Active Intervention Research Articles

Efficacy and Safety of Advanced Therapies in Moderately-to-Severely Active Ulcerative Colitis: a Systematic Review and Network Meta-analysis.

This study aimed to compare the efficacy and safety of biologics and small molecules for treatment of adults with moderately-to-severely active ulcerative colitis (UC). A systematic literature review was conducted to identify randomised controlled trials evaluating approved and emerging targeted therapies for patients with UC. A Bayesian network meta-analysis (NMA) approach was applied. Outcomes assessed included clinical response and remission, endoscopic mucosal healing, and safety. Thirty studies were included in the NMA following a feasibility assessment comparing approved induction dosing regimens and 22 studies comparing approved maintenance dosing regimens. In the biologic/Janus kinase inhibitor (JAKi)-naïve population, induction studies showed similar clinical response and remission rates across most interventions, with upadacitinib demonstrating significant improvements versus most other interventions. For maintenance studies, mirikizumab demonstrated significant improvements in clinical response and remission versus most other interventions. In the biologic/JAKi-experienced population, no significant differences were observed between most interventions in induction studies, except for significantly improved clinical response and remission for mirikizumab versus adalimumab, and upadacitinib demonstrated significant improvement versus all other interventions. Few differences between active treatments were observed in maintenance studies. In both populations, all active interventions had similar efficacy in terms of endoscopic mucosal healing in both induction and maintenance studies. Regardless of prior treatment exposure, similar rates of serious adverse events were seen across all active interventions in the induction period. Among the available interventions, owing to its favourable efficacy and safety profile, mirikizumab has a relevant role in the long-term treatment of UC.

Referral pathway and competency profiles of primary care physiotherapists and kinesiologists for physical activity interventions for diabetes: a modified Delphi study

BackgroundHigh quality diabetes care is an essential service in primary care settings since the prevalence and associated complications of diabetes is increasing. Physical activity is effective for the prevention and management of diabetes yet is underutilized in diabetes care. Exercise professionals have specialized skills to deliver physical activity interventions, but effective interprofessional collaboration for diabetes care requires role clarity. This study established the competencies of entry-level physiotherapists and kinesiologists for physical activity interventions for diabetes care in primary care settings and used these competencies to develop clinical tools to promote role clarity in interprofessional care teams.MethodsWe used a modified Delphi process. Eleven physiotherapy and three kinesiology subject matter experts participated in two rounds of Delphi surveys to develop discipline and context specific competencies. These competencies were used to draft competency profiles and a referral pathway tool. Eleven of the participants then participated in a focus group for member-checking of the tools. Descriptive statistics and content analysis were used to analyze quantitative and qualitative data respectively.ResultsThe modified Delphi process resulted in 38 physiotherapy and 27 kinesiology competencies that identify the distinct roles of physiotherapists and kinesiologists in delivering physical activity interventions for diabetes care. The physiotherapy competencies describes their unique role in supporting people with all types of diabetes to engage in physical activity despite complex medical or physical barriers. The kinesiology competencies indicate where these professionals may require additional training, especially when working with people living with type 1 diabetes or who are pregnant. All developed tools had good face validity and were seen to be potentially useful tools by the subject matter experts.ConclusionsThe findings highlight that both physiotherapists and kinesiologists have fundamental skills and abilities to deliver physical activity interventions to people living with diabetes, but that different exercise professionals may be needed depending on the complexity of the clinical profile. The developed clinical tools support improved interprofessional collaboration by clarifying physiotherapy and kinesiology roles in delivering physical activity interventions for diabetes care and highlighting how the two distinct professions can contribute to addressing the growing diabetes epidemic in primary care.

Diet Quality Changes in a 12-Week Web-Based Physical Activity Intervention without Explicit Dietary Guidance

