Higher Quality Scores Research Articles

Chinese guideline for the diagnosis and treatment of childhood obstructive sleep apnea (2020).

Chinese guideline for the diagnosis and treatment of childhood obstructive sleep apnea (2020).

Comparison of curvilinear-array (microconvex) and phased-array transducers for ultrasonography of the lungs in dogs.

To compare the use of curvilinear-array (microconvex) and phased-array transducers for ultrasonographic examination of the lungs in dogs. 13 client-owned dogs with left-sided congestive heart failure. In a prospective methods comparison study, 24 ultrasonographic examinations of the lungs (4 sites/hemithorax) were performed with both curvilinear-array and phased-array transducers at 3 clinical time points. Two observers independently assessed the number of B lines (scored per site and in total), number of sites strongly positive for B lines (ie, those with > 3 B lines/site), and image quality (scored on a 5-point scale). Analyses included assessment of interobserver agreement with κ analysis, comparison of quality scores between transducers with mixed-effects modeling, and investigation of agreement and bias for B-line data and quality scores between transducers with Passing-Bablok regression. Interobserver agreement for total B-line scores and number of strong-positive sites was excellent (κ > 0.80) for both transducers. There was no evidence of analytic bias for the number of B lines or strong-positive sites between transducers. Interobserver agreement for image quality scores was moderate (κ, 0.498 and 0.517 for the curvilinear-array and phased-array transducers, respectively). Both observers consistently assigned higher-quality scores to curvilinear-array images than to phased-array images. Results indicated both curvilinear-array (microconvex) and phased-array transducers can be used by experienced sonographers to obtain diagnostic ultrasonographic images of the lungs in dogs with acute or resolving left-sided congestive heart failure and suggested the former transducer may be preferred, particularly to aid identification of anatomic landmarks for orientation.

Coronavirus in Wisconsin Nursing Homes: A Longitudinal Analysis of the First 10 Months of the Pandemic

Background: The COVID-19 pandemic has disproportionately affected nursing home residents, and emerging evidence suggests quality, location, resident demographics, and staffing levels may be related to COVID-19 incidence within facilities. We describe the distribution of COVID-19 cases in Wisconsin nursing homes from January 2020 to October 2020, the effect of rural versus urban locations on COVID-19 incidence, and the temporal changes in COVID-19 incidence. Methods: We constructed a database using the Center for Medicaid and Medicare Services’ (CMS) publicly available data. Variables obtained per facility included location, number of beds, ownership type, average census, 5-star ratings (overall, quality, health, staffing, and nurse staffing categories), number of COVID-19 cases, resident Medicaid/Medicare share, area deprivation index, and social vulnerability index. Nursing homes were divided into tertiles based on total COVID-19 cases for descriptive analysis (zero cases, 1–7 cases, >7 cases). Demographic and clinical variables were reported as frequencies, mean (standard deviation) or median (interquartile range). We compared groups using the Pearson χ2 test and the Kruskal-Wallis test. COVID-19 incidence rates were calculated by dividing the number of COVID-19 cases by monthly occupied bed days and multiplied by 10,000. Results: From January 1, 2020, to November 1, 2020, in total, 3,133 SARS-CoV-2–confirmed cases were reported among 248 (70.5%) nursing homes. Urban location (P = .027), overall 5-star rating (P = .035), number of beds (p < 0.001), and average count of residents per day (p < 0.001) were associated with a greater number of COVID-19 cases. Temporal analysis showed that the highest incidence rates of COVID-19 in NHs were observed from January to May and in October 2020 (11.36 and 30.33 cases per 10,000 occupied-bed days, respectively). Urban NHs experienced higher incidence rates until September, then incidence rates among rural facilities surged (Fig.1A). In the first half of the year, NHs with lower quality scores (1-3 stars) had a higher COVID-19 incidence rate; however, in August this trend reversed, and facilities with higher quality scores (4-5 stars) showed the highest incidence rates (Fig.1B). Fig. 2 shows a temporal depiction of the shift from urban to rural settings. Conclusions: Higher COVID-19 incidence rates during the first 5 months of the pandemic were observed in urban, larger facilities with lower 5-star rating. By the end of the year, nursing homes in rural areas and those with higher quality ratings had the highest incidence rates.Funding: NoDisclosures: None

The association of mycoprotein-based food consumption with diet quality, energy intake and non-communicable diseases' risk in the UK adult population using the National Diet and Nutrition Survey (NDNS) years 2008/2009-2016/2017: a cross-sectional study.

