Completed Diaries Research Articles

Concordance between daily diary reported pre-exposure prophylaxis intake and intraerythrocytic tenofovir diphosphate in the Amsterdam Pre-exposure Prophylaxis demonstration project.

We assessed the association and concordance between self-reported oral pre-exposure prophylaxis (PrEP) intake in a diary app and intraerythrocytic drug metabolite concentrations. AMPrEP was a prospective demonstration study providing daily and event-driven PrEP to MSM in Amsterdam, the Netherlands (2015-2020). Participants could record their PrEP intake in a diary app. Dried blood spots (DBS) were taken at 6, 12, 24, and 48 months and analysed for tenofovir diphosphate (TFV-DP) and emtricitabine triphosphate (FTC-TP) concentrations. We included TFV-DP measurements preceded by diary completion on at least 90% of days in the 6 weeks prior. We examined the association between self-reported PrEP intake (i.e. number of pills) and TFV-DP concentrations using tobit regression with a random intercept per participant. We also calculated concordance between categorized PrEP intake (i.e. <2, 2-3, 4-6 or 7 pills per week) and categorized TFV-DP concentrations (i.e. <350, 350-699,700-1249 or ≥1250 fmol/punch) using weighted Cohen's kappa. Last, we calculated concordance between self-reported recent PrEP intake (yes/no, in past 2 days) and quantifiability of FTC-TP (yes/no) using Cohen's kappa. Seven hundred and fifty-nine DBS measurements from 282 MSM were included. Self-reported PrEP intake was strongly and positively associated with TFV-DP concentration ( β = 0.77, 95% CI = 0.70-0.84, P < 0.0001). Concordance between categorized PrEP intake and TFV-DP concentration was moderate ( κ = 0.44, 95% CI = 0.39-0.50). Concordance between self-reported recent PrEP intake and FTC-TP quantifiability was perfect ( κ = 0.83, 95% CI 0.76-0.90). Self-reported PrEP intake in a diary app is strongly correlated with actual use, and therefore reliable for comparing PrEP adherence between groups. Still, suboptimal criterion validity according to clinically relevant categories warrants caution when assessing 6-week reported adherence for individuals.

Nightly Sleep Predicts Next-Morning Expectations for Stress and Positive Experiences.

Abundant research has linked nightly sleep as an antecedent of daily psychosocial experiences; however, less is known about sleep's influence on daily expectations of these experiences. Therefore, this research examined the day-to-day associations of sleep quality, duration, and efficiency with next-day expectations for stress(ors) and positive experiences, as well as whether these expectations were related to end-of-day reports of physical symptoms. In Study 1, U.S. adults ( n = 354; ages 19 to 74) completed twice-daily diaries for 10 weekdays about sleep, expectations for encountering daily stressors and positive events, and physical symptoms. In Study 2, adults in Canada ( n = 246; ages 25 to 87) wore a sleep watch for 14 consecutive days and completed mobile surveys 5×/day about sleep, stressfulness and pleasantness expectations, and physical symptoms. Multilevel models indicated that self-reported sleep quality and duration, but not efficiency, were associated with lower next-day expectations for stressors (Study 1) and stressfulness (Study 2). Self-reported sleep quality (Study 1) and all sleep indices (Study 2) predicted greater next-day expectations for positive events and pleasantness, respectively. For actigraphy-assessed sleep (Study 2), only longer-than-usual actigraphic sleep duration was associated with lower stressfulness expectations, whereas both sleep duration and efficiency were positively linked with daily pleasantness expectations. Only pleasantness expectations (Study 2)-but not daily stressfulness and event expectations (Study 1)-predicted end-of-day physical symptoms. Findings suggest the importance of sleep on expectations of next-day stress and positive experiences, of which may have implications for daily physical health.

