Intervention Period Research Articles

Music and Sleep Hygiene Interventions for Pregnancy-Related Insomnia: An Online Randomized Controlled Trial.

Approximately 50% to 60% of all pregnant women suffer from insomnia during pregnancy. Pregnancy-related insomnia has been associated with severe outcomes for both mother and child postnatally. Currently, the treatment of pregnancy-related insomnia is often neglected due to a lack of suitable treatments. This online assessor-masked randomized controlled trial aimed to evaluate the effectiveness of music listening and sleep hygiene for treating pregnancy-related insomnia. We recruited first-time pregnant women at the end of the second trimester with a report of poor sleep. Participants in the music and sleep hygiene (MSH) group received standard sleep hygiene advice and were instructed to listen to music daily at bedtime for 4 weeks. They could choose from 6 sleep playlists of different genres. Participants randomized to the sleep hygiene alone (SH) group received standard sleep hygiene only. Primary outcomes were sleep quality measured with the Pittsburgh Sleep Quality Index (PSQI) and insomnia severity measured with the Insomnia Severity Index. gov Identifier: NCT04633395. Among the 98 participants receiving the online intervention, 31 participants in the MSH group (62%) and 40 participants in the SH group (80%) completed the postintervention measurements. Both groups experienced improved sleep quality during the intervention period (PSQI change, -2.10; 95% CI, -3.27 to -0.93; P <.001), with no significant difference between the groups. Similarly, insomnia symptoms were reduced (Insomnia Severity Index change, -3.42; 95% CI, -5.02 to -1.83; P <.001) with no significant difference in the effect between groups. There was a significant difference in adherence to sleep hygiene between the MSH and SH groups (42% vs 8%; P =.007). Sleep quality and insomnia severity can be improved in pregnant women with relatively simple interventions like music listening and sleep hygiene advice. These results align with previous research, but larger trials are recommended to support introduction into clinical practice.

The Impact of a Creativity Camp Intervention on Depression and Well-Being in Adolescents.

Depression is a serious public health problem that often emerges during adolescence. Many adolescents do not respond to standard treatments, necessitating the development of novel interventions. We conducted a preliminary study to assess the impact of a novel creative arts intervention on depression and well-being in adolescents. In this quasi-experimental study, 69 adolescents 12-17years completed an 8-day "Creativity Camp" intervention encompassing multiple creative activities. Self-report questionnaires to measure depression, anxiety, and well-being were administered at five time points to allow examination of change across multiple temporal segments: the 2 weeks before the intervention, the 2 weeks during the intervention, the 2 weeks after the intervention, and the 6months after the intervention. Adolescents were assigned to one of two groups to compare changes observed during the 2 week before-intervention period (Group A) to the changes observed during the intervention period (pre-post intervention) (Group B). According to both parent and child reports, pre-to-post-intervention, mean adolescent depressive symptoms significantly decreased, and these changes were sustained 2 weeks after the intervention and (according to parents) at the 6-month follow-up. There was preliminary evidence for improved well-being at post-intervention. Comparison of Group A's changes during the before-intervention period to Group B's changes pre-post intervention was significant for parent-reported depression. Preliminary evidence suggests that the Creativity Camp intervention may positively impact adolescent depression and well-being. This evidence highlights the importance of investigating and implementing treatment approaches focusing on creative arts for adolescents with depression.

Challenging Childhood Obesity: The Influence of Education and Close Monitoring on Obesity-Related Behaviors.

We aimed to evaluate the role of nutrition and behavior education intervention in the prevention and treatment of childhood obesity by comparing changes in obesity-related characteristics among obese children during a follow-up period of 12 months. This study was designed as a prospective cohort study in children aged between 6 and 18 years, with exogenous obesity who applied to Istanbul Research and Training Hospital, Pediatrics Department, between January 2018 and July 2019. Beginning at the sixth month, a program for nutrition and behavior education for obesity prevention and treatment was initiated and continued during the second half of the study period. The mean age of 59 children (29 females, 30 males) was 11.73 ± 2.78. BMI levels did not show a significant difference in the first 6 months, but decreased significantly during the second 6 months of the study. Screen time, fast eating behavior, overeating behavior and food score index scores also demonstrated significant improvements during the intervention period of the study, between 6 and 12 months. It was concluded that nutrition and behavior education for the prevention and treatment of childhood obesity could be a successful intervention with close follow-up.

Mitigating overuse of antinuclear antibody (ANA) testing through educational intervention: a study in internal medicine and neurology departments.

