Effectiveness Of Activity Interventions Research Articles

Improving Athletic Trainers' Knowledge of Clinical Documentation Through Novel Educational Interventions: A Randomized Controlled Trial.

Athletic trainers (ATs) have reported the need for more educational resources about clinical documentation. To investigate the effectiveness of passive and active educational interventions to improve practicing ATs' clinical documentation knowledge. Randomized controlled trial, sequential explanatory mixed methods study. Online module(s), knowledge assessment, and interviews. We emailed 18 981 practicing ATs across employment settings, of which 524 ATs were enrolled into a group (personalized learning pathway [PLP = 178], passive reading list [PAS = 176], control [CON = 170]) then took the knowledge assessment. A total of 364 ATs did not complete the intervention or postknowledge assessment; therefore, complete responses from 160 ATs (PLP = 39, PAS = 44, CON = 77; age = 36.6 ± 11.2 years, years certified = 13.9 ± 10.7) were analyzed. Knowledge assessment (34 items) and interview guides (12-13 items) were developed, validated, and piloted with ATs before study commencement. We summed correct responses (1 point each, 34 points maximum) and calculated percentages and preknowledge and postknowledge mean change scores. Differences among groups (PLP, PAS, CON) and time (preintervention, postintervention) were calculated using a 3 × 2 repeated-measures analysis of variance (P ≤ .05) with post hoc Tukey HSD. Semistructured interviews were conducted (PLP = 15, PAS = 14), recorded, transcribed, and analyzed following the consensual qualitative research tradition. No differences in the preknowledge assessment were observed between groups. We observed a group × time interaction (F2,157 = 15.30, P < .001; partial η2 = 0.16). The PLP group exhibited greater mean change (M = 3.0 ± 2.7) than the PAS (M = 1.7 ± 3.0, P = .049) and CON (M = 0.4 ± 2.2, P < .001) groups. Descriptively, ATs scored lowest on the legal (61.3% ± 2.1%), value of the AT (63.7% ± 4.3%), and health information technology (65.3% ± 3.7%) items. Whereas ATs described being confident in their documentation knowledge, they also identified key content (eg, legal considerations, strategies) which they deemed valuable. The educational interventions improved ATs' knowledge of clinical documentation and provided valuable resources for their clinical practice; however, targeted continuing education is needed to address knowledge gaps.

Maintaining the impact of action-oriented entrepreneurship training: the role of error mastery orientation for training transfer in an active learning setting

ABSTRACT Action-oriented entrepreneurship training can boost entrepreneurship, but positive short-term effects often decay over time. Based on training transfer theory, we argue that error mastery orientation is a personal characteristic that affects the maintenance of training outcomes over time in the transfer context of entrepreneurship. We implemented an action-oriented entrepreneurship training at a university in Uganda and collected data from training participants before (NT0 = 175) and after the training programme (NT1 = 164) as well as at a 1-year follow-up measurement (NT2 = 52). Growth curve models showed that the participants experienced an increase in entrepreneurial action and new venture creation over time. Furthermore, error mastery orientation influenced the maintenance of entrepreneurial action and new venture creation over time. The study contributes to theories of entrepreneurship training and training transfer by demonstrating that error mastery orientation is a boundary condition of the long-term effectiveness of active learning interventions, such as action-oriented entrepreneurship training.

Activities of daily living interventions on activity performance of inpatients post-stroke: A systematic review and meta-analysis

Introduction: Inpatient rehabilitation is the best time window to improve patient performance post-stroke. Little is known about the type and effectiveness of activity interventions. This study aims to review activities of daily living interventions and evaluate their effectiveness on activity performance for stroke inpatients. Method: MEDLINE, Embase, CINAHL and Web of Science were searched. Randomised controlled trials investigating the effects of activities of daily living interventions for stroke inpatients were included. Two reviewers independently selected the studies and extracted data. Meta-analysis was conducted on relevant data with a random effect model with 95% CI. Results: Fourteen randomised controlled trials involving 602 stroke inpatients, were included. Both experimental and control groups offered activities of daily living interventions. Thirteen experimental groups offered added components, such as imagery and repetitive practice. Five studies reported significant improvement in activity performance within experimental and control groups. A meta-analysis of 12 randomised controlled trials with 512 participants revealed non-significant results for activity performance between the two groups. Conclusion: Both experimental and control groups in the included studies provided activities of daily living interventions. Added components were included in 13 out of 14 experimental groups. Meta-analysis revealed no significant difference between the two groups as they both offered activities of daily living interventions.

