Individual Health Benefits Research Articles

Type 1 Diabetes and the Menstrual Cycle: Where/How Does Exercise Fit in?

Regular exercise is associated with substantial health benefits for individuals with type 1 diabetes (T1D). However, the fear of hypoglycemia (low blood glucose) due to activity-induced declines in blood glucose levels acts as a major barrier to partaking in exercise in this population. For females with T1D, hormonal fluctuations during the menstrual cycle and their effects on blood glucose levels can act as an additional barrier. The impact that these cyclic changes may have on blood glucose and insulin needs and the consequent risk of hypoglycemia during or after exercise are still unknown in this population. Therefore, in this narrative review, we gathered existing knowledge about the menstrual cycle in T1D and the effects of different cyclic phases on substrate metabolism and glucose response to exercise in females with T1D to increase knowledge and understanding around exercise in this underrepresented population. This increased knowledge in such an understudied area can help to better inform exercise guidelines for females with T1D. It can also play an important role in eliminating a significant barrier to exercise in this population, which has the potential to increase activity, improve mental health and quality of life, and decrease the risk of diabetes-related complications.

Decentralised point-of-care testing for acute, chronic and infectious disease – benefits and challenges

The COVID-19 pandemic has reinforced Australia’s need for diagnostic testing frameworks that are well-prepared, well-resourced, responsive, appropriately governed, scalable, interdisciplinary and collaborative.1 Point-of-care (POC) technologies offer diagnostic solutions capable of delivering individual, community and public health benefits in settings where: a) laboratory testing is not available, b) rapid turn-around time is needed, c) high loss to follow-up occurs in high-risk populations with standard of care cascades and/or d) disease transmission rates exceed laboratory response capacity. Key translational research derived from collaborative point-of-care testing networks for a) diabetes management (238 remote health services; 3,233 operators; 172,069 HbA1c and 51,379 urine albumin:creatinine ratio tests), b) acute care (106 remote health services; 2,279 operators; 32,950 blood gas, 32,689 cardiac troponin, 46,418 urea/electrolytes, 48,193 international normalised ratio tests), c) hepatitis C virus (HCV) (41 sites; 110 operators; 5,733 HCV tests; 4,978 RNA, 755 antibody), d) syphilis screening (156 sites; 1,412 operators), e) chlamydia, gonorrhea or trichomonas (51 sites; 795 operators; >50,000 tests) or f) COVID-19 (101 remote health services, 733 operators, 72,624 tests) will be used to highlight operational, clinical, public health, and economic benefits of POC testing. Challenges associated with scale-up and accreditation pathways for decentralised POC testing will be discussed. Reference 1. Revised Testing Framework for COVID-19 in Australia, March 2022 Version 2.1. Communicable Disease Network Australia and Public Health Laboratory Network.

Personal network size and social accompaniment: Protective or risk factor for momentary loneliness, and for whom?

Personal networks yield important health benefits for individuals, in part by providing more opportunities to be in the company of others throughout daily life. Social accompaniment is generally believed to protect against momentary feelings of loneliness, although this hypothesis remains understudied. We examine how personal network size shapes older adults' experiences of momentary loneliness and whether this association varies by momentary social accompaniment. We use three waves of ecological momentary assessments (EMA; N = 12,359) and personal network data from 343 older adults in the Chicago Health and Activity in Real-Time study. Older adults with large personal networks experienced more intense momentary loneliness compared to those with smaller social networks when they were momentarily alone. This association was more pronounced among men. We discuss how research approaches that bridge global and momentary measures of social connectedness can reveal important nuances of our understanding of how interpersonal factors influence later-life well-being over time.

Oral Arginine Supplementation in Healthy Individuals Performing Regular Resistance Training.

