condition diagnosed on the basis of differences in social communication, interaction and repetitive behaviours, including sensory sensitivities. Autistic individuals without intellectual disabilities often face barriers...

Mindfulness Meditation Improves Mental Health in Flood Survivors and Disaster Volunteers: A Randomized Wait-List Controlled Trial

ObjectivesBeing affected by a natural disaster or helping victims can impact mental health. This study aimed to examine whether a digital mindfulness intervention positively affects self-compassion, life satisfaction, and positive affect, and alleviates negative affect, perceived stress, and pathological symptoms in victims and volunteers of the flood disaster in Germany in July 2021.MethodParticipants were 146 people affected by the flood (via house, n = 88; friends, n = 100; workplace, n = 54) and/or volunteered after the disaster (n = 86). After the randomized assignment, 74 received a 6-week application-based mindfulness intervention, and 72 were allocated to the wait-control condition. The control group received the same intervention 6 weeks later. Before (T1) and after (T2) the intervention of the first group and after the intervention of the control group (T3), participants filled out questionnaires regarding different aspects of mental health.ResultsWe found significant interaction effects of time and intervention for all variables (self-compassion, life satisfaction, positive and negative affect, perceived stress, and pathological symptoms), indicating effectiveness of the digital mindfulness intervention. No deterioration were found between T2 and T3 in the intervention group for any of the variables.ConclusionsThe 6-week digital mindfulness program positively affected the mental health of both disaster victims and volunteers. Therefore, a digital mindfulness intervention could be a good alternative in situations where group programs or face-to-face meetings are infeasible.

Effects of Transcranial Direct Current Stimulation Targeting Dorsolateral Prefrontal Cortex and Orbitofrontal Cortex on Somatic Symptoms in Patients With Major Depressive Disorder: A Randomized, Double-Blind, Controlled Clinical Trial.

There is a lack of research on transcranial direct current stimulation (tDCS) for the treatment of somatic symptoms in major depressive disorder (MDD) and the suitable stimulating brain region. We investigated the efficacy of tDCS targeting the dorsolateral prefrontal cortex (DLPFC) versus orbitofrontal cortex (OFC) on depressive somatic symptoms and somatic anxiety in patients with MDD and aimed to identify the appropriate stimulating brain regions. In this randomized, double-blind, sham-controlled study, a total of 70 patients diagnosed with MDD were randomly allocated into DLPFC group, OFC group, and Sham group. Subjects participated in 2 weeks of 10 primary interventions and subsequently 2-week maintenance interventions weekly (20 min, 2 mA). The DLPFC group showed a more significant improvement in somatic symptoms compared to the Sham group at week 2. At the maintenance and follow-up stages, the DLPFC group outperformed the Sham and OFC groups, but the difference with the Sham group was not significant. Neither active group demonstrated superiority over the Sham group in improving depression and anxiety. In conclusion, the tDCS targeting DLPFC may be a potentially effective therapeutic target for alleviating somatic symptoms in patients with MDD.

The effect of vitamin D3 supplementation on vitamin D status and associated health outcomes in children