Mycoprotein is a fungal-based ingredient rich in fibre and protein used in meat substitutes called Quorn. Fibre and protein positively regulate glycaemia, lipidaemia and energy intake which are non-communicable diseases' (NCD) markers. We performed a cross-sectional study to investigate the association of mycoprotein intake with diet quality, nutrient, energy intake and NCD risk within 5507 UK free-living adults from the National Diet and Nutrition Survey from years 2008/2009 to 2016/2017. Dietary approaches to stop hypertension (DASH) and healthy diet index (HDI) were calculated to estimate diet quality. Comparison between mycoprotein consumers (>1 % kcal) and non-consumers, and associations between consumers and nutrient intakes, NCD's risk markers and diet quality were investigated using a survey-adjusted general linear model adjusted for sex, age, BMI, ethnicity, socio-economic, smoking status, region of residency, total energy, energy density, HDI and non-mycoprotein fibre intake. Mycoprotein consumers (3·44 % of the cohort) had a higher intake of dietary fibre (+22·18 %, P < 0·001), DASH score (+23·33 %) and HDI (+8·89 %) (P < 0·001, both) and lower BMI (-4·77 %, P = 0·00) v. non-consumers. There was an association (P = 0·00) between mycoprotein consumers and diet quality scores (+0·19 and +0·26), high fibre (+3·17 g), total and food energy (+3·09 and +0·22 kcal), but low energy density intakes (-0·08 kcal/g, P = 0·04). Consumers were negatively associated with fasting blood glucose (-0·31 mmol/l, P = 0·00) and glycated HbA1c (-0·15 %, P = 0·01). In conclusion, mycoprotein intake is associated with lower glycaemic markers and energy density intake, and high fibre, energy intake and diet quality scores.

Exploration of coupling effects in the Economy–Society–Environment system in urban areas: Case study of the Yangtze River Delta Urban Agglomeration

The rapid development of the economy and society in China has led to a series of environmental pollution problems. Exploring the interaction and coupling effects within the Economy–Society–Environment (ESE) system in urban agglomeration areas is conducive to promoting high-quality sustainable urban development. Based on systems theory, we constructed an ESE system with multiple elements, information and interaction flows. Taking the Yangtze River Delta Urban Agglomeration (YRDUA) in the period from 2010 to 2018 as a research sample, we used the Entropy Method (EM) and the Coupling Coordination Degree Model (CCDM) to synthetically evaluate the coupling coordination degree of the ESE system. The Back-Propagation Artificial Neural Network (BPANN) was applied to explore the influencing factors of the ESE system’s coupling coordination degree considering the nonlinear relationship between the various indicators and the ESE system’s coupling coordination degree. The main results can be summarized as follows. (1) The coupling coordination degree of the ESE system and the comprehensive quality of its subsystems in the YRDUA showed trends of growth during 2010–2018. There were obvious spatial differences: Shanghai had the highest quality scores, Jiangsu and Zhejiang had medium values, and Anhui had the lowest scores. However, these disparities continued to decrease during the study period. The overall coupling coordination degree distribution presents a normal distribution shape, most of cities concentrated in the moderate coordination grade. (2) At present, the coupling coordination of the society-environment binary system makes a great contribution to the ESE ternary system. (3) The comprehensive quality of the economy provides strong support for sustainable social and environmental development. (4) Factors such as the urbanization rate, proportion of tertiary industry in GDP, per-capita retail sales of consumer goods are critical to the coordinated development of the ESE system.