Resistance exercise training is well documented as having cardiovascular benefits, but paradoxically, it seems to increase arterial stiffness, favoring the development of high blood pressure. The present study investigates the potential effects of oral supplementation with arginine in healthy individuals performing exercise resistance training. We studied 70 non-smoking male subjects between the ages of 30 and 45 with normal or mildly increased blood pressure on ambulatory monitoring (for 24 h) and normal blood samples and echocardiography, who performed regular resistance exercise training for at least five years with a minimum of three workouts per week. They were divided into two groups in a random manner: 35 males were placed in the arginine group (AG) that followed a 6-month supplementation of their regular diets with 5 g of oral arginine powder taken before their exercise workout, and the control (non-arginine) group (NAG) consisted of 35 males. All subjects underwent body composition analysis, 24 h blood pressure monitoring and pulse wave analysis at enrollment and at six months. After six months of supplementation, blood pressure values did not change in the NAG, while in the AG, we found a decrease of 5.6 mmHg (p < 0.05) in mean systolic blood pressure and a decrease of 4.5 mmHg (p < 0.05) in diastolic values. There was also a 0.62% increase in muscle mass in the AG vs. the NAG (p < 0.05), while the body fat decreased by 1% (p < 0.05 in AG vs. NAG). Overall, the AG gained twice the amount of muscle mass and lost twice as much body fat as the NAG. No effects on the mean weighted average heart rate were recorded in the subjects. The results suggest that oral supplementation with arginine can improve blood pressure and body composition, potentially counteracting the stress induced by resistance exercise training. Supplementation with arginine can be a suitable adjuvant for these health benefits in individuals undertaking regular resistance training.

The inclusion of garlic and turmeric powder in high-fructose diets protects against the development of metabolic syndrome in Wistar rats

The worldwide prevalence of the metabolic syndrome is largely attributable to excessive consumption of high-energy food sweeteners and lifestyle practices that encourage physical inactivity. This study was designed to evaluate the potential benefits of garlic and/or turmeric in down-regulating the risk factors associated with metabolic syndrome. Twenty-four male Wistar rats were divided into 8 groups of 3 rats per group. Group 1 received standard rat chow, Group 2 received a high-fructose diet only, while Group 3 received a 2% turmeric-supplemented high-fructose diet. Groups 4 and 5 were fed a standard diet supplemented with 2% each of garlic and turmeric:garlic (50% w/w), respectively. Groups 6, 7, and 8 were respectively fed a high-fructose diet supplemented with 2% garlic, a standard diet supplemented with 2% turmeric, and a high-fructose diet supplemented with 2% turmeric:garlic (50% w/w). Feed intake and changes in body weight were monitored weekly and after 56 days, the rats were sacrificed. Activities of serum antioxidant enzymes, lipid profile, and atherogenic indices were determined. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was computed from the measured blood glucose and insulin levels. The positive control (Group 2) gained weight significantly (p &lt; 0.05) when compared with groups that received diet supplementation. Total cholesterol, triglycerides, low-density lipoprotein, and atherogenic indices of diet-supplemented groups were significantly low (p &lt; 0.05) when compared with the positive control. Interestingly, while no differences (p &gt; 0.05) were observed in the catalase and glutathione peroxidase enzyme activities in the high-fat diet group supplemented with 2% mixed turmeric:garlic when compared with the normal control, activities of these enzymes in the garlic and/or turmeric supplemented high-fructose diet groups were significantly elevated (p &lt; 0.05) when compared with the positive control. The HOMA-IR and atherogenic indices results revealed the inclusion of turmeric and garlic in a high-fat diet had anti-dyslipidemic effects, decreased oxidative stress, and reduced coronary risk factors. Our findings strongly suggest supplementation of high-calorie diets with garlic and/or turmeric powder has potential long-term health benefits in individuals exposed to the risks of developing metabolic syndrome.

A review of states' decisions regarding health insurance exchanges

Health insurance exchanges play a principal role in the structure of the Patient Protection and Affordable Care Act’s (ACA) goal of providing access to affordable, quality health insurance, and reducing the growth in health care spending in the U.S. Exchanges are proposed to simplify and streamline the health insurance choices and benefits for individuals and small businesses. The ACA and the Exchange Final Rule stipulate states are required to have an approved statebased exchange or participate in the federally facilitate marketplace. This paper examines the variety of decisions made by states, including the type of exchange established, the structure of the exchange and various other relevant characteristics. Additionally, we examine whether any significant differences exist between state-level population demographics and political factors by exchange type. Our discussion highlights the heterogeneity in states’ decisions regarding health insurance exchange and provides a valuable source of intuitional information that helps to inform regulators, policymakers and other health insurance market participants. Our paper also helps identify future research topics related to health insurance markets and exchanges.