Sufficient vitamin D status is required in childhood for normal skeletal health and the development of muscle and motor function(1). Vitamin D primarily acts through the promotion of calcium absorption from the gut and mobilisation from bone tissue(2). Childrens’ vitamin D dietary intakes are currently below the recommended guidelines within the UK and Ireland suggesting a need for vitamin D3 supplementation to prevent the risk of developing vitamin D deficiency(3). The aim of this study was to examine the effect of 12 weeks’ supplementation with 10µg/d vitamin D3 vs placebo control on vitamin D status and to determine if improved vitamin D status impacted muscle function and cognition in children aged 4-11 years.In the D-VinCHI randomised, double-blind, placebo-controlled trial, healthy children (n = 118; mean age 8.1 ± 1.8 y; 51% girls) were randomly assigned to either placebo or 10µg/day of vitamin D3 for 12 weeks (year-round). Baseline and endpoint measures included anthropometric measures, hand grip strength, balance, and cognitive assessment. Blood samples were analysed for plasma 25hydroxyvitamin D [25(OH)D], and parathyroid hormone. Vitamin D consumption from food sources was assessed via a 13-item food frequency questionnaire.Following the 12-week intervention vitamin D status [25(OH)D concentration] increased in the treatment group from 66.31 ± 17.25 nmol/L to 69.04 ± 16.92 nmol/L. Change in status was significantly different compared to the placebo group within which a decrease in 25(OH)D was observed from 63.67 ± 19.48 to 56.29 ± 18.58 nmol/L, p<0.001. Supplementation with vitamin D3 prevented deficiency of plasma 25(OH)D during the winter months. Vitamin D3supplementation had a positive effect on cognitive function, improving simple movement time from 707 ± 380 to 599 ± 207 milliseconds, compared to the placebo group within which time increased from 680 ± 284 to 728 ± 372 milliseconds, p = 0.017. Vitamin D mean dietary intake from food sources alone was 2.68µg/day. There was no effect of supplementation on muscle function.Vitamin D3 supplementation maintained year-round sufficiency in children and importantly, prevented deficiency during the extended winter months. Vitamin D supplementation may enhance cognitive function via improvements in attention and psychomotor speed. The reported intakes of vitamin D food sources were low and were well below the current dietary reference value for this age group. Further health promotion policies and (bio)fortification strategies should be considered within this age group to maximise vitamin D status for optimal growth and development.

Effects of Baduanjin on motor function in children with developmental coordination disorders: study protocol for a randomised controlled trial

IntroductionChildren diagnosed with developmental coordination disorder (DCD) exhibit a range of challenges in both gross and fine motor skills, characterised by sluggish and awkward movements. Additionally, they experience deficits in...

Efficacy of a Wearable Activity Tracker With Step-by-Step Goal-Setting on Older Adults' Physical Activity and Sarcopenia Indicators: Clustered Trial.

Smart wearable technology has potential benefits for promoting physical activity and preventing sarcopenia. The purpose of this study was to explore the efficacy of a wearable activity tracker with 2-stage goal-setting for daily steps on older adults' physical activity and sarcopenia indicators. The study used a clustered trial design and was conducted in March to June 2022. Participants were community-dwelling adults older than 60 years who were recruited from 4 community centers in Taipei City. The intervention was designed with 2-stage goals set to 5000 steps/day in the first 4 weeks and 7500 steps/day in the final 4 weeks while wearing a commercial wearable activity tracker. Data were collected by self-reported questionnaires, a body composition analyzer, a handle grip tester, and 5 sit-to-stand tests. All 27 participants in the experimental group and 31 participants in the control group completed the 8-week intervention. Total and light-intensity physical activities, skeletal muscle index, and muscle strength increased, while sedentary time, BMI, and the waist circumference of participants decreased in the experimental group, with significant group-by-time interactions compared to the control group. A wearable activity tracker with gradual goal-setting is an efficient approach to improve older adults' physical activity and sarcopenia indicators. Smart wearable products with behavioral change techniques are recommended to prevent sarcopenia in older adult populations.

Feasibility and Acceptability of the We See You, Sis Sister Circle for Black Women With Depression Symptoms

ObjectiveTo test the feasibility and acceptability of We See You, Sis, a therapeutically grounded virtual sister circle intervention for Black women with depression symptoms. DesignA two-group quasi-experimental design. SettingVirtual on the Zoom platform. ParticipantsBlack women who were at least 40 years of age, with current depression symptoms, who had reliable access to Zoom (N = 30). MethodWe See You, Sis is a virtual sister circle intervention that is therapeutically grounded in the core processes of Pulling Out of Fire, a culturally adapted version of acceptance and commitment therapy. Groups 1 and 2 received the 6-week intervention during Weeks 1 through 6 and 7 through 12, respectively. The main outcomes were feasibility (recruitment, retention, and completion) and acceptability. The theoretical framework of acceptability informed the focus group guide used to assess acceptability. We used thematic analysis to code the qualitative data and to identify salient themes across participants’ narratives. ResultsRecruitment (70%), retention (83.3%), and completion (82%) rates demonstrated that the intervention was feasible. Participants perceived the intervention to be acceptable, especially because it fit with their personal and collective values. We generated two overarching themes: Becoming More Whole and Having a Trusted Space to Address Depression Symptoms and Related Experiences, which represented the interconnected processes of personal growth and collective healing that occurred throughout the intervention. ConclusionThe findings provide evidence to support the delivery of peer-delivered mental health interventions for middle-age and older Black women.