Estimating Clostridioides difficile infection-associated readmission rates: A systematic review and meta-analysis.

The economic burden of Clostridioides difficile infection (CDI) is considerable and mostly associated with a high frequency of hospitalizations. Numerous publications have demonstrated that CDI is associated with a higher risk of hospital readmission, but not always a specific rate or attributable to disease recurrence. In this systematic review, we describe the incidence of 30-day CDI-associated readmission rates and the effect of active interventions. Three search engines were utilized for the literature search, and a total of 9 studies were included in this review. Hospital readmission proportions from interventional and observational studies were analyzed through meta-analysis with random effects. Two thousand five hundred and twenty-one articles were identified. After screening full-text articles, 9 eligible articles published between 2002 and 2023 met the inclusion criteria. In total, 132,862 CDI patients were evaluated. Thirty-day CDI-associated readmissions were defined as either an ICD9/10 code indicating CDI admission with a prior admission within the past 30 days (n = 4) or a medical chart evaluation of signs and symptoms consistent with CDI (diarrhea) along with a positive diagnostic test (n = 5) with a prior hospitalization for CDI within the past 30 days. Meta-analysis of observational studies estimated 30-day CDI readmissions were 6% (95% CI, 5%-7%). Three studies evaluated the effect of active interventions to reduce CDI-associated 30-day readmission rates. Two of 3 interventions reduced the likelihood of CDI-associated 30-day readmissions. This systematic review identified a 6% rate of 30-day CDI-associated hospital readmission. Antimicrobial stewardship efforts and the use of specific therapeutics were shown to reduce these rates.

The role of information systems in emergency department decision-making-a literature review.

Healthcare providers employ heuristic and analytical decision-making to navigate the high-stakes environment of the emergency department (ED). Despite the increasing integration of information systems (ISs), research on their efficacy is conflicting. Drawing on related fields, we investigate how timing and mode of delivery influence IS effectiveness. Our objective is to reconcile previous contradictory findings, shedding light on optimal IS design in the ED. We conducted a systematic review following PRISMA across PubMed, Scopus, and Web of Science. We coded the ISs' timing as heuristic or analytical, their mode of delivery as active for automatic alerts and passive when requiring user-initiated information retrieval, and their effect on process, economic, and clinical outcomes. Our analysis included 83 studies. During early heuristic decision-making, most active interventions were ineffective, while passive interventions generally improved outcomes. In the analytical phase, the effects were reversed. Passive interventions that facilitate information extraction consistently improved outcomes. Our findings suggest that the effectiveness of active interventions negatively correlates with the amount of information received during delivery. During early heuristic decision-making, when information overload is high, physicians are unresponsive to alerts and proactively consult passive resources. In the later analytical phases, physicians show increased receptivity to alerts due to decreased diagnostic uncertainty and information quantity. Interventions that limit information lead to positive outcomes, supporting our interpretation. We synthesize our findings into an integrated model that reveals the underlying reasons for conflicting findings from previous reviews and can guide practitioners in designing ISs in the ED.

What might an interactive music therapy service bring to the adult intensive care unit? A suggested service based on data from a scoping review

Individual music listening in intensive care units (ICU) has more frequently reported benefits for reducing anxiety and pain. There may be benefits in reducing heart rate and respiratory rate. There is a lack of research in the ICU setting that examines the effects of active music-based interventions, for example, where patients play instruments as part of structured exercises for cognitive or physical rehabilitation or improvise music with a Health and Care Professions Council (HCPC) registered Music Therapist in ways that may benefit emotional well-being in addition to physical and cognitive function, including management of deconditioning. The search string of the present scoping review was used on 25 January 2022 and then again for PubMed on 24 June 2023 and brought up any research using music or music therapy in the intensive care setting. Out of 139 titles, 45 full texts were included, with a total of 3,441 participants. Forty-three studies meeting the inclusion criteria used pre-recorded music, ranging from cassette to CDs, audio files, and MP3, most often delivered using headphones, some with audio pillows. All interventions were passive (listening) except for one, which delivered music played live. More research is needed into the workings of active and receptive music therapy in the adult ICU.