FERMENTATION ENHANCED NUTRITIONAL QUALITY OF FOOD- A REVIEW

Among the earliest processed food products, fermented foods are those ingested by humans. Through fermentation techniques different semi-digested and reactive meals can sometimes be converted into functional foods which have a beneficial effect on health. Generally, fermentation helps to eliminate numerous unwanted microbes and toxins from food particles while also introducing helpful microbes to help with digestion, these bacteria also help to develop new enzymes. Fermentation also enhances the quality of different food products such as soybeans, dairy products, cereals, etc. by including their nutritional status. Thereby quality of functional foods can be increased through fermentation which generally improves the GI Tract health, acts as immune system enhancer, improving the bio-availability of nutrients, lowering the lactose intolerance habitat, reducing the appearance of allergic symptoms in susceptible persons and also sometimes decreasing the risk of certain diseases including cancer. Basically fermented foods contain probiotic organisms which may be the probable agents to enhance the health benefits of individuals. In this article, emphasis has been given to the beneficial effect of fermented foods on the general health of the human being.

Human Milk from Tandem Feeding Dyads Does Not Differ in Metabolite and Metataxonomic Features When Compared to Single Nursling Dyads under Six Months of Age.

Given the long-term advantages of exclusive breastfeeding to infants and their mothers, there is both an individual and public health benefit to its promotion and support. Data on the composition of human milk over the course of a full period of lactation for a single nursling is sparse, but data on human milk composition during tandem feeding (feeding children of different ages from different pregnancies) is almost entirely absent. This leaves an important knowledge gap that potentially endangers the ability of parents to make a fully informed choice on infant feeding. We compared the metataxonomic and metabolite fingerprints of human milk samples from 15 tandem feeding dyads to that collected from ten exclusively breastfeeding single nursling dyads where the nursling is under six months of age. Uniquely, our cohort also included three tandem feeding nursling dyads where each child showed a preferential side for feeding-allowing a direct comparison between human milk compositions for different aged nurslings. Across our analysis of volume, total fat, estimation of total microbial load, metabolite fingerprinting, and metataxonomics, we showed no statistically significant differences between tandem feeding and single nursling dyads. This included comparisons of preferential side nurslings of different ages. Together, our findings support the practice of tandem feeding of nurslings, even when feeding an infant under six months.

The paid sick leave and sickness benefits for universal health coverage: a scoping review

Abstract Background The countries with paid sick leave (PSL) and sickness benefits (SB) mostly provide the benefit coverage to specific categories of workers, which results in health inequalities among employees in COVID-19. The PSL and SB are key factors to achieve universal health coverage (UHC) in that they protect access to healthcare and improve population health. This study attempted to investigate whether the policies helped achieve the UHC when they were expanded. Methods This review followed the scoping review protocol of PRISMA-ScR. On April 6, 2021, we extracted the literature using the keywords ‘paid sick leave', ‘sickness benefits', ‘paid sick day', and ‘earned sick leave’ from PubMed and Web of Science and added two studies through hand-search. All articles were written in English. We did not limit the publication date. Results Forty-four selected studies were based in four single countries and the European Union. Most of the studies were published after 2010 (84.1%) and were conducted as cross-sectional (72.7%) studies. Not only workers who use PSL and SB but also children whose parents use PSL and SB increased their use of healthcare services and getting flu shots. Also, using PSL and SB decreased their unmet healthcare needs and emergency use. The various health status factors, such as infectious disease incidence, mortality, and presenteeism, also decreased. Conclusions The provisions of PSL and SB offer individual and public health benefits by allowing employees and their families to use healthcare services. Group of employees, we can expect similar public health impacts on newly covered groups, thus contributing to achieving the UHC. Since more than 90% of articles are published from the United States, future studies need to evaluate the outcomes of health effects in various European or Asian countries. Key messages • The provision of PSL and SB positively affects employees and their families by allowing them to use healthcare services. • The expansion of PSL and SB contributes to the UHC by guaranteeing indirect medical costs that enable universal access to essential healthcare services.