Overuse of antinuclear antibody (ANA) tests leads to increased costs, false positives, and unnecessary treatments. This study evaluated ANA overuse in internal medicine and neurology departments and assessed the impact of an educational intervention. This quality improvement educational intervention study examined ANA test overuse in five internal medicine departments and one neurology department at a university-affiliated medical center. The educational intervention included a session focusing on ANA testing appropriateness. Outcome measures comprised the ANA/new patient ratio (APR) and the percentage of positive ANA test results. Outcomes were compared between the pre- and post-intervention periods (both 6months). The intervention took place in December 2021. The APR decreased from 43% in the pre-educational intervention period to 27% in the post-intervention period in the neurology department (odds ratio [OR] 0.49, confidence interval [95% CI] 0.37-0.63, P < 0.0001) and from 2.6% to 2.2% in the internal medicine departments (OR 0.89, 95% CI 0.73-1.10, P = 0.28). The percentage of positive ANA tests increased from 43% pre-intervention to 53% in the post-intervention period (OR 1.49, 95% CI 0.90-2.46, P = 0.12) in the neurology department and from 48% to 59% (OR 1.56, 95% CI 0.99-2.44, P = 0.0543) in the internal medicine departments. A simple educational intervention reduced unnecessary ANA testing in the neurology department but not in internal medicine departments, improving patient selection and potential cost savings. The results underscore the importance of targeted education to promote evidence-based behavior among healthcare professionals. Further research with longer follow-up is needed to assess the sustainability of these improvements.

The effect of neurofeedback and somatosensory exercises on balance and physical performance of older adults: a parallel single-blinded randomized controlled trial

This study examines the effects of a 5-week program of neurofeedback combined with somatosensory exercises on balance and physical performance in older adults, with the goal of addressing age-related declines in sensory processing and motor function. Sixty older adult men with balance disorders were randomly assigned to one of three groups: neurofeedback combined with somatosensory training, somatosensory training alone, or a control group. The interventions were administered over 5 weeks, with participants attending three sessions per week. Assessments were conducted both before and after the intervention period, including measurements of static balance using the Stork test, dynamic balance using the Timed Up and Go (TUG) test, and physical performance using the Continuous Scale Physical Functional Performance-10 (CS-PFP-10) test. The findings revealed significant improvements in balance and physical performance among participants who received either neurofeedback combined with somatosensory training or somatosensory training alone. Specifically, the Stork test (with both open and closed eyes) showed significant increases in duration, while the TUG test indicated reductions in completion times for both intervention groups (p = 0.001), suggesting enhanced balance and mobility. Additionally, the CS-PFP-10 test results demonstrated a significant difference following the interventions (p = 0.001). These findings suggest that incorporating neurofeedback training into somatosensory exercises may provide additional benefits for older adults in improving balance and mobility.

Ordering and Utilization of Peripheral Blood Flow Cytometry in an Academic Medical Center

Abstract Introduction/Objective The American Society for Clinical Pathology and the American Board of Internal Medicine’s Choosing Wisely campaign have developed best practice utilization guidelines for laboratory testing. Wisconsin Diagnostic Laboratories and Medical College of Wisconsin leadership noticed an increase in inappropriate peripheral blood flow cytometry testing in the last two years. An intervention was developed to help reduce inappropriate testing requests. Methods/Case Report The laboratory implemented a clinical decision support tool in the electronic medical record system that looked at patient diagnosis, history of stem cell transplant, and recommendations from pathology to help improve utilization of peripheral blood flow cytometry testing. Based on patient history, flow cytometry testing would move forward, or an alternative order of a peripheral blood pathology smear review with reflex to flow cytometry was offered. Pathologists would reflex flow cytometry if abnormalities were present by light microscopy or predetermined reflexing criteria were met. Results (if a Case Study enter NA) 314 cases were included for analysis. The intervention reduced volumes of peripheral blood flow cytometry in patients without a history of hematologic malignancy by 49.1% (p=&amp;lt;0.001). Appropriate utilization increased from 47.0% in the pre-intervention period to 80.4% in the post intervention period (p=&amp;lt;0.001). Significant diagnosis rate increased from 42.5% to 50.0% (p=.261). This resulted in a cost savings of $12,232 for the health system during the intervention period. Conclusion Clinical decision support based utilization efforts provide strong and consistent interventions to reduce the unnecessary and inappropriate ordering of peripheral blood flow cytometry.

Yoga, Physical Therapy and Home Exercise Effects on Chronic Low Back Pain: Pain Perception, Function, Stress, and Quality of Life in a Randomized Trial.