Lifestyle habits seem interconnected and extant studies suggest that a lifestyle-related modification can impact other related behaviors. For instance, interventions targeting physical activity (PA) could potentially impact dietary patterns and quality. Therefore, we hypothesized that a web-based intervention to increase PA would lead to changes in diet quality without explicit dietary guidance. Our aim was to evaluate changes in diet quality, measured by the Healthy Eating Index 2020 (HEI-2020), following a 12-week web-based PA intervention in adults with obesity. The study consisted of secondary analysis of a 12-week pilot randomized controlled trial, wherein participants (N = 82) were randomized to the Physical Activity for The Heart (PATH) intervention group, which included workout videos and virtual coaching, or a wait-list control group. Diet quality was assessed at baseline and post-intervention using the HEI-2020 based on recalls collected through the Automated Self-Administered 24-h recall (ASA-24) system. Baseline characteristics were similar across groups. Both groups showed small improvements in HEI-2020 total scores after 12 wk (PATH: 65.11 vs. Control: 62.24). Stratification by moderate to vigorous physical activities increase (<60 min. vs. ≥60 min.) revealed greater improvements in specific HEI-2020 components in the ≥60 min group, though overall changes remained modest. The PA intervention led to small improvements in certain diet quality components, suggesting potential interconnectedness between PA and dietary habits. However, overall changes in HEI-2020 scores were modest. Future research with larger samples should explore the effects of PA intervention alone vs. combined with dietary guidance on diet quality in adults with obesity.

Investigating the impact of an AI-based play activities intervention on the quality of life of school-aged children with ADHD

BackgroundAttention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder that not only impacts children's behavior, learning, and social interactions but also their quality of life. Advances in artificial intelligence (AI) may provide new opportunities to improve the ADHD symptoms and quality of life of children with ADHD, especially through customized play activities that address their specific needs. AimsThis study examined the impact of AI-based play activities on the quality of life of 61 Saudi children aged between 8 and 12 years who had an ADHD diagnosis. MethodsAI-based play activities intervention consisted of twelve 45-minute sessions, delivered to the experimental group over four weeks (three sessions per week). The control group did not receive any intervention. Children and parents completed the Pediatric Quality of Life Inventory (PedsQL) at pre-test, post-test and follow-up. Results and outcomesThe experimental group exhibited significant improvements in all dimensions and total scores of PedsQL, with moderate to large effect sizes. These improvements were not observed in the control group. The beneficial effects of the AI-based play activities were maintained at the 7-weeks follow-up. ConclusionsAI-based play interventions may enhance quality of life for children with ADHD, with sustained improvements observed after 7-weeks. Incorporating such interventions into educational and therapeutic settings could improve behavioral, social, and cognitive ADHD symptoms. Future research should explore broader applications and long-term effects of AI-based play activities interventions.

The Influential Role of Baduanjin on the Mental Health of Medical Students: A Review

Baduanjin, a traditional Chinese health care practice, not only promotes muscle relaxation and bone strengthening while preventing and treating illnesses but also contributes positively to mental nourishment and emotional regulation. This paper employs a literature review and logical analysis to comprehensively assess the impact of Baduanjin on the mental health of medical students in higher education institutions. The findings indicate a significant prevalence of mental health issues among medical students in recent years, with a myriad of complex influencing factors. Furthermore, interventions aimed at enhancing the mental well-being of college students have become increasingly diverse. Notably, Baduanjin stands out as a traditional physical activity intervention that is both straightforward to implement and effective in bolstering students' mental health. Moving forward, it may serve as a preventive measure for mental wellness in the physical education curricula of universities, fostering the holistic development of both physical and mental health.

The Effect of 6 weeks Physical Activity on Cognitive Control and Trait Impulsivity in Multi-problem Young Adults: First Findings of an RCT-study.

This study aimed to report the effect of a 6-week light-active versus moderate-active physical activity intervention embedded in a multimodal day treatment program on selected measures of cognitive control (i.e., response inhibition, error processing, and cognitive interference) and trait impulsivity. A randomized controlled design was implemented, including male multi-problem young adults (aged 18-27) assigned to either light-active (N = 12) or moderate-active physical activity lessons (N = 11). A repeated measures design was used to examine treatment effects between the two groups over time on response inhibition, error processing, and cognitive interference (measured respectively with a Go/NoGo task, a Flanker task, and the Stroop) and trait impulsivity (measured with the Dutch Baratt Impulsiveness Scale). Cognitive control, but not trait impulsivity, improved over time. Specifically, enhancements in inhibition and reduced cognitive interference were observed after 6 weeks. Error processing did not improve, but we did observe improved performance on an error-processing task. No interaction with physical activity intensity was found, suggesting similar treatment effects regardless of intensity. Results should be interpreted with caution due to several limitations, including the small sample size. Overall, due to current limitations (i.e., physical activity embedded in a larger treatment program, small sample size at follow-up, and low intervention adherence), it is not possible to draw any definite conclusions. However, the current findings contribute to a growing body of evidence suggesting potential benefits of physical activity (embedded in a multi-modal day treatment program) in the enhancement of cognitive control deficits in at-risk populations, independent of exercise intensity.