Robust tracking for functional electrical stimulation cycling with unknown time-varying input delays: A switched systems approach.

Motorized functional electrical stimulation (FES) cycling has been demonstrated to have numerous health benefits for individuals suffering from neurological disorders. FES-cycling is usually designed to track the desired trajectories in real time. However, there are input delays between the exertion of the stimulation and the corresponding muscle contraction that potentially destabilize the system and undermine training efforts. Meanwhile, muscle fatigue gives rise to a time-varying input delay and decreased force. Moreover, switching between FES and motor control can be chattering and destabilizing owing to the high frequency. This article constructs Lyapunov-Krasovskii functionals to analyze the stability and robustness of the nonlinear cycling system with time-varying input delay. A new average dwell time condition is then provided to ensure the input-to-state stability of the considered systems. Finally, numerical simulations are illustrated to verify the effectiveness of the developed controller.

Integrated Multi-Omics Analysis Reveals Differential Effects of Fructo-Oligosaccharides (FOS) Supplementation on the Human Gut Ecosystem.

Changes in the gut ecosystem, including the microbiome and the metabolome, and the host immune system after fructo-oligosaccharide (FOS) supplementation were evaluated. The supplementation of FOS showed large inter-individual variability in the absolute numbers of fecal bacteria and an increase in Bifidobacterium. The fecal metabolome analysis revealed individual variability in fructose utilization in response to FOS supplementation. In addition, immunoglobulin A(IgA) tended to increase upon FOS intake, and peripheral blood monocytes significantly decreased upon FOS intake and kept decreasing in the post-FOS phase. Further analysis using a metagenomic approach showed that the differences could be at least in part due to the differences in gene expressions of enzymes that are involved in the fructose metabolism pathway. While the study showed individual differences in the expected health benefits of FOS supplementation, the accumulation of “personalized” knowledge of the gut ecosystem with its genetic expression may enable effective instructions on prebiotic consumption to optimize health benefits for individuals in the future.

Experiences of an Equine-Assisted Therapy Intervention among Children and Adolescents with Mental Illness in Sweden - A Nursing Perspective

Mental illness among children and adolescents is increasing globally, and prescription of psychiatric drugs for children and adolescents with mental illness is increasing worldwide, including Sweden. Holistic health-promoting interventions have shown promising long-lasting significant health benefits in young individuals with mental illness, but holistic health-promoting mental health interventions are often disregarded due to a lack of systematic theory-based knowledge. Consequently, the lack of scientific knowledge thwarts implementation of equine-assisted therapy as an established intervention in mental health nursing for children and adolescents with mental illness. The purpose of the study was to better understand experiences of equine-assisted therapy among children and adolescents with mental illness. The study adopted an inductive approach and data was collected using photovoice methodology. Six young persons, 7–18 years of age, referred by a psychologist to the equine-assisted intervention due to mental health issues, were included in the study. Data was analyzed using qualitative content analysis. The results could be summarized by an overarching theme, a physical, emotional, and social milieu for growth, consisting of three subcategories: feeling relief from everyday stress and anxiety; nurturing self-esteem in a mutual friendship; and strengthening self-reliance through synchronized interplay. The results indicate that equine-assisted therapy has essential values closely related to the goals of mental health nursing. Further research should strive to attain even gender distribution in study samples and focus on how equine-assisted therapy could be thoroughly integrated into established nursing intervention for children and adolescents with mental illness.

HIV drug resistance in a community-randomized trial of universal testing and treatment: HPTN 071 (PopART).