Étude CamiCon : évaluation d’un nouvel outil pour la réalisation d’un calendrier mictionnel automatisé et connecté

IntroductionA voiding diary (VD) is a key element in the evaluation of patients with overactive bladder (OAB) at initial presentation and during treatment to assess its effectiveness. In order to be clinically relevant, it must be performed over 3 days according to the International Continence Society (ICS). Unfortunately, some patients find it cumbersome. We aimed to evaluate the reliability and patient satisfaction when using a connected tank device. Material and methodWe conducted a single-center prospective study including 41 patients. Each patient completed a paper voiding diary and then a diary with Diary Pod® (DP) or inversely depending on the study arm. Data from 34 patients were collected. After completion of both diaries, patients completed a satisfaction questionnaire sent by email via GoogleForm. Study statistics were performed with Jamovi® and Excel® software. ResultData from 34 patients were analyzed. There was a statically significant difference (P=0.046) between the mean volume calculated from the paper VD and that calculated from the connected VD (DP). There was no statistically significant difference (P=0.112) between the mean number of daytime voids, mean number of nighttime voids (P=0.156), mean water intake (P=0.183) reported on the paper VD and the connected VD. Thirteen (42%) paper VD and 1 connected VD did not include documentation of the presence or absence of urine leakage or urgency. There was no statistically significant difference between the two calendars regarding the presence or absence of urine leakage (P=0.180) and urinary urgency (P=0.564). Eighty-four percent (26/31) preferred the connected tank to the usual method (paper/pen), while 55% (17/31) and 29% (9/31) of the participants respectively answered that the DP was “very definitely” or “definitely” an aid for performing VD. Nevertheless, 39% (12/31) and 55% (17/31) considered its price to be high or fair and only 22% (7/31) were inclined to buy it. ConclusionThis study showed that the Diary connected reservoir Pod® is a reliable and innovative tool for voiding schedules. It facilitates data collection for the majority of patients (83%) and could, through better patient compliance, provide better quality data and help their interpretation by the physician. These factors could encourage the implementation of the connected voiding diary as a diagnostic tool. It would also be used for the assessment of treatment effectiveness in daily clinical practice as well as in research. Its cost remains a major obstacle, judged by 39% of patients to be too high, and could therefore be proposed in specific situations requiring precise data.

Concurrent and lagged associations among pain medication use, pain, and negative affect: a daily diary study of people with chronic low back pain.

People with chronic pain often attempt to manage pain and concurrent emotional distress with analgesic substances. Habitual use of such substances-even when not opioid-based-can pose side effect risks. A negative reinforcement model has been proposed whereby relief of pain and emotional distress following medication consumption increases the likelihood that the experience of elevated pain and distress will spur further medication use. People with chronic low back pain (N = 105) completed electronic diary assessments 5 times/day for 14 consecutive days. Lagged and cross-lagged analyses focused on links between time 1 pain and negative affect (NA) and time 2 analgesic medication use and vice versa. Sex differences were also explored. Primary results were as follows: (1) participants on average reported taking analgesic medication during 41.3% of the 3-hour reporting epochs (29 times over 14 days); (2) time 1 within-person increases in pain and NA predicted time 2 increases in the likelihood of ingesting analgesic medications; (3) time 1 within-person increases in medication use predicted time 2 decreases in pain and NA; and (4) lagged associations between time 1 pain/NA and time 2 medication use were strongest among women. Findings suggest that the use of analgesic medications for many people with chronic pain occurs frequently throughout the day. Results support the validity of a negative reinforcement model where pain and distress lead to pain medication use, which in turn leads to relief from pain and distress.