Commentary on "Effect of Active Motor Learning Interventions on Gross Motor Function and Mobility in Children Aged 2 to 6 Years With Bilateral Cerebral Palsy: A Systematic Review and Meta-analysis".

Commentary on "Effect of Active Motor Learning Interventions on Gross Motor Function and Mobility in Children Aged 2 to 6 Years With Bilateral Cerebral Palsy: A Systematic Review and Meta-analysis".

O.6.3-6 The effects of an active breaks intervention on physical and cognitive performance: results from the I-MOVE study

Abstract Purpose The present quasi-experimental study aimed to evaluate the effects of active breaks intervention (ABs) to promote physical and cognitive improvement in primary school. Methods The active breaks group (ABsG) performed 10 minutes of ABs three times per school day and the control group (CG) did normal lessons. The baseline and follow-up evaluation was conducted respectively in October-2019 and in May-2021. Cognitive performance was assessed using working memory test, physical performance was analysed with ActiGraph accelerometers and physical fitness tests, quality of life was monitored using the Paediatric Quality of Life questionnaire (PedsQL) and classroom behaviour was collected with an ad hoc questionnaire. Results We enrolled 153 children (age:7.61±1.41, 54.2% males). Working memory significantly increased in the ABsG (ΔWM:1.30±1.17) than in CG (ΔWM:0.96±1.20). The 6-minutesCooper test increased in the ABsG (Δ:1.77±136.03) but not in CG (Δ:-156.42±187.53) p &amp;lt; 0.05. The weekly PA levels increased in both groups however the sedentary behaviour significantly increased both in ABsG and CG. Children reported improvements in their quality of school life including feeling better in class and in school when using ABs, moreover children improved their time on task behaviours in ABsG. Conclusion The present study proven to be effective on children's physical and cognitive performance.

The translation process of the culturally sensitive active aging scale for community-dwelling older adults in Pakistan

BackgroundThe assessment of active aging levels in Pakistani older adults is crucial yet; research tools are scarce in the local language. Therefore, this study aims to translate and validate the English version of an Active Aging Scale into a cross-culturally sensitive Urdu version to assess active aging levels in Pakistani older adults.MethodsTo translate and validate the scale, we used the ISPOR (International Society for Pharmacy Economic and Outcome Research) standards. Reliability, concurrent validity, construct validity, convergent validity, and discriminatory validity were checked on a total sample of 160 community-dwelling older adults. After two weeks, the test–retest reliability was examined. AMOS version 23 and SPSS version 23 were used to analyze the data.Results The average content validity index for clarity was 0.91 and relevancy was 0.80. The total variance in the pilot study of all items secured > 0.3 variances except for two items scored < 0.30 that were omitted before the validity and reliability test. The remaining items explained 65.46% of the overall variation and had factor loadings ranging from 0.46 to 0.90 in the principal factor analysis (PFA). The confirmatory factor analysis of the Active Aging Scale revealed that the model fit was good with a Chi-square value (418.18 (DF = 2.2) which is less than 3.00. This is further evidenced by the root mean square error of approximation (RMSEA) of 0.042, goodness of fit index (GFI) of 0.92, adjusted goodness of fit index (AGFI) of 0.94, and comparative fit index (CFI) values of 0.92 and 0.96 (unstandardized and standardized, respectively). The scale’s Cronbach’s alpha coefficient was 0.88, indicating dependability and its test–retest reliability with the significance of (P. < 0.05).ConclusionThe Urdu version of the Active Aging Scale was successfully translated and validated in a culturally sensitive manner, and can be used to evaluate the effectiveness of various active aging interventions for older adults in Pakistan.

Emergency Care Follow-Up for Children and Adolescents With Suicide Attempts or Ideation