The cardiovascular risks of sedentary behavior and the progress of physical activity interventions

Since the 1960s, sedentary behavior has been on the rise globally. Modern culture is characterized by sedentary behavior (SB), which has become a distinct risk factor for non-communicable illnesses. Cardiovascular diseases (CVD) are rapidly spreading around the world. A growing body of research has established the significance of SB as a risk factor for the onset of CVD. Additionally, blood lipoprotein (BL), blood pressure (BP), blood glucose (BG), and endothelial function (EF) are among the CVD risk variables that SB may significantly affect. Chinese scholars have not paid enough attention to the harm of SB to CVD, which needs urgent attention. Physical activity (PA) can improve the health of sedentary people. Increased PA may be able to counteract sedentary-induced CVD events, as analyzed by the study. In particular, a multi-component approach to exercise can significantly enhance cardio-metabolic health. Therefore, people may choose PA control as a means of reducing the incidence of CVD.

Research on the effect of post-activation potentiation under different velocity loss thresholds on boxer's punching ability.

This study was conducted in accordance with the principles of velocity-based training theory, with the objective of investigating the effects of post-activation potentiation (PAP) induced by different velocity loss (VL) thresholds (10% vs. 20%) on the punching ability of boxers. In addition, the aim was to determine the velocity loss thresholds and time nodes that produced the optimal activation effect. Twenty-four male elite boxers were randomly assigned to three groups: CON, 10 VL, and 20 VL. All subjects in the three groups underwent an activation intervention involving an 85% of the one-repetition maximum (1RM) squat, with 6-8 repetitions performed in the CON. The number of repetitions in the 20%VL and 10 VL was determined based on the velocity loss monitored by the GymAware PowerTool system. Four time points were selected for observation: the 4th, 8th, 12th and 16th minutes. These were chosen to test the subjects' punching ability. The results demonstrated that activation training at different VL induced a post-activation potentiation in boxers, improving punching ability bilaterally and to a greater extent than in the CON. The dominant side demonstrated the greatest efficacy at the 12th minute under the 20% velocity loss threshold, while the non-dominant side exhibited the greatest efficacy at the 8th minute under the 10% velocity loss threshold.

Effects of sildenafil on gas exchange, ventilatory, and sensory responses to exercise in subjects with mild-to-moderate COPD: A randomized cross-over trial

Excess exercise ventilation (high ventilation (V̇E)/carbon dioxide output (V̇CO2)) contributes significantly to dyspnea and exercise intolerance since the earlier stages of chronic obstructive pulmonary disease (COPD). A selective pulmonary vasodilator (inhaled nitric oxide) has shown to increase exercise tolerance secondary to lower V̇E/V̇CO2 and dyspnea in this patient population. We aimed to assess whether a clinically more practical option - oral sildenafil - would be associated with similar beneficial effects. In a randomized, placebo-controlled study, twenty-four patients with mild-to-moderate COPD completed, on different days, two incremental cardiopulmonary exercise tests (CPET) one hour after sildenafil or placebo. Eleven healthy participants performed a CPET in a non-interventional visit for comparative purposes with patients when receiving placebo. Patients (FEV1= 69.4 ± 13.5 % predicted) showed higher ventilatory demands (V̇E/V̇CO2), worse pulmonary gas exchange, and higher dyspnea during exercise compared to controls (FEV1= 98.3 ±11.6 % predicted). Contrary to our expectations, however, sildenafil (50 mg; N= 15) did not change exertional V̇E/V̇CO2, dead space/tidal volume ratio, operating lung volumes, dyspnea, or exercise tolerance compared to placebo (P>0.05). Due to the lack of significant beneficial effects, nine additional patients were trialed with a higher dose (100 mg). Similarly, active intervention was not associated with positive physiological or sensory effects. In conclusion, acute oral sildenafil (50 or 100 mg) failed to improve gas exchange efficiency or excess exercise ventilation in patients with predominantly moderate COPD. The current study does not endorse a therapeutic role for sildenafil to mitigate exertional dyspnea in this specific patient subpopulation.Clinical trial registry: https://ensaiosclinicos.gov.br/rg/RBR-4qhkf4Web of Science Researcher ID: O-7665–2019