Managing the challenge of fatigue for pilots operating ultra-long range flights

IntroductionUltra-long range (ULR) flights are defined as exceeding regulatory limits: normally 16 h flight time. They pose challenges due to long duty periods that could result in extended wakefulness and sleep loss, increasing the risk of fatigue. This study describes the mitigations used to manage fatigue in these operations. Two data collection phases were conducted on the Auckland-Chicago ULR route: when the route commenced (Study 1) and when the flight crew complement was altered (Study 2). Seasonal differences were also investigated.MethodsStudy 1 involved 72 crew who completed diaries and wore an actigraph to record sleep pre-departure, throughout the trip, and on return. In-flight, fatigue, sleepiness and workload were reported, and reaction time performance was measured. Study 2 involved 75 crew and data collection in the northern summer and northern winter. Crew completed diaries throughout the trip.ResultsStudy 1 data found crew sleep longer than usual in the 24 h pre trip and post flights. On the shorter outbound flight in-flight sleep averaged 3.3 h and on the longer inbound flight, 3.3–3.8 h, with most crew taking 3 breaks. Ratings of sleepiness and fatigue increased, and reaction time performance declined across flights, with greater decrements on longer inbound flights. Pilots did not fully adjust their sleep patterns to local time during the layover and no seasonal differences were found. Comparisons between Study 1 and 2 showed no difference in ratings of fatigue and sleepiness or in-flight sleep duration with an altered crew complement. There was a trend for Captains to report greater workload and less in-flight sleep in Study 2.DiscussionMitigations that allow for preparation and recovery are well utilized by crew. In-flight sleep is relatively short and ways of increasing the amount of sleep obtained should be considered. The incomplete adaptation of sleep during the layover has implications for rest break strategies on the return flight. The altered crew complement did not result in higher levels of fatigue or sleepiness or less in-flight sleep on average, although findings suggest a need to understand the effects of changing the crew complement on workload and in-flight sleep for Captains.

The middle-aged and older Chinese adults’ health using actigraphy in Taiwan (MOCHA-T): protocol for a multidimensional dataset of health and lifestyle

Background and objectivesOlder adults keep transforming with Baby Boomers and Gen Xers being the leading older population. Their lifestyle, however, is not well understood. The middle-aged and older Chinese adults’ health using actigraphy in Taiwan (MOCHA-T) collected both objective and subjective data to depict the health and lifestyle of this population. The objectives, design, and measures of the MOCHA-T study are introduced, and the caveats and future directions related to the use of the data are presented.MethodsPeople aged 50 and over were recruited from the community, with a subset of women aged 45–49 invited to supplement data on menopause and aging. Four instruments (i.e., self-reported questionnaires, diary, wrist actigraphy recorder, and GPS) were used to collect measures of sociodemographic, health, psychosocial, behavioral, temporal, and spatial data.ResultsA total of 242 participants who returned the informed consent and questionnaires were recruited in the MOCHA-T study. Among them, 94.6%, 95.0%, and 25.2% also completed the diary, actigraphy, and GPS data, respectively. There was almost no difference in sociodemographic characteristics between those with and without a completed diary, actigraphy, and GPS data, except for age group and educational level for those who returned completed actigraphy data.ConclusionThe MOCHA-T study is a multidimensional dataset that allows researchers to describe the health, behaviors, and lifestyle patterns, and their interactions with the environment of the newer generation of middle-aged and older adults in Taiwan. It can be compared with other countries with actigraphy and GPS-based lifestyle data of middle-aged and older adults in the future.

Effect of green banana and pineapple fibre powder consumption on host gut microbiome.

To determine whether green banana powder (GBP) and pineapple fibre powder (PFP) promote beneficial bacterial species, directly improve human gut health and modulate the gut microbiome and understand their utility as functional foods and dietary supplements. Over 14 days, 60 adults followed protocol requirements, completed food diaries and study questionnaires, avoided consuming supplements with prebiotics, probiotics or postbiotics, and ingested food containing 5 g of total daily fibre [placebo (10.75 g), GBP (10.75 g) or PFP (7.41 g)]. Participants' medical and baseline wellness histories, as well as stool samples, were collected at baseline, day 7 and 14. Stool DNA was processed for sequencing. Dietary fibre and resistant starches (RS) in GBP and PFP promoted temporal increases in beneficial bacteria. GBP significantly elevated 7 species (F. prausnitzii, B. longum, B. bifidum, B. adolescentis, B. pseudocatenulatum, B. obeum, and R. inulinivorans), while PFP enriched 6 species (B. ovatus, B. cellulosilyticus, B. bifidum, B. intestinalis, R. inulinivorans, and E. siraeum). These bacteria, found to be deficient in younger adults, were promoted by both powders. PFP benefitted both genders aged 16-23, while GBP benefitted overweight/obese individuals, including females. GBP and PFP fiber and RS improved bowel regularity and health as well as metabolism by promoting histidine, branched-chain amino acids, short-chain fatty acids, and biotin production. The additional fiber caused "low" bloatedness and reduced "fairly bad" sleep disruptions, without affecting sleep durations. GBP and PFP supplementation increased beneficial bacteria and metabolites, improved host gut health, and present a valuable nutritional strategy for enhancing human health. AMILI Institutional Review Board, Identifier 2023/0301.