&#x0D; Death by suicide is the second-leading cause of death for young people in Canada. Because 10% to 15% of the people seen in hospital emergency departments for a suicide attempt will repeat the attempt within 12 months following their discharge, it is important to identify what interventions are effective for preventing further self-harm during this time.&#x0D; Active follow-up care following an emergency department visit for a suicide attempt is common; however, it is unclear what type (e.g., text message, home visit) or timing (e.g., 24 hours, within 72 hours after emergency department discharge) of interventions is most effective for preventing further self-harm in people younger than 18 years. The objective of this review is to summarize the evidence regarding the clinical effectiveness of active contact and follow-up interventions, and the timing and duration of care, for children and adolescents (younger than 18 years) who present to emergency care for suicide attempts or suicide ideations.&#x0D; For children and adolescents presenting to the emergency department for suicide attempts or ideation, telephone-based follow-up care initiated within 1 week of discharge may not affect the number of people who completed the full course of postdischarge treatment, the mean number of sessions attended, or the number of suicide deaths. This finding was based on evidence from 2 systematic reviews, each with 1 primary study relevant to this report. The small sample sizes of these studies (N = 64 and N = 97) and their limited or unclear quality should be considered when interpreting these results.&#x0D; None of the relevant primary studies within the systematic reviews reported on mental health outcomes (e.g., depression, social functioning) or harms from the intervention.&#x0D; No studies were found that evaluated the clinical effectiveness of other methods of active follow-up care or of different time durations of follow-up care for children and adolescents who present to emergency care for suicide attempts or suicide ideations that met our criteria for this review.&#x0D; No evidence-based guidelines were identified that provided recommendations about timing, modality, and which health care professionals should be involved in follow-up care for children and adolescents who present to emergency care for suicide attempts or ideations that met our criteria for this review.&#x0D; Guidance documents and guidelines for adults generally recommend that follow-up should occur within 48 hours, particularly for those with safety concerns of subsequent self-harm. These guidance documents also suggest different modalities for follow-up during that time, including telephone calls, visits, and electronic communication. Given the higher risk and potential vulnerability experienced by children and adolescents and the absence of formal clinical guidelines, person-centred follow-up care for all children and adolescents within 48 hours may be considered, similar to adults who present with high concerns.&#x0D;

The effects of an active breaks intervention on physical and cognitive performance: results from the I-MOVE study.

The present quasi-experimental study aimed to evaluate the effects of active breaks intervention (ABs) to promote physical and cognitive improvement in primary school. The active breaks group (ABsG) performed 10min of ABs three times per school day and the control group (CG) did normal lessons. The baseline and follow-up evaluation was conducted respectively in October 2019 and in May 2021. Cognitive performance was assessed using working memory test, physical performance was analyzed with ActiGraph accelerometers and physical fitness tests, quality of life was monitored using the Paediatric Quality of Life questionnaire (PedsQL) and classroom behavior was collected with an ad hoc questionnaire. We enrolled 153 children (age: 7.61±1.41, 54.2% males). Working memory significantly increased in the ABsG (ΔWM: 1.30±1.17) than in CG (ΔWM: 0.96±1.20). The 6 min Cooper test increased in the ABsG (Δ: 1.77±136.03) but not in CG (Δ: -156.42±187.53), P<0.05. The weekly physical activity levels increased in both groups; however, the sedentary behavior significantly increased both in ABsG and CG. Children reported improvements in their quality of school life including feeling better in class and in school when using ABs; moreover, children improved their time on task behaviors in ABsG. The present study has proven to be effective on children's physical and cognitive performance.

The effects of active music interventions on cognitive function and neuropsychiatric symptoms in patients with dementia: A systematic review and meta-analysis

Active music interventions represent one promising nonpharmacological intervention; however, the effects of these interventions are not well understood. This systematic review and meta-analysis examined the effects of active music interventions on cognitive function and neuropsychiatric symptoms in patients with dementia. Four independent database searches revealed 747 independent studies that were filtered by article type, topic, and relevancy, based on inclusion criteria. Nine randomized controlled trials (RCTs) were selected for inclusion and were assessed for quality using the Cochrane Risk of Bias tool. Results of the meta-analyses revealed those receiving an active music intervention scored significantly higher than controls on the Mini-Mental State Exam and reported fewer neuropsychiatric symptoms as denoted by the Neuropsychiatric Inventory, post-intervention. There is a need for additional RCTs with consistent standardized cognitive measures to compare dosage, duration, and intervention type (e.g., instrumental or vocal) across domains. Future research is necessary to distinguish the benefits of active music interventions on cognitive function and neuropsychiatric symptoms (e.g., agitation, depression) in patients with dementia.