Using contribution analysis to assess evaluation capacity outcomes in community organizations

AbstractCommunity organizations face challenges in addressing the needs of their members and beneficiaries, particularly during times of crisis. More than ever, evidence‐informed programming and decision‐making are essential to help organizations “do more with less”; however, community organizations seldom have the individual and organizational evaluation capacity required to conduct and use evaluations to inform decision‐making. This article provides an overview of the evaluation of the LaboEval evaluation capacity building (ECB) intervention, a 5‐year program implemented in 16 organizations. LaboEval brings together direct and indirect individual and organizational ECB activities to enhance evaluation capacity. Contribution analysis (CA) was used as the evaluation approach in this study, assessing the intervention's activities, outputs, outcomes, and assumptions. Data sources include interviews, document reviews, surveys, administrative data, and a literature review. This evaluation contributes to the field by applying CA to a multiyear, multi‐organizational ECB intervention. The findings inform evaluation capacity builders and evaluators interested in CA, showcasing a unique approach to evaluating complex interventions across multiple organizations.

Key elements of Goal-Directed Training for children with cerebral palsy: A qualitative content analysis

Background: Goal-directed training is an evidence-based occupational therapy intervention for children with cerebral palsy targeting motor performance and goal attainment. There is variability and limited description on goal-directed training delivery within the studies who found it a successful intervention. The aim of this study was to establish the who, what, why and how of goal directed training according to practicing occupational therapists. Methods: Occupational therapists currently delivering goal-directed training to children with cerebral palsy were recruited. Qualitative data were collected from structured, open-ended interviews and analysed through content analysis. Themes and consensus answers were elicited and mapped to the Template for Intervention Description and Replication checklist. Results: Four key elements were identified as essential for goal-directed training: goal setting, task analysis, active intervention and evaluation. Within each area, occupational therapists provided rich descriptions of what these elements looked like in practice. Despite having a clear understanding of goal-directed training, some barriers to implementation were identified. Conclusion: Occupational therapists identified key elements and barriers to implementing goal-directed training in their practice. It is recommended that further support and training is provided to ensure that occupational therapists deliver goal-directed training with high fidelity.

Microscale sampling of the coral gastrovascular cavity reveals a gut-like microbial community

Animal guts contain numerous microbes, which are critical for nutrient assimilation and pathogen defence. While corals and other Cnidaria lack a true differentiated gut, they possess semi-enclosed gastrovascular cavities (GVCs), where vital processes such as digestion, reproduction and symbiotic exchanges take place. The microbiome harboured in GVCs is therefore likely key to holobiont fitness, but remains severely understudied due to challenges of working in these small compartments. Here, we developed minimally invasive methodologies to sample the GVC of coral polyps and characterise the microbial communities harboured within. We used glass capillaries, low dead volume microneedles, or nylon microswabs to sample the gastrovascular microbiome of individual polyps from six species of corals, then applied low-input DNA extraction to characterise the microbial communities from these microliter volume samples. Microsensor measurements of GVCs revealed anoxic or hypoxic micro-niches, which persist even under prolonged illumination with saturating irradiance. These niches harboured microbial communities enriched in putatively microaerophilic or facultatively anaerobic taxa, such as Epsilonproteobacteria. Some core taxa found in the GVC of Lobophyllia hemprichii from the Great Barrier Reef were also detected in conspecific colonies held in aquaria, indicating that these associations are unlikely to be transient. Our findings suggest that the coral GVC is chemically and microbiologically similar to the gut of higher Metazoa. Given the importance of gut microbiomes in mediating animal health, harnessing the coral “gut microbiome” may foster novel active interventions aimed at increasing the resilience of coral reefs to the climate crisis.

Effectiveness of a Digital Health Intervention Leveraging Reinforcement Learning: Results From the Diabetes and Mental Health Adaptive Notification Tracking and Evaluation (DIAMANTE) Randomized Clinical Trial.