IntroductionUniversal HIV testing and treatment (UTT) has individual and public health benefits. HPTN 071 (PopART), a community‐randomized trial in Zambia and South Africa, demonstrated that UTT decreased HIV incidence. This endpoint was assessed in a cohort of >48,000 randomly selected adults in the study communities. We evaluated the impact of UTT on HIV drug resistance in this cohort and compared other resistance‐related outcomes in participants with recent versus non‐recent HIV infection.MethodsTwo years after the start of HPTN 071 (2016–2017), 6259 participants were HIV positive and 1902 were viremic (viral load >400 copies/ml). HIV genotyping and antiretroviral (ARV) drug testing were performed for viremic participants in three groups: seroconverters (infected <1 year), non‐seroconverters (infected >1 year, random subset) and participants with unknown duration of infection (random subset). A two‐stage cluster‐based approach was used to assess the impact of the study intervention on drug resistance. Treatment failure was defined as being viremic with ARV drugs detected. Participants were classified as ARV naïve based on self‐report and ARV drug testing.ResultsGenotyping results were obtained for 758 participants (143 seroconverters; 534 non‐seroconverters; and 81 unknown duration of infection). The estimated prevalence of resistance in the study communities was 37% for all viremic persons and 11% for all HIV‐positive persons. There was no association between UTT and drug resistance. Resistance was detected in 14.0% of seroconverters and 40.8% of non‐seroconverters (non‐nucleoside reverse transcriptase inhibitor resistance: 14.0% and 39.9%; nucleoside/nucleotide reverse transcriptase inhibitor resistance: 0.7% and 15.5%; protease inhibitor resistance: 0% and 1.9%; multi‐class resistance: 0.7% and 16.1%, respectively). ARV drugs were detected in 2/139 (1.4%) of seroconverters and 94/534 (17.6%) of non‐seroconverters tested. These participants were classified as failing ART; 88 (93.6%) of the non‐seroconverters failing ART had resistance. Mutations used for surveillance of transmitted drug resistance were detected in 10.5% of seroconverters and 15.1% of non‐seroconverters who were ARV naive.ConclusionsUTT was not associated with an increase in drug resistance in this cohort. Higher rates of drug resistance and multi‐class resistance were observed in non‐seroconverters compared to seroconverters.

239-OR: Physical Activity, Hypoglycemia, and Type 1 Diabetes: A Data-Driven Approach

Physical activity (PA) provides numerous health benefits for individuals with T1D. However, the threat of exercise-induced hypoglycemia may impede the desire for regular PA. We aimed to study the association between three common types of PA (walking, running, and cycling) and hypoglycemia risk in 50 individuals with T1D. Real-world data including characteristics of PA, CGM values, and insulin doses were available from the Tidepool Big Data Donation Project. Participants were aged 38.0 ± 13.1 yrs with 21.4 ± 12.9 yr duration of diabetes and avg 26.2 weeks of CGM data available. We built a linear regression model for each of the three PA types to predict the probability of level 1 hypoglycemia (&amp;lt;70 mg/dL) during the 2 hours after start of PA using the following predictors: PA duration (mins) , PA intensity (calories burned) , 2-hr pre-exercise glucose AUC, glucose value at start of PA, and total bolus insulin within 2 hrs before PA. Regression results are provided in Table 1. Our models indicated that glucose value at the start of exercise (p&amp;lt;0.0for all three activities) and pre-exercise glucose AUC (p&amp;lt;0.0for walking and cycling) were the most significant predictors of hypoglycemia. Duration and intensity of PA and 2-hr bolus insulin were weakly associated with hypoglycemia for certain exercises. These findings may provide T1D individuals with a data-driven approach in preparing for PA that minimizes hypoglycemia risk. Disclosure S.Prasanna: None. S.Barua: None. J.J.Johnson: None. A.F.Siller: None. A.Sabharwal: None. D.Desalvo: Consultant; Dexcom, Inc., Insulet Corporation, Research Support; Insulet Corporation. Funding National Science Foundation (1648451)

Natural History of Obesity Due to POMC, PCSK1, and LEPR Deficiency and the Impact of Setmelanotide.