A Content Analysis of Free, Popular Low FODMAPs Diet mHealth Apps

ObjectivesCanada has one of the highest Irritable Bowel Syndrome rates (IBS) globally (18% vs. 11%). There is growing interest in the low FODMAPs (Fermentable Oligo-, Di-, Mono-saccharides, And Polyols) diet as nutrition therapy for IBS. However, recognizing IBS symptoms and identifying low FODMAPs foods has been challenging for users. Mobile technology may be a convenient and cost-effective tool in helping users adhere to the low FODMAPs diet. The objective was to assess free, popular mobile Health (mHealth) Apps supporting a low FODMAPs diet. MethodsApple iTunes and GooglePlay App stores were searched on December 22, 2020, using pre-selected search terms. The top 100 returns were screened for eligibility. Free and popular (≥3 out of 5 ratings; ≥100 total reviews) mHealth Apps available in English and primarily marketed to help follow FODMAPs diets were included. Apps were downloaded and assessed by 3 nutrition professionals using the Mobile App Rating Scale (MARS) and the App Quality Evaluation (AQEL) tool. ResultsOf the 1304 screened Apps, n = 9 (mean ratings ± SEM = 4.4 ± 0.1) met the eligibility criteria for assessment, comprising 5 FODMAPs identifiers and 4 tracking/monitoring symptoms Apps. Apps targeted the general population, and 70% focused on nutrition education and food shopping. The Apps used education (9), skills training (5), and/or goal setting (5) as a behavior change tool. 3 Apps provided a cognitive behavioral therapy component. The MARS (rated out of 5) revealed a high overall App quality score (3.6 ± 0.2), credibility (3.1 ± 0.5) and subjective quality scores (2.9 ± 0.3). The AQEL (rated out of 10) revealed high scores in App function (6.2 ± 0.7) and purpose (7.4 ± 0.8), but low scores in behavioral change potential (5.2 ± 0.7), knowledge acquisition (5.4 ± 0.7) and skills development (2.4 ± 1.2). ConclusionsA small number of free FODMAPs diet Apps are available, with limited information on the nutritional adequacy and users’ compliance in following a low FODMAPs diet. Considering the need for careful assessment and management of IBS symptoms with the highly restrictive low FODMAPs diet, Apps should be evidence-based and designed with Behavioral Change Techniques and easy access to healthcare professionals that support Canadians in acquiring knowledge about the diet and in self-monitoring IBS. Funding SourcesNone.

A Content Analysis of Free, Popular Plant-Based Mobile Health Apps

ObjectivesThere has been an increased emphasis on plant-based foods and diets in numerous dietary guidelines worldwide. Although mobile technology has the potential to be a convenient and cost-effective tool to aid adherence to dietary guidelines, little is known about the content and the quality of available mobile Apps on plant-based diets. Therefore, the objective of the study was to assess free, popular mobile health (mHealth) Apps supporting plant-based diets for Canadians. MethodsUsing pre-defined search terms, Apple iTunes and GooglePlay App stores were searched on December 22, 2020; the top 100 returns for each search term were screened for eligibility. Free and popular (≥3 out of 5 ratings; ≥100 total reviews) mHealth Apps available in English, primarily marketed to help users follow plant-based diets were included. Included Apps were downloaded and assessed for quality by three research assistants/dietitians using the Mobile App Rating Scale (MARS) and the App Quality Evaluation (AQEL) tool. ResultsOf the 998 Apps screened, 16 Apps (mean ratings ± SEM = 4.5 ± 0.08) met the eligibility criteria for assessment, comprising 10 recipe manager and meal planners, 2 food scanners, 2 vegan community builders, 1 restaurant identifier, and 1 sustainability-focused App. All included Apps targeted the general population and focused on changing behaviours using education (14 Apps), skills training (14 Apps), and/or goal setting (5 Apps). Vegan, vegetarian or other plant-based (e.g., pescatarian, flexitarian) settings were available in 13 Apps, while 3 Apps offered no plant-based diet settings. The MARS (rated out of 5) revealed a high overall App quality score (3.84 ± 0.66) and subjective quality score (3.63 ± 0.62), but low credibility score (2.09 ± 0.36). The AQEL (rated out of 10) revealed high scores in App function (8.29 ± 0.47), purpose (8.11 ± 0.39), and behavioral change potential (8.35 ± 0.45), but a low score in support of knowledge acquisition (4.82 ± 0.43). ConclusionsAlthough a variety of free plant-based Apps with different focuses and behavioural change techniques are available to help Canadians follow plant-based diets, our findings suggest a need for credible Apps and other resources to complement the low support of knowledge acquisition in plant-based Apps. Funding SourcesBanting & Best Diabetes Centre.

Feature Importance in the Quality of Protein Templates

Proteins are in the focus of research due to their importance as biological catalysts in various cellular processes and diseases. Since the experimental study of proteins is time-consuming and expensive, in silico prediction and analysis of proteins is common. Template-based prediction is the most reliable, which is why the aim of this study is to analyze how important are the primary features of proteins for their quality score. Statistical analysis shows that protein models with a resolution lower than 3 A or R value lower than 0.25 have higher quality scores when compared individually to their counterparts. Machine learning algorithm random forest analysis also shows resolution to have the highest importance, while other features have lower but moderate importance scores. The exception is the presence of ligand in protein models, which does not have an effect on the global protein quality scores, both through statistical and machine learning analyses.