Can we increase the value of data from bladder diaries? International Consultation on Incontinence-Research Society 2023.

Bladder diaries represent a fundamental component in the assessment of patients presenting with lower urinary tract symptoms. Nevertheless, their importance often remains underappreciated and undervalued within clinical practice. This paper aims to conduct a comprehensive review of the existing literature concerning the utility of bladder diaries, underscore the criticality of their precision, elucidate the factors contributing to noncompliance with bladder diary completion, and investigate potential strategies for enhancing patient compliance. A review of the English-language scientific literature available in the domains of Medline, Embase, Emcare, Midirs, and Cinahl was conducted. This was supplemented by discussion at the International Consultation on Incontinence Research Society Proposal session to define knowledge and identify gaps in knowledge surrounding the utility of bladder diaries. The existing evidence and outcome of the relevant discussion held in the meeting are presented. Bladder diaries (BD) serve to characterize the nature and severity of storage lower urinary tract symptoms (LUTS) and provide an objective record of an individual's urination patterns. They aid in the refinement and customization of treatment strategies based on the clinical responses documented in the diary, optimizing treatment outcomes. Notably, both BD and urodynamic studies (UDS) play complementary yet distinct roles in LUTS evaluation. BD offers a more comprehensive and accessible approach to assessing specific storage LUTS, particularly due to their affordability and widespread availability, especially in resource-limited settings. Nevertheless, the absence of a standardized BD format across global healthcare systems presents a significant challenge. Despite being recognized as reliable, noninvasive, validated, and cost-effective tools for evaluating patients with LUTS, the implementation and completion of BD have proven to be complex. The introduction of automated bladder diaries heralds an era of precise, real-time data collection, potentially enhancing the patient-clinician relationship. Completion of bladder diaries depends on an array of individual, social, and healthcare-specific factors. Compliance with bladder diary completion could be enhanced with clear instructions, patient education, regular follow-ups and positive re-enforcement. This study has identified four critical areas for future research: Addressing healthcare disparities between affluent and developing nations, enhancing the current functionality and effectiveness of bladder diaries, exploring the feasibility of incorporating bladder diaries into the treatment and education process and improving the quality and functionality of existing bladder diaries. Bladder diaries play a pivotal role in the evaluation and management of patients with LUTS, providing a holistic perspective. When their complete potential is harnessed, they have the capacity to revolutionize the paradigm of LUTS management, ushering in a patient-centered era of care.

Temporal Daily Relationships Between Sleep and Pain in Adolescents With Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder characterized by recurrent episodes of pain. This study aimed to describe the temporal daily relationships between sleep and pain in adolescents with SLE. Twenty-three adolescents with SLE recruited from a pediatric hospital wore actigraphy and completed diaries. Generalized estimating equation models were used. On average, evening pain negatively predicted subsequent sleep quality that night, and, on average, sleep quality negatively predicted morning pain. Shorter total sleep time significantly predicted higher morning pain (95% confidence intervals [CI], -0.38 to -0.03, p = .02), whereas sleep efficiency and sleep quality were not significantly associated with morning pain (95% CI, -0.03 to 0.03; 95% CI, -0.08 to 0.06, respectively). Subsequent evening pain did not predict daily nighttime sleep DISCUSSION: Our findings suggest that sleep is a target for pain interventions to include among adolescents with SLE.