Effects of Active Video Game Interventions on Physical Health and Development Among Healthy Preschool Children

Early physical activity (PA) interventions during preschool ages are necessary and critical to cultivate healthy movement behaviors for healthy growth and development. The increasing obesity rate among children is a major public health concern globally, which is largely due to poor adherence to participating in regular PA. Active video game (AVG) interventions have been increasingly used in promoting PA. The narrative review synthesized current literature regarding the effect of AVG interventions on physical health and development indicators among healthy preschoolers. A systematic review was performed in Academic Search Premier, CINAHL, ERIC, PubMed, SPORT Discus, and Web of Science, following the PRISMA guidelines. A total of seven experimental studies were included; two were home-based interventions and five were center-based interventions. Three studies confirmed AVG interventions had a positive effect on the targeted outcomes: fruit and vegetable acceptance, execution function, and perceived competence. All other studies found partially positive effects on PA levels, motor skill competence, fundamental movement skills, or cognitive flexibility. The available evidence suggests that AVGs could be a promising channel to promote PA outcomes that contribute to physical health and development in preschoolers. The results underline advantages and usages of AVG interventions in preschoolers although evidence provided limited robustness. There is a paucity of studies that investigated the effect of AVG PA interventions on physical health and development in healthy preschoolers. Future studies are needed to replicate findings and test feasibility and efficacy of AVG PA interventions.

Protocol and biomarker strategy for a multi-site randomized controlled trial examining biological mechanisms and dosing of active music engagement in children with acute lymphoblastic leukemia and lymphoma and parents

BackgroundMusic therapy is a standard palliative care service in many pediatric and adult hospitals; however, most research has focused on the use of music to improve psychosocial dimensions of health, without considering biological dimensions. This study builds on prior work examining psychosocial mechanisms of action underlying an Active Music Engagement (AME) intervention, designed to help manage emotional distress and improve positive health outcomes in young children with cancer and parents (caregivers), by examining its effects on biomarkers of stress and immune function.MethodsThis two-group randomized controlled trial (R01NR019190) is designed to examine biological mechanisms of effect and dose-response relationships of AME on child/parent stress during the consolidation phase of Acute B- or T-cell Lymphoblastic Leukemia (ALL) and T-cell Lymphoblastic Lymphoma (TLyLy) treatment. Child/parent dyads (n = 228) are stratified (by age, site, risk level) and randomized in blocks of four to the AME or attention control condition. Each group receives one session (30-minutes AME; 20-minutes control) during weekly clinic visits (4 weeks standard risk B-cell ALL; 8 weeks high risk B-cell ALL/T-cell ALL/TLyLy). Parents complete questionnaires at baseline and post-intervention. Child/parent salivary cortisol samples are taken pre- and post-session (sessions 1–4). Child blood samples are reserved from routine draws before sessions 1 and 4 (all participants) and session 8 (high risk participants). We will use linear mixed models to estimate AME’s effect on child/parent cortisol. Examining child/parent cortisol as mediators of AME effects on child and parent outcomes will be performed in an ANCOVA setting, fitting the appropriate mediation models using MPlus and then testing indirect effects using the percentile bootstrap approach. Graphical plots and non-linear repeated measures models will be used to examine dose-response relationship of AME on child/parent cortisol.DiscussionDuring pediatric cancer treatment there are special challenges that must be considered when measuring cortisol and immune function. In this manuscript we discuss how we addressed three specific challenges through our trial design. Findings from this trial will increase mechanistic understanding of the effects of active music interventions on multiple biomarkers and understanding of dose-response effects, with direct implications for clinical practice.Trial RegistrationClinicalTrials.gov: NCT04400071.

The effectiveness of low-dosed outpatient biopsychosocial interventions compared to active physical interventions on pain and disability in adults with nonspecific chronic low back pain: Asystematic review with meta-analysis.