Feature Importance in the Quality of Protein Templates

Proteins are in the focus of research due to their importance as biological catalysts in various cellular processes and diseases. Since the experimental study of proteins is time-consuming and expensive, in silico prediction and analysis of proteins is common. Template-based prediction is the most reliable, which is why the aim of this study is to analyze how important are the primary features of proteins for their quality score. Statistical analysis shows that protein models with a resolution lower than 3 Å or R value lower than 0.25 have higher quality scores when compared individually to their counterparts. Machine learning algorithm random forest analysis also shows resolution to have the highest importance, while other features have lower but moderate importance scores. The exception is the presence of ligand in protein models, which does not have an effect on the global protein quality scores, both through statistical and machine learning analyses.

Validation of a Mortality Composite Score in the Real-World Setting: Overcoming Source-Specific Disparities and Biases.

PURPOSEThis study tested whether a composite mortality score could overcome gaps and potential biases in individual real-world mortality data sources. Complete and accurate mortality data are necessary to calculate important outcomes in oncology, including overall survival. However, in the United States, there is not a single complete and broadly applicable mortality data source. It is further likely that available data sources are biased in their coverage of sex, race, age, and socioeconomic status (SES).METHODSSix individual real-world data sources were combined to develop a high-quality composite mortality score. The composite score was benchmarked against the gold standard for mortality data, the National Death Index. Subgroup analyses were then conducted to evaluate the completeness and accuracy by sex, race, age, and SES.RESULTSThe composite mortality score achieved a sensitivity of 94.9% and specificity of 92.8% compared with the National Death Index, with concordance within 1 day of 98.6%. Although some individual data sources show significant coverage gaps related to sex, race, age, and SES, the composite score maintains high sensitivity (84.6%-96.1%) and specificity (77.9%-99.2%) across subgroups.CONCLUSIONA composite score leveraging multiple scalable sources for mortality in the real-world setting maintained strong sensitivity, specificity, and concordance, including across sex, race, age, and SES subgroups.

How Does Rescuer Fitness Affect the Quality of Prolonged Cardiopulmonary Resuscitation?

Objective: High quality cardiopulmonary resuscitation (CPR) is crucial for patients experiencing cardiac arrest. CPR quality declines within the first few minutes of CPR performance. Being more fit is associated with higher CPR quality, yet the fitness parameters needed remain uncertain. It is also unknown how CPR quality is affected during a protocol of realistic CPR when rescuers switch compressors every two minutes, as recommended by the American Heart Association (AHA), and extended duration, as might be encountered with an out-of-hospital cardiac arrest. The purpose of the present study is to determine the extent to which different measures of physical fitness predict high quality CPR performance when rescuers follow current CPR guidelines. Methods: Subjects underwent a fitness assessment evaluating lower back muscular endurance, abdominal muscular endurance, upper body muscular strength, and upper body anaerobic power. At least 48 hours later, subjects returned to the laboratory for CPR testing. CPR quality was determined by compression rate (>100/minute), compression depth (>2 inches, or 50 mm), and adequate (full) chest recoil between compressions, based on American Heart Association guidelines. A CPR Quality Score, designed to represent cardiac output, was calculated as the product of compression rate and depth. Results: Thirty-three of 42 subjects were able to achieve a CPR Quality Score greater than 5000, the minimum needed to meet AHA recommendations. Higher anaerobic power and bench press scores were predictive of both high CPR Quality Scores (R2=0.47) and compression depth (R2=0.47). Sex (female) was predictive of better chest compression recoil percentages (R2=0.15). Conclusion: Most rescuers can maintain high quality CPR if given two minute breaks between cycles. Rescuers with high anaerobic fitness and muscular strength may be able to provide higher quality CPR.

Treatment of urinary incontinence: a critical appraisal of clinical practice guidelines with the AGREE II instrument.