Efficacy of Mindfulness Meditation on Patients With Stroke With Concurrent Coronary Heart Disease: A Randomised Controlled Trial.

This study aimed to investigate the efficacy of mindfulness meditation on sleep quality and negative emotions in patients with stroke with concurrent coronary heart disease. This study was a randomised controlled trial. A total of 72 patients with stroke with concurrent coronary heart disease were randomly divided into an observation group and a control group, with 36 patients in each group. The control group received routine treatment plus eszopiclone tablets at a dosage of 3 mg once daily. The observation group received mindfulness meditation in addition to the treatment given to the control group. The Pittsburgh Sleep Quality Index was used to assess sleep status, the Self-Rating Anxiety Scale and Self-Rating Depression Scale were used to assess depression and anxiety, and the Fugl-Meyer Assessment was used to assess motor function. All participants in both groups received a 6-week intervention. Pairwise comparisons revealed that the observation group had better outcomes in sleep quality, sleep onset latency, sleep duration, sleep efficiency, sleep disturbances, daytime function and total scores at both 6 and 12 weeks compared with the control group (p < 0.05). After 12 weeks of intervention, compared with the control group, the total score of sleep quality improved more significantly (9.22 ± 2.35/6.26 ± 2.47). Additionally, different treatment methods had varying effects on anxiety scores, depression scores and motor function scores between the two groups (p < 0.001). Further comparisons showed that the observation group had lower anxiety and depression scores and higher motor function scores at both 6 and 12 weeks compared with the control group (p < 0.05). Mindfulness meditation can effectively improve sleep quality and reduce negative emotions in patients with stroke with concurrent coronary heart disease, as well as promote the recovery of limb functions.

UK university students’ perceptions about the benefits and value of personalised nutrition advice delivered by the web-based eNutri app

University students often make less healthful dietary choices whilst at university however, do not typically receive advice and support to help them eat more healthily(1,2). A tool which could be provided to students to promote more favourable dietary behaviours is the eNutri web-based app which includes a food frequency questionnaire (FFQ) and delivers automated personalised nutrition advice (PNA) and a diet quality score (DQS) consisting of 11 food/nutrient components(3). The PNA includes scores and general advice for each component and, for the user’s three lowest scoring components, recommends which foods to eat more/less frequently to improve their DQS. As part of a 4-week intervention study, we aimed to explore the perceptions of the eNutri PNA in UK university students.As part of this intervention, 14 students from the Universities of Reading and Hertfordshire completed the eNutri FFQ and received their PNA. At the end of the study, they rated how much they agreed with statements about the perceived value and benefit (if any) of the eNutri PNA tool, on a 6-point scale ranging from strongly disagree to strongly agree. The percentage of respondents reported is the total number who responded “somewhat agree”, “agree”, or “strongly agree” to each statement.Of the 14 students, 79% were female with a mean age of 25y (range = 18-37y) and mean BMI of 24.7kg/m2 (range = 19.4-31.9kg/m2). At baseline, the average importance of a healthy diet to the participants (n = 13) was rated at 7.2 out of 10 (with 0 being ‘not important at all’ and 10 being ‘very important’). In total, 57% of respondents indicated that they felt they ‘were eating a healthier diet because of the eNutri advice received’ and only 14% reported that ‘the advice did not motivate them to make changes to their diet’. Furthermore, 64% of respondents indicated that the ‘eNutri PNA gave them confidence in their ability to make changes to their diet’ and that it ‘supported them to do so’. Half of the students agreed that ‘they would want to use eNutri long term to track their progress and receive regular PNA’. In addition, 79% agreed that ‘eNutri should be offered to all university students to help them make healthier food choices’, and that if eNutri was offered to them for free by their university, ‘it would be a valuable student benefit’ and they ‘would want to use it again’.In general, university students indicated the eNutri PNA tool supported them to eat healthier and providing access to the wider student population would be beneficial to encourage healthy eating at university. These findings along with the quantitative data from the PNA intervention which is currently being analysed will support the development of larger, suitably-powered studies to confirm these findings.