To evaluate the effectiveness of low-dosed outpatient biopsychosocial interventions versus active physical interventions on pain intensity and disability in adults with nonspecific chronic low back pain. Research has shown that primary care biopsychosocial interventions (PCBI) can reduce pain intensity and disability. While scattered studies support low-dosed (≤ 15 treatment hours) PCBI, no systematic review exists comparing the effectiveness of low-dosed PCBI treatment with traditional physical activity interventions in adults with nonspecific chronic low back pain (CLBP). Randomized controlled trials that evaluate low-dosed PCBI compared to physical treatment with an active component such as exercise, physical activity or usual physiotherapy treatment for adult participants (18 years or older), who suffer from CLBP were included. Not recommended interventions that feature only passive therapies, spinal surgery or pharmacological treatment, and studies with inpatient multidisciplinary-based rehabilitation (MBR) were excluded. Databases were searched from inception to December 31, 2021. Language was restricted to English or German. Keywords and derivatives of "chronic back pain", "exercise intervention", "cognitive-behavioral therapy", "primary care" and "randomized controlled trials" were used. Sources were CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Ovid Medline, Physiotherapy Evidence Database (PEDro), PubMed and Web of Science. Search was finished on March 08, 2022. Data appraisal, extraction and synthesis followed JBI guidance for systematic reviews of effectiveness. Risk of Bias was assessed using JBI 13-item checklist for randomized controlled trials. The GRADE approach for grading the certainty of evidence was followed. PROSPERO 2022 CRD42022302771. Eighteen RCTs were found eligible and 15 trials comprising a total of 1531 participants suffering from CLBP were entered in the meta-analyses. Risk of Bias was low. Overall evidence was moderate. Significant effects in favor of PCBI were found for pain intensity post-treatment (standardized mean difference (SMD)=-1.09, 95% confidence interval (CI)=-1.84 to -0.34, I2 =97%, p=0.004) as well as at short-term (SMD=-0.23, 95% CI=-0.39 to -0.08, I2 =0%, p=0.004), long term (SMD=-0.79, 95% CI=-1.42 to -0.17, I2 =96%, p=0.01) and very long-term (SMD=-1.13, 95% CI=-1.93 to -0.33, I2 =94%, p=0.005) follow-up. Significant effects in favor of PCBI for physical function were found post-treatment (SMD=-1.33, 95% CI=-2.17 to -0.49, I2 =97%, p=0.002) at short-term (SMD=-0.20, 95% CI=-0.36 to -0.04, I2 =0%, p=0.01) and at long-term follow-up (SMD=-1.17, 95% CI=-2.06 to -0.28, I2 =98%, p=0.01). The results were characterized by high heterogeneity due to different types (cognitive behavioral therapy, pain-neuroscience education, mindfulness, and motivation), delivery modes (individual and/or group), durations (3-12 weeks) and contact times (2-15 h) of PCBI. In sensitivity analysis outliers were removed to reduce heterogeneity. The results remained significant for pain intensity at short-term (SMD=-0.23, 95% CI=-0.39 to -0.08, I2 =0%, p=0.004) and long-term follow-up (SMD=-0.22, 95% CI=-0.41 to -0.03, I2 =39%, p=0.02). This meta-analysis suggests that low-dosed PCBI has favorable effects in terms of disability and pain intensity compared to active physical treatments alone. All conducted meta-analyses indicate that biopsychosocial interventions produce better outcomes than active physical treatment alone. Therefore, we strongly recommend decision makers and clinical practitioners to analyze how psychosocial elements can be introduced into outpatient (low-dosed) CLBP interventions.

Effect of active video games on cognitive functions in healthy children and adolescents. Systematic review of randomized controlled studies

Aims: To examine the effect of active video game interventions (exergames) on cognitive functions in healthy children and adolescents. Methods: A systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement, using PubMed, Scopus, and Web of Science databases. The search was restricted to randomized controlled studies evaluating the effect of exergames in a young healthy population on some cognitive variable. Results: Five studies met the inclusion criteria. All studies identified an improvement in some cognitive variable after exergame interventions. Only one study implemented an acute protocol of active video games finding a positive effect on cognitive flexibility. Concerning the chronic exergame interventions (range 4–24 weeks), favorable effects on global executive functions and inhibitory control were identified. Conclusions: The results of the included studies suggest a favorable acute effect and positive chronic effects of active video game interventions on cognitive variables in healthy children and adolescents. However, these effects appear to be inconclusive given the low number of studies, and the overall methodological quality and risks of bias. Thus, it is necessary to support these findings with future research.

The effectiveness of low-dosed outpatient biopsychosocial interventions compared to active physical interventions on pain and disability in adults with nonspecific chronic low back pain: A protocol for a systematic review with meta-analysis.