This systematic review evaluated the rigor of the development of clinical practice guidelines (CPG). The searched sources were MEDLINE, EMBASE, Web of Science, Scopus, and specific databases of CPG. Reviewers, organized in triplicate and independently, selected the studies and assessed the quality of the guidelines using the Appraisal of Guidelines Research and Evaluation (AGREE II) instrument, which contains six domains for classification. The classification of the CPGs prioritized the domain 3 (developmental rigor) considering: high (score > 60%), moderate (score 30-60%), or low quality (score < 30%). The results were checked for discrepancies and decided by consensus. The interventions were described. Descriptive statistics presented the results. Of the ten CPGs evaluated, five were of high methodological quality, three were of moderate quality, and two of low quality. Three documents were not recommended for use. The domains with the highest scores were scope and purpose (mean = 90.1%) and clarity of presentation (mean = 88.9%). The domains of editorial independence (mean = 41.4%) and applicability (mean = 29.3%) were those with the lowest score. The most cited interventions in CPGs were the nonpharmacological, such as lifestyle interventions, bladder training, or re-education and pelvic floor muscle training. Most guidelines showed rigor in development and were recommended for use; however, editorial independence and applicability were domains that need to be improved in these documents. Our findings can guide the choice of CPG for the treatment of urinary incontinence.

Know-do gaps in obstetric and newborn care quality in Uganda: a cross-sectional study in rural health facilities.

Variable and inadequate quality of maternity care is a critical factor in persistently high rates of maternal and neonatal mortality in Uganda. We investigated whether provider quality of care deviates from knowledge and the factors associated with these 'know-do gaps' in Ugandan maternity facilities. Data were collected from 109 providers in 40 facilities. Quality was measured using direct observations of intrapartum care, and scores were based on the percentage of essential care actions provided out of a 20-item validated quality index. Knowledge was measured based on the percentage of items that providers reported knowing to do using vignette surveys. The know-do gap was the difference between knowledge and quality. Multivariable models were used to assess the association between provider- and facility-level characteristics and knowledge, quality and know-do gaps. The average quality score was 45%, with quality varying widely within and across providers. The mean knowledge score was 70%, yielding a mean know-do gap of 25%. Know-do gaps were largest for practices related to infection control, vitals monitoring, and prevention of postpartum haemorrhage. The association between quality and knowledge scores was positive but small (P=0.08), so know-do gaps were largest for providers with the highest knowledge scores. Greater provider training was positively associated with knowledge (P=0.005) but not with quality (P=0.60). Having 10 or more years of work experience was associated with higher quality scores (5.3, 95%CI: 0.6 to 10.1), while higher patient volumes were associated with lower quality scores (-2.2, 95%CI: -3.7 to-0.07). None of the factors of provider motivation, cadre, availability of essential medicines and supplies or facility staffing were associated with quality or know-do gaps. Our results indicate that, in Uganda, gaps between knowledge and quality do not appear to be explained by factors such as lack of motivation, education, training or supplies. Gaps are particularly large for essential practices related to prevention of postpartum haemorrhage, a leading cause of maternal mortality in Uganda and similar settings.

Assessing the Quality of Clinical Practice Guidelines in the Middle East and North Africa (MENA) Region: A Systematic Review.

AimClinical practice guidelines (CPGs) have progressively become a popular tool for making optimal clinical decisions. The literature shows that the poor quality of CPGs can form a barrier against adhering to them, resulting in a suboptimal level of healthcare. The objective of this systematic review is to evaluate the quality of CPGs in the Middle East and North Africa (MENA) region using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) Instrument.MethodsThe authors searched in the MEDLINE and EMBASE databases through the Ovid interface on May 25, 2019. Keywords relating to CPGs and MENA countries were combined using Boolean search operators. The search was not limited to specific diseases. The quality of guidelines was appraised by two reviewers independently using the AGREE II Instrument. Discrepancies within a group were resolved through the involvement of a principle investigator.ResultsA total of 61 CPGs were appraised. These guidelines were mainly from Saudi Arabia, and the most covered disease topic was cancer. Among the six domains of the AGREE II Instrument, CPGs scored the highest on clarity of presentation (mean 82%), while the lowest score was granted to the rigor of development domain (mean 28%). This indicates substantial deficiencies in reporting the developmental processes of CPGs and the resources used for the synthesis of evidence.ConclusionFrom this review, it was found that the number of retrieved guidelines published in the MENA region is limited considering the large geographical area of the MENA region. The main domains that have higher quality scores were clarity of presentation and scope and purpose, whereas domains with the lowest scores were rigor of development and applicability. The authors’ findings will help policymakers identify areas for improvement in CPGs, which can lead them to implement strategies such as the training of individuals and recruitment of international experts to ultimately develop high-quality CPGs.

Using the Google™ Search Engine for Health Information: Is There a Problem? Case Study: Supplements for Cancer.