Hernia Active Living Trial (HALT): an exercise intervention in people with a parastomal hernia or bulge

Background: Parastomal hernias are a common consequence of stoma surgery and can occur in up to 50% of patients. They are mangaged either conservatively, through support hosiery, or surgically. A patient feasibility study called the Hernia Active Living Trial (HALT) was designed to examine if a clinical pilates-based exercise programme offers an alternative approach to managing a parastomal hernia or bulge. Method: Adults with an ileostomy or colostomy who perceived they had a bulge around their stoma were included in the study. The intervention included up to 12 online sessions of an exercise booklet and videos with an exercise specialist. Interviews were conducted to explore participants' experiences of the intervention. The interview data were analysed systematically and thematically. Participants were also asked to complete patient diaries every week. Results: Twelve of the 13 participants who completed the intervention agreed to be interviewed. Following analysis, three main themes emerged including managing a hernia/bulge, benefits and barriers. Participants talked about the benefits of this programme including: reduction of the size of their hernia, increased abdominal control, body confidence and posture, as well as increased physical activity levels. The barriers described were generally overcome allowing participants to engage in what was perceived to be a positive and potentially life-changing experience. Conclusions: A clinical pilates-based exercise programme for people with a parastomal hernia can bring both direct and indirect improvements to a patient's hernia management, sense of wellbeing and day-to-day life. Individuals with a hernia should be informed about the need for, and value of, exercise to strengthen core muscles, as part of their non-surgical options for self-management.

Questioning the disposability of plastic packaging: Consumer challenges to fresh food packaging market devices and their afterlives

ABSTRACT Disposable plastic packaging has been conceptualised as a market device that has effects on the functioning of economic markets. It is particularly influential in food retail environments but also has significant environmental consequences. Consumers are aware of these issues, and this paper addresses their questions and objections to the packaging market device for fresh food. Drawing on empirical insights from 28 interviews and 25 completed research diaries conducted as part of the ‘Reducing plastic packaging and food waste through product innovation simulation’ project, these contestations are explored in a number of ways. Firstly, it explores how such objections become possible and the role of unintended consequences of marketing arrangements. Secondly, conflicting ontologies of freshness are examined, as they also create the potential for objections. Thirdly, the paper engages with the role of responsibility, looking at how municipal recycling systems and packaging design enable contestations. Exploring these contestations contributes to an understanding of how we can address non-market effects of market devices, once they have left the physical spaces associated with market activity and moved into other spheres of activity. It also holds several contributions for debates concerning consumer engagement and acceptance of plastic packaging and plastics policy discourses more broadly.

What Interval of Daily Pain Assessment Is Required to Reliably Diagnose Chronic Pain in Sickle Cell Disease? the Pisces Study