Digital and mobile health interventions using personalization via reinforcement learning algorithms have the potential to reach large number of people to support physical activity and help manage diabetes and depression in daily life. The Diabetes and Mental Health Adaptive Notification and Tracking Evaluation (DIAMANTE) study tested whether a digital physical activity intervention using personalized text messaging via reinforcement learning algorithms could increase step counts in a diverse, multilingual sample of people with diabetes and depression symptoms. From January 2020 to June 2022, participants were recruited from 4 San Francisco, California-based public primary care clinics and through web-based platforms to participate in the 24-week randomized controlled trial. Eligibility criteria included English or Spanish language preference and a documented diagnosis of diabetes and elevated depression symptoms. The trial had 3 arms: a Control group receiving a weekly mood monitoring message, a Random messaging group receiving randomly selected feedback and motivational text messages daily, and an Adaptive messaging group receiving text messages selected by a reinforcement learning algorithm daily. Randomization was performed with a 1:1:1 allocation. The primary outcome, changes in daily step counts, was passively collected via a mobile app. The primary analysis assessed changes in daily step count using a linear mixed-effects model. An a priori subanalysis compared the primary step count outcome within recruitment samples. In total, 168 participants were analyzed, including those with 24% (40/168) Spanish language preference and 37.5% (63/168) from clinic-based recruitment. The results of the linear mixed-effects model indicated that participants in the Adaptive arm cumulatively gained an average of 3.6 steps each day (95% CI 2.45-4.78; P<.001) over the 24-week intervention (average of 608 total steps), whereas both the Control and Random arm participants had significantly decreased rates of change. Postintervention estimates suggest that participants in the Adaptive messaging arm showed a significant step count increase of 19% (606/3197; P<.001), in contrast to 1.6% (59/3698) and 3.9% (136/3480) step count increase in the Random and Control arms, respectively. Intervention effectiveness differences were observed between participants recruited from the San Francisco clinics and those recruited via web-based platforms, with the significant step count trend persisting across both samples for participants in the Adaptive group. Our study supports the use of reinforcement learning algorithms for personalizing text messaging interventions to increase physical activity in a diverse sample of people with diabetes and depression. It is the first to test this approach in a large, diverse, and multilingual sample. ClinicalTrials.gov NCT03490253; https://clinicaltrials.gov/study/NCT03490253. RR2-10.1136/bmjopen-2019-034723.

A multi-pathogen behavioral exposure model for young children playing in public spaces in developing communities.

Diarrheal disease is the second leading cause of death among children under five in developing communities, despite active interventions to improve access to water, sanitation, and hygiene resources. Even interventions with high fidelity and compliance saw minimal improvements in health outcomes, necessitating a need for looking beyond traditionally targeted exposure pathways. This study focuses on the pathogen exposure a young child may receive while playing in the public spaces of informal settlements, where animal feces, human feces, and garbage are frequently observed. The study utilized 79 soil samples previously collected across ten cluster sites in Corail, Haiti and processed using DelAgua cultural assays and quantitative Polymerase Chain Reaction methods. Molecular assays screened for Aeromonas, Vibrio cholera, and several pathogenic Escherichia coli species. Behavioral observations of young children (<5 years old) were also conducted in overlapping areas with the environmental sampling to quantify frequency of risky and mitigating behaviors. Environmental and behavioral data were combined to obtain the posterior distribution of children's pathogen exposure from playing in a public space for one hour. The model estimated that children have a likelihood of approximately 70% of being exposed to a pathogen during one hour of play and a greater than 30% chance of being exposed to multiple pathogens in the same period. While children and toddlers practice fewer risky behaviors compared to infants, they were shown to have higher likelihood of exposure and slightly higher pathogen dose per exposure. As anticipated, a high correlation between genes from the same E. coli species was observed in the model output. These findings demonstrate the need to consider public spaces as an important exposure pathway for young children for both future research and interventions.

Effects of health at every size based interventions on health-related outcomes and body mass, in a short and a long term.