ABSTRACTWe assessed the quality of online health and nutrition information using a Google™ search on “supplements for cancer”. Search results were scored using the Health Information Quality Index (HIQI), a quality-rating tool consisting of 12 objective criteria related to website domain, lack of commercial aspects, and authoritative nature of the health and nutrition information provided. Possible scores ranged from 0 (lowest) to 12 (“perfect” or highest quality). After eliminating irrelevant results, the remaining 160 search results had median and mean scores of 8. One-quarter of the results were of high quality (score of 10–12). There was no correlation between high-quality scores and early appearance in the sequence of search results, where results are presumably more visible. Also, 496 advertisements, over twice the number of search results, appeared. We conclude that the Google™ search engine may have shortcomings when used to obtain information on dietary supplements and cancer.

New Evidence on the Jensen Hypothesis: A Note for Social Scientists

A recent paper by Lasker et al. provides a gold standard test for genetic causes of the US Black/white test score gap by simple regression estimation linking high-quality intelligence test scores to African/European genetic admixture proportions precisely measured with modern DNA technology. The paper gives new, empirically powerful evidence for a large genetic component to the gap. This note critically reviews some key findings of the paper from a social science perspective.

Does retirement trigger depressive symptoms? A systematic review and meta-analysis.

Retirement is a major life transition that may improve or worsen mental health, including depression. Existing studies provide contradictory results. We conducted a systematic review with meta-analysis to quantitatively pool available evidence on the association of retirement and depressive symptoms. We applied PRISMA guidelines to conduct a systematic review and meta-analysis to retrieve, quantitatively pool and critically evaluate the association between retirement and both incident and prevalent depression and to understand better the potential role of individual and contextual-level determinants. Relevant original studies were identified by searching PubMed, Embase, PsycINFO and the Cochrane Library, through 4 March 2021. Subgroup and sensitivity meta-analyses were conducted by gender, study design (longitudinal v. cross-sectional studies), study quality score (QS) and considering studies using validated scales to diagnose depression. Heterogeneity between studies was evaluated with I2 statistics. Forty-one original studies met our a priori defined inclusion criteria. Meta-analysis on more than half a million subjects (n = 557 111) from 60 datasets suggested a protective effect of retirement on the risk of depression [effect size (ES) = 0.83, 95% confidence interval (CI) = 0.74-0.93], although with high statistical heterogeneity between risk estimates (χ2 = 895.19, df = 59, I2 = 93.41%, p-value < 0.0001). Funnel plot asymmetry and trim and fill method suggested a minor potential publication bias. Results were consistent, confirm their robustness and suggest stronger protective effects when progressively restricting the included studies based on quality criteria: (i) studies with the highest QS [55 datasets, 407 086 subjects, ES = 0.81, 95% CI = 0.71-0.91], (ii) studies with a high QS and using validated assessment tools to diagnose depression (44 datasets, 239 453 subjects, ES = 0.76, 95% CI = 0.65-0.88) and (iii) studies of high quality, using a validated tool and with a longitudinal design (24 datasets, 162 004 subjects, ES = 0.76, 95% CI = 0.64-0.90). We observed a progressive reduction in funnel plot asymmetry. About gender, no statistically significant difference was found (females ES = 0.79, 95% CI = 0.61-1.02 v. men ES = 0.87, 95% CI = 0.68-1.11). Pooled data suggested that retirement reduces by nearly 20% the risk of depression; such estimates got stronger when limiting the analysis to longitudinal and high-quality studies, even if results are affected by high heterogeneity.As retirement seems to have an independent and protective effect on mental health and depressive symptoms, greater flexibility in retirement timing should be granted to older workers to reduce their mental burden and avoid the development of severe depression. Retirement may also be identified as a target moment for preventive interventions, particularly primary and secondary prevention, to promote health and wellbeing in older ages, boosting the observed impact.

Assessing teaching quality in nutrition education: A study of two programs in the Netherlands and Australia

The quality with which teachers deliver school-based nutrition programs may impact program effectiveness. The current study examined teaching quality of two programs, Taste Lessons (n = 15 Grade 6 and 7 teachers) and CUPS (n = 3 Year 3 and 4 teachers) via lesson observation using the Quality Teaching Model (QTM). Taste Lessons is a well-established Dutch program on healthy eating and CUPS is a novel Australian program that contains lessons in which nutritional content is integrated with mathematical concepts. The QTM evaluates three dimensions of teaching (Intellectual Quality, Quality Learning Environment and Significance), each containing six elements of classroom practice. Each element was coded using a 1–5 scale (1 – ‘not evident’ to 5 - ‘highly evident’) to describe the degree to which the lesson exhibits high levels of the element. Both programs were of moderate to high teaching quality and lowest scores were observed for Metalanguage, Student direction, Cultural knowledge and the use of Narrative. The QTM can be an effective tool to assess the teaching quality of nutrition education programs by examining classroom practice.