Background: In Sickle Cell Disease (SCD), chronic pain, i.e., pain on most days over a 6 month time period, is a major complication associated with substantial morbidity and poor outcomes. In the landmark Pain in Sickle Cell Epidemiology Study (PiSCES), the largest study of pain in SCD, one-third of individuals age 16 years or older had daily or near-daily pain, and &amp;gt;50% had chronic pain. However, PiSCES required patients to have 5-6 months of completed diaries in order to qualify for chronic pain analysis. Practically, the International Association for the Study of Pain (IASP) has used three months as the interval upon which to base a definition of chronic pain. Shorter daily assessment intervals upon which to reliably base a definition of chronic pain would reduce respondent burden, and would improve the frequency and accuracy of pain phenotyping for clinical and research purposes. Method: We chose as the gold-standard for chronic pain definition subjects enrolled in PiSCES that had at least 5 months of daily diaries (n=127). We excluded 10 patients who had at least 182 diaries (essentially 6 months), but had at least 50% of diaries missing in any of months 1-4. We simulated daily diary assessment over less burdensome, shorter intervals, always beginning on day one of assessment, to mimic what would be done clinically. We chose the time frames of 2 weeks (2w), 4 weeks (4w), 1 month (1m), 2 months (2m), 3 months (3m), and 4 months (4m). To operationalize the definition of chronic pain, we used a definition of pain severity rated as &amp;gt;0 on &amp;gt; 50% of diary days, regardless of interval. To determine if using diaries collected over a shorter period of time would still classify patients correctly, we calculated the sensitivity and the number of false negatives, as well as the specificity and number of false positives of each simulated diary interval. Results: Within the gold standard sample, 51.3% of patients had chronic pain based on all diaries submitted. The Table shows the percent of patients diagnosed with chronic pain, the sensitivity as well as the number of false negatives, and the specificity as well as the number of false positives, for each simulated diary interval. Simulated intervals of two months or more of daily diaries yielded chronic pain percentage estimates with both high sensitivity and high specificity, compared to the gold standard estimate. Simulated intervals of two week and four weeks yielded increasingly lower specificity, i.e., increasingly more false-positive indications of chronic pain, as the interval shortened. However, each interval still yielded high sensitivity-few patients with gold-standard chronic pain were missed, even at two weeks. Results were very similar even if data from the entire 127 participants was used. Conclusion : For determining the presence of chronic SCD pain, defined as pain on more than 50% of days enrolled in PiSCES, simulated intervals of two months or more of daily diary collection yield both very good sensitivity and very good specificity, compared to intervals of 5-6 months. Clinicians and researchers may reliably choose to adopt two months of dairy collection, as a matter of practicality, to reduce respondent burden when phenotyping SCD pain as acute versus chronic.

A Prospective, Observational Study of Bleeding and Quality of Life in Patients with Glanzmann Thrombasthenia in the United Kingdom: Updated Results

Glanzmann thrombasthenia (GT) is a rare bleeding disorder characterized by impaired platelet function. Recent studies suggest that patients with GT experience high-frequency bleeds, often access medical care, and have a significant burden of disease. There are no detailed, prospective studies characterizing bleeds and associated patient-reported impacts in GT. We conducted a prospective diary study characterizing bleeds and associated patient-reported impacts in 30 patients with GT over 3 months. Patients record bleed events daily in a custom-designed electronic bleed diary. At approximately the same time each day, they answer the question, “Have you had a bleed?” If the answer is yes, they also include the anatomical site of the bleed. Female patients are asked to record menstrual bleeding. For each bleed reported, patients can document symptoms, treatments received, and the location where the treatment was received (e.g., at home or in the hospital). They are also asked to record the socioeconomic impacts of individual bleeds, such as missed social or leisure activities, missed work, and missed education. The updated results confirm the high frequency of bleeds in patients with GT. Key variables will include diary completion compliance, mean monthly bleed rate (excluding menstrual bleeding), as well as detailed recordings of types and anatomical locations of bleed events. Further details will include patient reported, bleed-associated symptoms and socioeconomic impacts. In addition, a thorough description of menstrual bleeds and the impacts reported by women will be presented. This study provides further evidence of the high frequency and significant impact of bleeds in patients with GT. These prospective data establish a direct link between bleed events and the corresponding impact on QOL (quality of life) in patients with GT. In addition, the findings of this study suggest that there is a need for new treatments for GT that can reduce the frequency of bleeds and improve the quality of life for patients.

Substitutability of menthol cigarette alternatives: a clinical trial

IntroductionThis study assessed the substitutability of plausible combustible menthol cigarette alternatives (MCAs) for usual brand menthol cigarettes (UBMCs) in adults who smoke menthol cigarettes.MethodsFollowing three in-lab sampling sessions, 80 adults...