This study aims to provide rapid and up-to-date evidence on the effectiveness of Health at Every Size (HAES) interventions compared to controls or other conventional approaches in individuals with overweight or obesity, with the goal of developing more effective and body-diverse respectful strategies. A review of literature was carried out using the following databases: PubMed, Scopus, Embase, Web of Science, and SciELO. Research articles were selected based on predefined inclusion and exclusion criteria. Extracted data included study characteristics (design, setting, population demographics, sample size, intervention characteristics, study duration, and follow-up period) and health-related outcomes. The search yielded 324 articles, of which 20 articles met the inclusion and exclusion criteria. The majority of studies focused on lifestyle improvement, particularly in nutrition, body image, and relationships with food, utilizing a HAES approach. Additionally, other studies examined outcomes such as general well-being, body weight, body composition, cardiovascular risk, and changes in physical activity. Long-term results were particularly noted in studies incorporating physical activity interventions. HAES interventions appear to be a feasible strategy for promoting overall health and wellness, regardless of body size or shape. However, further evaluation is needed to assess the sustainability of these changes and their long-term impact, as current evidence suggest a they may not be maintained over time.

Perceptions Experiences and Challenges of Physical Activity among Firefighters with Coronary Heart Disease Risk Factors in the City of Cape Town Fire and Rescue Services

Background The development of atherosclerosis in firefighters is affected by various cardiovascular risk factors, such as smoking, poor dietary choices, and lack of physical activity. Together, these elements lead to obesity, high blood pressure, unhealthy cholesterol, and increased blood sugar levels. Continuous exposure to these risks raises the chances of worsening atherosclerosis, which can impede blood circulation to essential organs like the heart and brain. As a result, sudden cardiac death is the leading cause of fatalities while on duty in the fire service. Aim This study aimed to explore and describe the perceptions, experiences, and challenges associated with physical activity among firefighters with risk factors for coronary heart disease in the City of Cape Town Fire and Rescue Services. Methods A purposive sample of nine full-time active career firefighters from the City of Cape Town Fire and Rescue Services, representing three different ranks, was employed, using a descriptive qualitative study design. The semi-structured interview responses were recorded and transcribed verbatim. The participants were free to leave the study at any time and without penalty, and their rights to confidentiality were protected. The thematic analysis was then used to examine the transcripts. Results The results revealed that firefighters were not physically active enough to meet the suggested minimum levels of physical activity and were physically inactive. Sedentary lifestyles have numerous detrimental effects on the human body, such as elevated rates of dyslipidemia, hypertension, diabetes mellitus, cardiovascular disease mortality, and all-cause death. Therefore, it is essential to reduce sedentary behavior and increase physical exercise to improve the health and well-being of firefighters. Conclusion Policy strategies should be designed to introduce physical activities at low-moderate intensity levels and accommodate firefighters with coronary heart disease risk factors. Implementing team-based physical activity interventions has demonstrated positive impacts on individual behavior changes within the fire service.

Cost-utility and cost consequence of a telehealth intervention targeting improvement in addictive eating for Australian adults (the TRACE program).

The TRACE (Targeted Research for Addictive and Compulsive Eating) intervention was evaluated in a 3-month randomized controlled trial which demonstrated significant improvement in Yale Food Addiction Scale scores favoring dietitian-led telehealth (active intervention) compared with passive and control groups. This study aimed to determine intervention costs and cost-utility. Costs of each intervention (2021$AUD) and incremental net monetary benefit (iNMB; incremental benefit, defined as Quality-Adjusted Life Years (QALY) gained, multiplied by willingness to pay threshold minus incremental cost) were calculated to estimate differences between groups. The active intervention (n=38) cost $294 (95% UI: $266, $316) per person compared to $47 (95% UI: $40, $54) in the passive intervention (n=24), and $26 in the control group (n=37). At a cost-effectiveness threshold of $50 000 per QALY score gained, the active intervention iNMB was -$186 (95% UI: -$1137, $834) and the passive group $127 (95% UI: -$1137, $834). Compared to the control group, estimates indicate a 30% chance of the active intervention, and a 60% chance of the passive intervention being cost effective. Although the overall cost of the active intervention was low, this was not considered cost-effective in comparison to the passive intervention, given small QALY score gains. Australia New Zealand Clinical Trial Registry ACTRN12621001079831.

Physical Activity and Executive Functioning in Children and Adolescents with Congenital Heart Defects: A Scoping Review.