Meta-Analysis of the Effect of Exercise Intervention on Improving the Executive Function of College Students

Objective To systematically evaluate the effects of different exercise styles on executive function of college students through a meta-analysis of relevant literatures at home and abroad, and to provide evidence-based reference for future studies on mental health and teaching. Method to "aerobic exercise" and "movement" executive function, "cognitive" "college students/female college students" "aerobic exercise/exercise" seven "executive function" keywords retrieval at home and abroad, such as database, retrieval time for January 2021. Literature screening was conducted, and a total of 6 relevant studies were included with high literature quality scores. Meta-analysis was performed on the fixed model. Results The combined effect size of exercise intervention on inhibition function of college students [SMD=2.73, 95%CI: 0.99 ~ 3.48, P < 0.01]. The combined effect size of exercise intervention on refresh function of college students [SMD=-82.52, 95%CI:-127.89 ~ -37.15, P < 0.01]; the combined effect size of exercise intervention on the conversion function of college students [SMD=-98.48, 95%CI:-168.56 ~ -28.39, P < 0.01]. Conclusion Aerobic exercise and bicycle can effectively improve the executive function of college students, while resistance exercise has no improvement effect. the exercise intervention of 30-50min/time has the best effect on improving the inhibition function, conversion function and refresh function of college students. The short-term intervention of 1-2 weeks or the intervention of 8 weeks can improve the inhibition function, conversion function and refresh function of college students. there is no gender difference in the improvement effect of exercise intervention on executive function of college students.

Intestinal parasitic infections and associated factors among people living with HIV/AIDS in Ethiopia: A systematic review and meta-analysis

BackgroundIntestinal parasitic infections are major public health problems throughout the world, particularly in people living with HIV/AIDS. People living with HIV/AIDS are vulnerable groups for a variety of diseases, hence they are easily affected by opportunistic and non-opportunistic intestinal parasites due to the weakening of their immunity. Therefore, this study aimed to estimate the pooled prevalence and factors associated with intestinal parasitic infections among people living with HIV/AIDS in Ethiopia.MethodsArticles were identified through search engines in the online electronic databases PubMed/MEDLINE, EMBASE, HINARI, CINAHL, Cochrane Library, Google Scholar, and reference lists of previous studies following the PRISMA Protocol. Studies conducted between 2003 and 2020 with English language were included in this study. This review included papers with having high-quality NOS scores. Meta-analysis was computed using STATA version 11 software. Heterogeneity was assessed using the Cochrane Q-test and I2 test statistics. Subgroup and sensitivity analysis was employed with evidence of heterogeneity. Publication bias was determined using the funnel plot and Egger’s regression test statistic.ResultsThis study included a total of twenty-two cross-sectional studies with 5,833 study participants. The mean age of the study participants was 35 years old. The pooled prevalence of intestinal parasitic infection among people living with HIV/AIDS in Ethiopia was 39.15% (95%CI: 32.34, 45.95). The pooled prevalence of intestinal parasitic infections among people living with HIV/AIDS who had taking ART and who had not to start ART was found to be 28.27% (95%CI 22.47, 34.06) and 41.63% (95%CI: 28.75, 54.52) respectively. Unavailability of latrine (AOR: 4.87, (95% CI: 2.39, 9.92)), CD4+ T cell count <200cells/μl ((AOR: 3.53, (95%CI: 1.98, 6.27)), and having a history of diarrhea (AOR: 4.79 (95%CI: 1.53, 14.99) were factors significantly associated with intestinal parasitic infections.ConclusionIn this study, the overall pooled prevalence of intestinal parasitic infections among HIV/AIDS patients in Ethiopia was relatively high. CD4+ T-cell count <200cells/μl, unavailability of a latrine, and history of diarrhea were significantly associated with intestinal parasitic infections. Therefore, the policymakers and health care professionals could give special attention to the presence of latrines, early detection and treatment of intestinal parasitic infections, and early initiation of ART drugs.