ContextRare homozygous or biallelic variants in POMC, PCSK1, and LEPR can disrupt signaling through the melanocortin-4 receptor (MC4R) pathway, resulting in hyperphagia and severe early-onset obesity. In pivotal Phase 3 clinical trials, treatment with the MC4R agonist setmelanotide reduced hunger and weight in patients with obesity due to proopiomelanocortin (POMC), proprotein convertase subtilisin/kexin type 1 (PCSK1), or leptin receptor (LEPR) deficiency.ObjectiveTo characterize the historical weight trajectory in these patients.MethodsThis analysis included data from 2 pivotal single-arm, open-label, Phase 3 trials (NCT02896192, NCT03287960). These were multicenter trials. Patients had obesity due to POMC/PCSK1 or LEPR deficiency. During the trial, patients were treated with setmelanotide. Historical data on measured weight and height were obtained during screening.ResultsA total of 17 patients (POMC, n = 8; PCSK1, n = 1; LEPR, n = 8) with historical weight and height data were included in this analysis. Before setmelanotide treatment, patients with obesity due to POMC/PCSK1 or LEPR deficiency were above the 95th percentile for weight throughout childhood, demonstrated continuous weight gain, and did not show long-term weight loss upon interventions (eg, diet, surgery, exercise). Setmelanotide treatment attenuated weight and body mass index trajectories over the observation period of 1 year.ConclusionIn patients with POMC, PCSK1, or LEPR deficiency, traditional interventions for weight loss had limited impact on the trajectory of severe early-onset obesity. However, setmelanotide treatment attenuated weight and body mass index trajectories and led to weight loss associated with health benefits in most individuals.

Supervised Cycling Training Improves Erythrocyte Rheology in Individuals With Peripheral Arterial Disease.

Peripheral arterial disease (PAD) results in insufficient flow to lower extremities. Aerobic exercise provides health benefits for individuals with PAD, but basic science behind it is still debated. Twenty-one PAD patients aged about 70 years with female/male as 7/14 were recruited. Among them, 11 were randomized to have supervised cycling training (SCT) and 10 to receive general healthcare (GHC) as controls. SCT participants completed 36 sessions of SCT at the first ventilation threshold within 12 weeks and the controls received GHC for 12 weeks. Ankle-brachial index (ABI), 6-min walk test (6MWT), peak oxygen consumption (O2peak), minute ventilation (E), minute carbon dioxide production (CO2), erythrocyte rheology, including the maximal elongation index (EImax) and shear stress at 50% of maximal elongation (SS1/2), and the Short Form-36 (SF-36) questionnaire for quality of life (QoL) were assessed before and 12 weeks after initial visit. SCT significantly decreased the SS1/2 as well as SS1/2 to EImax ratio (SS1/2/EImax) and increased the erythrocyte osmolality in the hypertonic region as well as the area under EI-osmolality curve. The supervised exercise-induced improvement of erythrocyte deformability could contribute to the increased peripheral tissue O2 delivery and was possibly related with increased O2peak. The physiological benefit was associated with significantly increased ABI, 6-min walking distance, cardiorespiratory fitness, and SF-36 score. However, no significant changes in aerobic capacity and erythrocyte rheological properties were observed after 12-week of GHC. In conclusion, SCT improves aerobic capacity by enhancing erythrocyte membrane deformability and consequently promotes QoL in PAD patients.

Incorporating environmental and sustainability considerations into health technology assessment and clinical and public health guidelines: a scoping review.

Healthcare systems account for a substantial proportion of global carbon emissions and contribute to wider environmental degradation. This scoping review aimed to summarize the evidence currently available on incorporation of environmental and sustainability considerations into health technology assessments (HTAs) and guidelines to support the National In stitute for Health and Care Excellence and analogous bodies in other jurisdictions developing theirown methods and processes. Overall, 7,653 articles were identified, of which 24 were included in this review and split into three key areas - HTA (10 studies), healthcare guidelines (4 studies), and food and dietary guidelines (10 studies). Methodological reviews discussed the pros and cons of different approaches to integrate environmental considerations into HTAs, including adjustments to conventional cost-utility analysis (CUA), cost-benefit analysis, and multicriteria decision analysis. The case studies illustrated the challenges of putting this into practice, such as lack of disaggregated data to evaluate the impact of single technologies and difficulty in conducting thorough life cycle assessments that consider the full environmental effects. Evidence was scant on the incorporation of environmental impacts in clinical practice and public health guidelines. Food and dietary guidelines used adapted CUA based on life cycle assessments, simulation modeling, and qualitative judgments made by expert panels. There is uncertainty on how HTA and guideline committees will handle trade-offs between health and environment, especially when balancing environmental harms that fall largely on society with health benefits for individuals. Further research is warranted to enable integration of environmental considerations into HTA and clinical and public health guidelines.