Children and adolescents (C&As) with congenital heart defects (CHDs) have decreased functional capacity and executive functioning (EF) due to brain abnormalities and decreased cerebral perfusion. Exercise may improve EF via increased cognitive demands and cerebral blood supply. The purpose of this review was to identify evidence describing the impact of physical activity (PA) interventions on EF in C&As with CHDs. The following databases were searched from 2000 to 2024: MEDLINE, EMBASE, CINAHL, Scopus, CENTRAL, and PsycInfo. The inclusion criteria consisted of participants aged from birth to 18 years with CHD, interventions related to PA, and EF as an outcome measure. Articles were excluded if adults were included, translation to English was impossible, and full access was unavailable. Of 613 initial articles, 3 were analyzed, with only 1 meeting all inclusion criteria. The included study found significant improvements in self-reported cognitive functioning and parent-reported social functioning after 12 weeks of aerobic exercise in children aged 10-15 years with CHDs. Common themes among the reviewed articles indicated that EF remains impaired throughout the lifespan, children have unique interventional and developmental needs, and research remains limited despite theoretical benefits. Further investigation of the effect of PA on EF in C&As with CHDs is needed.

Profess-sirs and Profess-hers: gender and ethnicity stereotypes that students associate with scientists

ABSTRACT A common narrative emerges from previous studies suggesting that scientists are most frequently thought of as being old, white men. This stereotype has been assessed in the past using drawing analysis methods but here, an updated approach – a drawing activity followed by a survey was chosen, to remove the need for inference. The purpose of the survey was to understand if the aspects of the scientist-stereotype are still present and impacting school students today and if students’ career prospects are influenced by learning about a diverse range of scientists. Our findings suggest gender and ethnicity aspects of the scientist stereotype are still present but a shift has occurred, away from the old-age associated with a scientist, towards a younger individual. This adaptation suggests that it is possible to influence this stereotype and we propose that further understanding of what caused this change could influence the stereotypical gender and ethnicity too. It was found that learning about a diverse range of scientists is not associated with a school student feeling like they can have a career in STEM, which we hypothesise may be due to the passive nature of this intervention and that a more active intervention method may be needed.

A Nationwide Physical Activity Intervention for 654,500 Adults in Singapore: Cost-Utility Analysis.

Increasing physical inactivity is a primary risk factor for diabetes and hypertension, contributing to rising health care expenditure and productivity losses. As Singapore's aging population grows, there is an increased disease burden on Singapore's health systems. Large-scale physical activity interventions could potentially reduce the disease burden but face challenges with the uncertainty of long-term health impact and high implementation costs, hindering their adoption. We examined the cost-effectiveness of the Singapore National Steps Challenge (NSC), an annual nationwide mobile health (mHealth) intervention to increase physical activity, from both the health care provider perspective, which only considers the direct costs, and the societal perspective, which considers both the direct and indirect costs. We used a Markov model to assess the long-term impact of increased physical activity from the NSC on adults aged 17 years and older. A Monte Carlo simulation with 1000 samples was conducted to compare two situations: the NSC conducted yearly for 10 years against a no-intervention situation with no NSC. The model projected inpatient and outpatient costs and mortality arising from diabetes and hypertension, as well as their complications. Health outcomes were expressed in terms of the quality-adjusted life-years (QALYs) gained. All future costs and QALYs were discounted at 3% per annum. Sensitivity analyses were done to test the robustness of our model results. We estimated that conducting the NSC yearly for 10 years with a mean cohort size of 654,500 participants was projected to prevent 6200 diabetes cases (95% credible interval 3700 to 9100), 10,500 hypertension cases (95% credible interval 6550 to 15,200), and 4930 deaths (95% credible interval 3260 to 6930). This led to a reduction in health care costs of SGD (Singapore dollar) 448 million (95% credible interval SGD 132 million to SGD 1.09 billion; SGD 1=US $0.73 for the year 2019). There would be 78,800 (95% credible interval 55,700 to 102,000) QALYs gained. Using a willingness-to-pay threshold of SGD 10,000 per QALY gained, the NSC would be cost-saving. When indirect costs were included, the NSC was estimated to reduce societal costs by SGD 1.41 billion (95% credible interval SGD 353 million to SGD 3.80 billion). The model was most sensitive to changes in the inpatient cost of treatment for diabetes complications, time horizon, and program compliance. In this modeling study, increasing physical activity by conducting a yearly nationwide physical activity intervention was cost-saving, preventing diabetes and hypertension and reducing mortality from these diseases. Our results provide important information for decision-making in countries that may consider introducing similar large-scale physical activity programs.