Does living alone mean being alone? Personal networks of solo-living adults in midlife

People living alone are often depicted as prone to social isolation and poor well-being. Since previous research largely focused on comparisons between the living arrangements of older adults, evidence on differences within middle-aged adults living alone remains sparse. The present study used a person-centered approach to allow for a comprehensive understanding of the heterogeneity of living alone in midlife. Middle-aged adults (N = 389; aged 35–60 years) reported on their personal networks, personality, and well-being and completed diaries on daily network interactions. Using latent class analysis, we constructed a network typology and examined differences in social motives, well-being, daily interaction quantity, and daily relationship quality. We found four structural network types: Individuals with diverse networks (highest in size, contact, proximity, and heterogeneity) felt less lonely than individuals with restricted (lowest in size, contact, proximity, and heterogeneity) or loose-knit networks (low in contact). Individuals with loose-knit networks reported poorer well-being than those in diverse or partner-focused networks (all partnered). We found little support for differences in social motives. All network types differed in daily interaction quantity but did not differ in daily relationship quality. The study highlights the heterogeneity of personal networks in middle-aged adults living alone. Possible implications for the social embeddedness and psychological adaptation of people living alone in midlife are discussed.

Using solicited research diaries to assess the restorative potential of exposure to inland blue space across time

Inland blue spaces, or freshwater environments, have been shown to provide people with positive mental health and wellbeing outcomes. Most inland blue space research focusing on wellbeing outcomes has so far been cross-sectional, utilising questionnaires and interviews. Therefore, there is significant uncertainty regarding the potential for inland waterways to benefit human populations over longer-term time scales. Across a sixteen-month data collection period, this study recruited four distinct sample groups to complete diaries for periods of three-months, focusing on inland blue space experiences in Scotland. The aim of the study was to use solicited diary methods to establish whether restorative exposure outcomes gained from visiting blue spaces may vary across time. Results from the diary data show that visiting freshwater areas consistently led to positive restorative outcomes, with minimal variation in restorative outcomes observed across time. Participants recorded three principal categories of blue space experiences; routine visits, getting fresh air; and day trips, with each visit type providing a range of restorative benefits. The findings highlight the potential for inland blue spaces to act as versatile public health resources and the need to consider long-term strategies to ensure these environments benefit populations across time.

Feasibility, Acceptability, and Preliminary Effectiveness of a Sleep Intervention in Adults at Risk for Metabolic Syndrome With Short Sleep Duration.

The prevalence of short sleep duration is rising and is linked to chronic comorbidities, such as metabolic syndrome (MetS). Sleep extension interventions in adults with MetS comorbidities and short sleep duration are limited and vary widely in terms of approach and duration. This pilot study aimed to test the feasibility and acceptability of a personalized 12-week systematic sleep time extension intervention on post-intervention sleep outcomes in middle-aged adults at risk for MetS with actigraphy-estimated short sleep duration. A single-arm, 12-week, 12-session systematic sleep time extension intervention was delivered weekly via videoconferencing. Feasibility and acceptability were assessed using retention rates and mean sleep diary completions. Sleep was estimated for 14 consecutive days prior to and immediately following the 12-week intervention using wrist actigraphy. Daytime sleepiness was assessed using the Epworth Sleepiness Scale. Paired sample t -tests modeled changes in study outcomes. Study participants ( N = 41) had a mean age of 52 years and were mostly female and White; 86% attended >80% of sessions, and mean sleep diary completion was 6.7 diaries/week. Significant improvements in sleep from pre- to post-intervention included increased total sleep time, earlier sleep onsets, more regular sleep onsets, a higher sleep regularity index, and reduced daytime sleepiness. Extending sleep, as well as improving sleep timing and regularity in middle-aged adults with actigraphy-estimated short sleep duration and at risk for MetS, is feasible and acceptable. Behavioral sleep characteristics may be modifiable and present a novel behavioral paradigm for mitigating MetS risk. This pilot study provides a proof of concept for the feasibility, acceptability, and preliminary effectiveness of a systematic sleep time extension for middle-aged adults at risk for MetS with actigraphy-estimated short sleep duration.

Seasonal and Regional Differences in Eating Times in a Representative Sample of the Brazilian Population.