Best outpatient treatment of nonspecific chronic low back pain is high-dosed exercise that is maintained after therapy. Primary care biopsychosocial intervention (PCBI) is an outpatient multicomponent intervention that includes an active component (exercise, physical activity, or physiotherapy) and at least one psychological, social, or occupational component. Research has shown that PCBI can reduce pain intensity and disability. While scattered studies support low-dosed (<15 treatment hours) PCBI, there is no systematic review comparing the effectiveness of low-dosed PCBI treatment with traditional physical activity interventions in adults with nonspecific chronic low back pain (CLBP). Randomised controlled trials that evaluate low-dosed outpatient biopsychosocial interventions compared to physical treatment with an active component such as exercise, physical activity or usual physiotherapy treatment for adult participants (18 years or older) who suffer from nonspecific CLBP will be included. A comprehensive search of multiple databases will be used to find relevant studies. The databases will be searched from inception to December 2021, with English or German language restrictions imposed. Keywords and derivatives of "chronic back pain", "exercise intervention", "cognitive-behavioral therapy", "primary care" and "randomized controlled trials" will be used. Sources will include CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Ovid Medline, Physiotherapy Evidence Database (PEDro), PubMed and Web of Science. To our knowledge, this will be the first systematic review and meta-analysis of narrowly defined low- dosed PCBI across populations with nonspecific chronic low back pain. The objective of this review is to evaluate the effectiveness of low-dosed outpatient biopsychosocial interventions versus physical active interventions on pain intensity and disability in adults with CLBP. This study will provide evidence that could improve treatment options for patients with nonspecific CLBP. Systematic review registration number: PROSPERO 2022 CRD42022302771. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022302771.

Does APOE ɛ4 Status Change How 24-Hour Time-Use Composition Is Associated with Cognitive Function? An Exploratory Analysis Among Middle-to-Older Adults.

The 24 h time-use composition of physical activity, sedentary behavior, and sleep is linked to cognitive function in adults and may contribute to future dementia risk. However, the impact of reallocating time between behaviors may differ depending on an individual's genetic dementia risk. To explore if there is an interaction between 24 h time-use composition and genetic dementia risk in relation to cognitive function, and to simulate how time-reallocations are associated with cognitive function across different levels of genetic dementia risk. Cross-sectional global cognition, executive function, genetic dementia risk (at least one apolipoprotein (APOE) ɛ4 allele versus none) and 7 days of 24 h accelerometry (average daily time-use composition of moderate-to-vigorous physical activity (MVPA), light physical activity, sedentary behavior, sleep) were collected from 82 adults (65.6±7.5 years, 49 females). Linear regression was used to explore the relationship between time-use composition and cognitive measures, testing for interaction between APOE ɛ4 status and time-use composition. The models were used to simulate time reallocations in both APOE ɛ4 status groups. The 24 h time-use composition was associated with global cognition (F = 2.4, p = 0.02) and executive function (F = 2.6, p = 0.01). For both measures, the association differed according to genetic risk (interactions p < 0.001). In both APOE groups, reallocating time to MVPA was beneficially associated with measures of cognitive function, but associations were larger among those with at least one APOE ɛ4 allele. Genetic dementia risk may impact the effectiveness of activity interventions. Increasing MVPA may provide greater benefits among those with higher genetic dementia risk.

Investigating the Effect of Active and Passive Proximal Interventions on Dynamic Knee Valgus in Patients With Patellofemoral Pain: A Systematic Review

Investigating the Effect of Active and Passive Proximal Interventions on Dynamic Knee Valgus in Patients With Patellofemoral Pain: A Systematic Review

The Preoperative Fasting Conundrum: An Audit of Practice in a Tertiary Care Children's Hospital.

Objective:This article aimed to study preoperative fasting times in children undergoing elective surgery and to analyze the effect of active interventions conducted to promote compliance with current fasting guidelines.Methods:An initial audit was performed in which 85 children up to 15 years of age posted for elective surgeries were surveyed. A questionnaire was circulated among nurses, resident medical officers, and surgeons to assess their knowledge regarding recent fasting guidelines and its importance. The mean preoperative fasting times were found to be much longer than the recommended guidelines. Interventions were carried out to spread awareness about recent preoperative fasting guidelines. A re-audit was done 4 months after the initial audit.Results:The initial audit revealed a mean preoperative fasting time for solids and water to be 9.43 hours and 6.64 hours, respectively. About 43.6% of hospital staff believed “fasting from midnight” regimen is the best method to prevent pulmonary aspiration. Incorrect orders by doctors (47%) and ward nurses (38%) were found to be important causes of non-adherence. After the intervention, mean preoperative fasting times for solids and water decreased to 7.7 hours and 2.6 hours, respectively.Conclusion:Adopting simple measures such as education and multidisciplinary teamwork can optimize fasting duration and children’s experiences preoperatively.