SOCIO-PSYCHOLOGICAL BARRIERS OF INDIVIDUAL REGARDING COVID-19 VACCINE ACCEPTANCE.

The aim: The aim of the article is to analyse the socio-psychological barriers to the COVID-19 vaccination process in the world and in Ukraine. Materials and methods: Electronic databases of Web of Science, Scopus and PubMed were searching using keyword searches. Conclusions: The implementation of an effective scientific strategy of health education and communication between representatives of the medical sphere and representatives of different social groups, gender and age is relevant today. At the moment it is difficult for the medical community and society to give an unambiguous assessment of the facts about COVID-19, because it is still unknown about the long-term impact of the COVID-19 pandemic on individual. To increase the vaccination coverage, vaccination evidence should be standardized and a choice of conditions, algorithm of beliefs instead of a standard approach should be proposed. Further research on individual health benefits is needed to identify and address socio-psychological barriers on COVID-19 vaccine acceptance.

The experiences and perceived health benefits of individuals with a disability participating in sport: A systematic review and narrative synthesis

Sports participation has many physical and mental health benefits for individuals with a disability including improved functionality and reduced anxiety, yet a large proportion of individuals with a disability are inactive. To investigate the experiences and perceived health benefits of sport participation across four disability populations: children and adolescents, adults, elite athletes and veterans with a disability. A mixed-methods systematic review was conducted. Eligible studies had participants who were children, adults, elite athletes or veterans with a physical, visual or intellectual disability. Data were extracted using the Joanna Briggs Institute (JBI) tool and quality assessment involved the Quality Assessment Tool for Studies with Diverse Designs (QATSDD). Content, thematic and narrative synthesis techniques were used. Confidence in cumulative evidence was determined using GRADE-CERQual and Classes of Evidence. Several positive aspects of sport participation were highlighted across all four populations, including socialisation opportunities, pure enjoyment, a sense of freedom and providing an arena to challenge stereotypes. The paucity of research within the 'veterans with a disability' group limited analysis of experiences and benefits of sport in this population. This systematic review was the first to explore this phenomena, finding that overall sport is a beneficial experience for individuals with a disability. The positive aspects should be promoted when encouraging sport participation for children, adolescents, adults and elite athletes. More research is needed to explore these phenomena in veterans and to compare perceived benefits between populations to enable tailored promotion of sport.

The effects of presenting health and environmental impacts of food on consumption intentions

Current patterns of food consumption are detrimental to our health and the environment. Consumers need to make informed changes to their diets but due to a lack of understanding of the health and environment benefits/risks of foods, this is difficult to do. The current study examined the effectiveness of a novel food label, the Health Nutrition Index (HENI; minutes of healthy life gained/lost per serving), that communicates the health benefits/risks of foods, and identifies how consumers negotiate and prioritise health and environmental concerns of foods. Participants (N = 901, females = 546, age: M = 46.62 (16.61) years, BMI: M = 27.39 (6.75)) viewed 24 foods presented with either no information (control), standard nutritional facts (nutrition), HENI (health), carbon footprint scores (kg CO2eq per serving; environment), or both HENI and carbon footprint scores (combined). Participants rated the perceived healthiness, environmentally friendliness and their intentions to increase/decrease consumption of each food. Perceptions of healthiness and environmentally friendliness were significantly correlated with HENI and carbon footprint scores respectively. Although, overall intentions to change consumption did not significantly differ across conditions, participants presented with HENI (health and combined conditions) scores reported intentions that significantly increased minutes of healthy life gained. Only participants in the environment condition intended to reduce consumption of foods that were beneficial to health but high risk for the environment. For foods that were harmful to health, but low risk for the environment, no significant difference in intentions was found. Overall, results suggest HENI is effective at portraying the health benefits of foods and individuals prioritise the health benefits of foods over the environmental impact they may have.