Human food intake and its timing are a complex behavior that can be influenced by a variety of factors, some of which may vary from season to season or from region to region. In this study, our aim was to investigate the seasonal variation in food intake times, with a particular focus on how these may vary across different regions of a country. We conducted an analysis of data from 20,622 adults from the National Household Budget Survey (POF-IBGE), encompassing complete food diaries collected from individuals residing in Brazil, and thereby ensuring representation across different latitudes. Each participant's daily food intake was reported for two non-consecutive days at different times in the same week using food diaries. An ANOVA revealed a later food intake time in the evening in high-latitude regions compared to low-latitude regions. The Sidak post-hoc test showed a significant interaction effect between region and season, demonstrating a pattern of early First Intake Time and Eating Midpoint in the Northeast region during spring/summer. Additionally, we observed an independent effect of the region, as early food intake times were found in low-latitude regions. These findings offer a basis for discussing food intake times among individuals living in different regions located on distinct latitudes.

Effects of a 12 week community-based high-level mobility programme on sustained participation in physical activity by adolescents with cerebral palsy: a single subject research design study

Purpose To assess if a high-level mobility programme (HLMP) can promote sustained participation in physical activity by adolescents with cerebral palsy. Methods Eight adolescents with cerebral palsy, Gross Motor Function Classification System levels I-II, 11–16 years, participated in 24 community-based group HLMP sessions across 12 weeks. Participants set attendance, involvement, and physical performance goals, completed activity diaries over 58 weeks and undertook physical capacity tests. Measures of activity frequency and diversity (attendance) and involvement level were collected weekly across baseline (4–6 weeks), intervention (12 weeks), and nine months follow-up (including Covid lockdown). Results Median attendance was 23 of 24 HLMP sessions. Attendance goal/s attainment was highest during COVID lockdown. Involvement goals were consistently attained throughout all phases. Physical performance goal/s attainment was highest during intervention phase but reduced during nine months follow-up. Frequency of participation in physical activities varied greatly across study phases (range 0–33 episodes/week) with stable variety of activities and generally high ‘involvement.’ During the intervention, seven participants improved physical capacity and six maintained, or increased, the gains six months later. Conclusion Most participants improved physical capacity post-intervention but only some had sustained attendance and involvement in physical activity, highlighting the complexity of physical activity participation.

Measurement of Sleep in Chronic Traumatic Brain Injury: Relationship Between Self-report and Actigraphy.

To examine the relationship between self-report and actigraphy measurement of sleep in people with and without traumatic brain injury (TBI) by addressing 2 aims: (1) to assess the relationship between self-report and actigraphy for sleep quantity in people with and without TBI; and (2) to explore how self-report and actigraphy capture sleep quality in TBI. Participants completed the study over 2 weeks in their own homes. They wore activity monitors, day and night, throughout the experiment and completed morning sleep diaries while interacting with an experimenter on videoconference. This project was embedded in a larger study on sleep and word learning in 100 adults: 50 with chronic, moderate-severe TBI and 50 demographically matched noninjured peers. Of the 100 participants who completed the larger study, 92 participants (45 with TBI and 47 noninjured peers) had sufficient actigraphy data for inclusion in the current study. We used multilevel linear regression models and correlation analyses to assess how well participants' self-report corresponded to actigraphy measurement of sleep. Actigraphy measures included nightly sleep duration and nighttime wakeups. Sleep diary measures included self-reported nightly sleep duration, nighttime wakeups, sleep quality, and morning fatigue. People with and without TBI did not differ in the relationship between self-reported and actigraphy measurement of sleep quantity. Performance on a neuropsychological memory assessment did not correlate with the difference in self-reported and actigraphy-measured sleep in the TBI group. Sleep characteristics that were measured by actigraphy did not predict subjective experiences of sleep quality or fatigue. Short-term self-report diaries capture accurate information about sleep quantity in individuals with TBI and may support self-report of other daily habits. Future research is needed to identify reliable metrics of sleep quality, and how they relate to other domains such as memory and mood, in the chronic phase of TBI.