Plyometric and Resistance Training: A Dual Approach to Enhance Physical Fitness in 12–15-Year-Old Girls

Background/Objectives: This study aimed to evaluate the effects of an 8-week combined plyometric and resistance training program on the physical fitness (PF) of adolescent girls aged 12 to 15 years. The objective was to determine whether combined training (CT) would yield greater improvements in performance measures compared to resistance training (RT) alone. Methods: Forty-seven adolescent girls were randomly assigned to either the CT group or the RT group. Performance measures such as the 20 m sprint, squat jump, vertical jump, handgrip strength, and flexibility (sit and reach test) were assessed before and after the 8-week intervention. Changes in these measures were analyzed to compare the effects of the two training approaches. Results: The CT group showed a significant reduction in sprint time (−6.5%) compared to the RT group (−4.1%), although the difference was not statistically significant. Squat jump height improved significantly by 5.6% in the CT group compared to 1.1% in the RT group (p &lt; 0.05). Similarly, vertical jump height increased by 6.7% in the CT group and by 2.4% in the RT group (p &lt; 0.05). Handgrip strength improved by 7.5% in the CT group and 4.6% in the RT group, with no significant differences between the groups. Flexibility showed slight, non-significant improvements in both groups. Conclusions: The findings suggest that a combined plyometric and RT program is more effective in enhancing explosive power, specifically squat and vertical jump performance, in adolescent girls compared to RT alone. These results highlight the potential of CT programs for improving overall physical performance in this population.

Effectiveness of King's Theory of Goal Attainment in Blood Glucose Management for Newly Diagnosed Patients With Type 2 Diabetes: Randomized Controlled Trial.

Diabetes poses a significant public health challenge in China and globally, with the number of patients expected to reach 592 million by 2035, notably in Asia. In China alone, an estimated 140 million individuals are living with diabetes, and a significant portion is nonadherent to medications, underscoring the urgency of effective management strategies. Recognizing the necessity of early and comprehensive management for newly diagnosed patients with type 2 diabetes, this study leverages an online teach-back method and "Internet + Nursing" platform based on King's Theory of Goal Attainment. The approach aims to enhance glycemic control and reduce fear and misconceptions about the disease, addressing both the educational and emotional needs of the patients. The primary aim of this study was to assess the effectiveness of King's Goal Attainment Theory in the management of newly diagnosed patients with type 2 diabetes. This research sought to develop a collaborative model for blood glucose management, integrating the expertise and roles of physicians, nurses, and patients. The model is designed to enhance the synergy in health care provision, ensuring a comprehensive approach to diabetes management. In this study conducted at Changzhou Traditional Chinese Medicine Hospital between January 2022 and February 2023, eligible patients were randomized into a control group or an online feedback group. The control group received standard care, while the online feedback group participated in a King's Theory of Goal Attainment-based online teach-back program, enhanced by "Internet + Nursing" strategies. This included an interactive platform for goal planning, video content sharing, comprehension assessment, misconception correction, and patient-driven recaps of disease information. Health monitoring was facilitated through the "Internet + Nursing" platform. The study focused on comparing changes in glucose metabolism and emotional disorder symptoms between the groups to evaluate the intervention's effectiveness. Following a 24-week intervention, we observed significant differences in key metrics between the online feedback group and the control group, each comprising 60 participants. The online feedback group demonstrated significant reductions in fasting plasma glucose, 2-hour postprandial glucose, and hemoglobin A1c (P<.05). Additionally, there was a notable decrease in hypoglycemia-related anxiety and alexithymia within this group. Conversely, the control group maintained relatively higher values for these metrics at the same time point (P<.05). These findings underscore the efficacy of online feedback in managing glycemic control and reducing psychological distress associated with hypoglycemia. The online teaching-back method, guided by King's Theory of Goal Attainment, effectively enhances glycemic control, reducing fasting plasma glucose, 2-hour postprandial glucose, and hemoglobin A1c levels in newly diagnosed patients with type 2 diabetes. Simultaneously, it alleviates hypoglycemia-related anxiety and mitigates alexithymia. This approach merits widespread promotion and implementation in clinical settings. Chinese Clinical Trial Registry ChiCTR2400079547; https://www.chictr.org.cn/showproj.html?proj=208223.

Exploring diet-induced ketosis with exogenous ketone supplementation as a potential intervention in post-traumatic stress disorder: a feasibility study.

Post-Traumatic Stress Disorder (PTSD) is a severe and pervasive mental disorder, and patients experience numerous distressing symptoms and impairments that significantly impact their lives. In addition to being a mental disorder, PTSD is strongly associated with a wide range of metabolic abnormalities that affect the entire body. Existing treatment options of psychotherapy and medications are often ineffective. Exploring other potential treatments is necessitated. The ketogenic diet has shown potential as a metabolic therapy in certain neurological and mental disorders and is a promising intervention in the treatment of PTSD. This study aimed to examine if a 4-week ketogenic diet intervention supplemented with exogenous ketones (KD-KS) was feasible in adult patients with PTSD, to what extent it was possible to recruit patients, attain and maintain ketosis (plasma concentration of β-hydroxybutyrate (BHB) ≥ 0.5 mmol/L), the occurrence of serious adverse reactions and adverse reactions to KD-KS, and acceptance of treatment. Our exploratory aims were changes in PTSD symptoms and health-related quality of life (QoL) from baseline to 4 weeks. Patients 18 ≤ 65 years old, diagnosed with PTSD, and receiving outpatient treatment for PTSD at Southern Oslo District Psychiatric Centre (DPC), Oslo University Hospital, Oslo, Norway, were included. The intervention consisted of a ketogenic diet supplemented with β-hydroxybutyrate salt to obtain ketosis. PTSD symptoms were measured with the PTSD Checklist for DSM-5 (PCL-5) and QoL was measured with the RAND 36-Item Health Survey 1.0. During a 21-week inclusion period, three of four eligible patients (75% [95% CI: 30 to 95%]) were included. Two patients (67% [95% CI: 21 to 94%]) completed the 4-week intervention and one patient (33% [95% CI: 6 to 79%]) completed 2 weeks of intervention before discontinuing. Ketosis was achieved on day 1 in one patient, and on day 2 in two patients, and was maintained in 87% of the intervention. There were no serious adverse reactions. Adverse reactions were reported in a total of 70% of intervention days, the most frequent being headache followed by fatigue. The participant-perceived degree of adverse reactions was low to moderate. The treatment was accepted by patients on all intervention days. PCL-5 decreased by 20 points (70 to 50) in patient 1 and by 10 points (50 to 40) in patient 2, from baseline to 4 weeks, which is a reliable and clinically meaningful improvement. QoL improved in six of eight RAND-36 subscales in patient 1 and three of eight in patient 2. Patient 3 did not complete assessments after week 2. To the best of our knowledge, this feasibility study is the first study examining a ketogenic diet intervention in patients with PTSD. Three of four predefined feasibility criteria were achieved. Ketosis was attained fast and maintained, patients were compliant and there were clinically meaningful improvements in PTSD symptoms and QoL. Despite the small sample size, the knowledge obtained in this study is important for the planning of future studies with ketogenic diet interventions in this patient group. It is a first step for potential dietary and metabolic therapies in PTSD. Further feasibility and pilot studies with larger sample sizes are needed to determine feasibility and safety before planning future randomised controlled trials investigating an effect. https://ClinicalTrials.gov, identifier NCT05415982.

Three and Twelve Month Body Mass Outcomes After Attendance at a Community-Based Weight Management Intervention in the North West of England

Background: Research suggests that commercial weight management services are efficacious in helping people manage their body mass, but they typically only include education and advice on physical activity. The objective of this analysis was to assess 3- and 12-month body mass after attendance at a community-based weight management programme delivered by a commercial slimming group, which included the provision of tailored physical activity sessions by a local leisure trust between January 2009 and November 2014. Methods: After institutional ethical approval and participants giving informed consent, a retrospective analysis of a 12-week multi-component intervention, tier 2 community weight management service for adults in Wigan, North West England, United Kingdom, was undertaken. Participants’ (n = 8514) mean ± SD age was 47.4 ± 14.3 years and starting body mass was 86.7 ± 14.3 kg. The main outcome measure was body mass (kg) at 0 months (baseline), 3 months (immediately post intervention) and 12 months. Significant differences in body mass were ascertained if p &lt; 0.05 using repeated measures ANOVA with Bonferroni post hoc test, with effect sizes calculated using partial eta squared. To confirm and account for missing data, the Last Observation Carried Forward (LOCF) approach was used. Results: Repeated measures ANOVA showed a significant effect of time (p &lt; 0.01, ηp2 = 0.36). Post hoc tests revealed there was a significant reduction in body mass from baseline to 3 months (86.7 ± 14.3 kg vs. 81.2 ± 13.6 kg) and baseline to 12 months (79.7 ± 14.0 kg). The difference between 3 months and 12 months was also significant. LOCF confirmed a significant effect of time (p &lt; 0.01, ηp2 = 0.42), with all previously highlighted significant differences remaining. Conclusions: Significant reductions in body mass were reported at 3 and 12 months, providing evidence for the efficacy of the community weight management programme that included tailored physical activity opportunities for participants. Whilst comparisons to a resting control group cannot be made, partnerships between commercial slimming groups and local leisure providers should be encouraged and explored nationally.

Modulating the gut microbiota in Crohn's disease: a pilot study on the impact of a plant-based diet with DNA-based monitoring.

Crohn's Disease (CD) is characterized by chronic intestinal inflammation and dysbiosis. This study aimed to investigate the effects of a plant-based diet (PBD) on gut microbiota composition and inflammation in CD patients and assess the utility of trnL gene sequencing for monitoring dietary adherence. Fourteen CD patients participated in a 12-week PBD intervention. Dietary adherence was monitored through self-reported food diaries and trnL sequencing, which detects plant residues in fecal samples. Gut microbiota was analyzed using 16S rRNA sequencing, and fecal calprotectin levels were measured as an indicator of intestinal inflammation. TrnL sequencing identified 55 plant genera in fecal samples, compared to 41 reported in food diaries, highlighting its accuracy in assessing plant residue diversity. By week 4, participants demonstrated a 1.4-fold increase in plant intake, correlating with a significant increase in microbial diversity. Key genera associated with gut health, such as Faecalibacterium and Bacteroides, increased in abundance. Additionally, fecal calprotectin levels decreased from 472 mg/kg at baseline to 207 mg/kg at week 12, indicating reduced intestinal inflammation. A PBD positively influenced gut microbiota composition and decreased intestinal inflammation in CD patients. The study also demonstrated that trnL sequencing is an effective tool for assessing dietary adherence in clinical settings, offering a more objective measure than self-reported food diaries.

Kinect-Based Mixed Reality Exercise Program Improves Physical Function and Quality of Life in Breast Cancer Survivors: A Randomized Clinical Trial.

Exercise is an effective non-pharmacological approach for alleviating treatment-related adverse effects and enhancing physical fitness in breast cancer survivors. A Kinect-based mixed reality device (KMR), with real-time feedback and user data collection, is an innovative exercise intervention for breast cancer survivors. This study aimed to investigate the effect of KMR exercise program on quality of life (QOL) and physical function in breast cancer survivors. Seventy-seven participants were randomly assigned to either the KMR exercise group or home stretching group with an 8-week intervention. Physical function (shoulder range of motion [ROM], body composition, aerobic capacity, and hand grip strength) was evaluated before and after the intervention period. Participants completed questionnaires such as the Disabilities of the Arm, Shoulder, and Hand (DASH), Functional Assessment of Cancer Therapy-Breast, and International Physical Activity Questionnaire (IPAQ) to assess upper extremity disabilities, QOL, and physical activity levels. Significant group-by-time interaction was found for flexion of the operated arm (154.3±12.5 to 165.8±11.2), and the non-operated arm (158.2±13.8 to 166.5±12.2), abduction of the non-operated arm (154.8±31.6 to 161.1±28.1), and adduction of the operated arm (46.5±9.1 to 52.6±7.2). Significant improvements were also observed in DASH (46.8±9.1 to 40.8±9.3) and IPAQ (1136.3±612.8 to 1287±664.1). The KMR exercise program effectively improved the physical function, alleviated edema, reduced upper extremity disability, and enhanced the QOL in breast cancer survivors. Coupled with significant group-by-time interactions for various outcomes, the results emphasize the potential benefits of incorporating the KMR exercise program to improve the QOL in breast cancer survivors.