Low back pain is a common health problem. In this study, we investigated the effects of yoga, physical therapy (PT), and home exercise (HE) on pain perception, function, stress, and quality of life in chronic low back pain (cLBP). We randomly assigned 54 participants to three distinct treatment groups: (a) a physical therapy group (PT) who received spinal stabilization exercises (SSE) combined with local heat and transcutaneous electrical stimulation; (b) a home exercise group (HE) who received SSE as part of the home program; and (c) a yoga group who received yoga exercises. The primary outcome measures were a Visual Analog Scale (VAS) for measuring pain, and the Oswestry Disability Index (ODI) to measure function. Secondary outcome measures were the Tampa Kinesiophobia Scale (TKS), Central Sensitization Inventory (CSI), pain sensitivity (L3 and deltoid R/L PPTs), Spielberger State-Trait Anxiety Inventory (STAI), plasma cortisol and DHEA-S levels, Transversus Abdominis (TrA) muscle activation, and the Nottingham Health Profile (NHP). Assessments were conducted before and after a six-week intervention period. All three groups demonstrated improvements in pain on the VAS, function on the ODI, pain sensitivity on the L3 and deltoid R/L PPTs, CSI, anxiety on the STAI, TrA muscle activation, and quality of life on the NHP (p < .05). The PT group exhibited a more pronounced improvement on the ODI score (p < .05) than the other groups. Cortisol levels only decreased in the PT group (p < .05). The exercises did not impact DHEA-S and NHP-S parameters. Thus, all interventions resulted in decreased stress, pain intensity, pain sensitivity, central sensitization, and improved function and quality of life; there was no singularly superior approach between interventions. These findings will aid in tailoring treatment programs for managing cLBP according to individual needs.

Individualised computerised cognitive training (iCCT) for community-dwelling people with mild cognitive impairment (MCI): results on cognition in the 6-month intervention period of a randomised controlled trial (MCI-CCT study)

BackgroundComputerised cognitive training (CCT) can improve the cognitive abilities of people with mild cognitive impairment (MCI), especially when the CCT contains a learning system, which is a type of machine learning (ML) that automatically selects exercises at a difficulty that corresponds to the person’s peak performance and thus enables individualised training.MethodsWe developed one individualised CCT (iCCT) with ML and one basic CCT (bCCT) for an active control group (CG). The study aimed to determine whether iCCT in the intervention group (IG) resulted in significantly greater enhancements in overall cognitive functioning for individuals with MCI (age 60+) compared with bCCT in the CG across a 6-month period. This double-blind randomised controlled study was conducted entirely virtually. The 89 participants were community-dwelling people with a psychometric diagnosis of MCI living in Germany. The iCCT stimulates various cognitive functions, especially working memory, visuo-constructional reasoning, and decision-making. The bCCT includes fewer and simpler tasks. Both CCTs were used at home. At baseline and after 6 months, we assessed cognitive functioning with the Montreal Cognitive Assessment (MoCA). A mixed-model ANCOVA was conducted as the main analysis.ResultsBoth CCTs led to significant increases in average global cognition. The estimated marginal means of the MoCA score increased significantly in the CG by an average of 0.9 points (95% CI [0.2, 1.7]) from 22.3 (SE = 0.25) to 23.2 (SE = 0.41) points (p = 0.018); in the IG, the MoCA score increased by an average of 2.2 points (95% CI [1.4, 2.9]) from 21.9 (SE = 0.26) to 24.1 (SE = 0.42) points (p < 0.001). In a confound-adjusted multiple regression model, the interaction between time and group was statistically significant (F = 4.92; p = 0.029). The effect size was small to medium (partial η2 = 0.057). On average, the participants used the CCTs three times per week with an average duration of 34.9 min per application. The iCCT was evaluated as more attractive and more stimulating than the bCCT.ConclusionsBy using a multi-tasking CCT three times a week for 30 min, people with MCI living at home can significantly improve their cognitive abilities within 6 months. The use of ML significantly increases the effectiveness of cognitive training and improves user satisfaction.Trial registrationISRCTN14437015; registered February 27, 2020.

Enhancing spelling skills in dyslexic primary students: A comparative study of remedial and compensatory interventions in chennai

Learning to spell poses significant challenges for young learners with dyslexia, who often encounter difficulties with phonological awareness and orthographic processing. This study explores the effectiveness of a structured, two-stage intervention aimed at enhancing spelling skills among 25 primary school students in Chennai, Tamil Nadu, whose native language is Tamil. In the initial four-week phase, participants engaged in remedial activities focused on developing phonological and orthographic awareness, essential foundations for accurate spelling. This phase targeted the students’ ability to recognize sound patterns and understand letter-sound associations, providing a base for further learning. In the following sixteen-week phase, the intervention expanded to include compensatory strategies designed to reinforce initial learning and foster a more comprehensive understanding of spelling. This phase incorporated the multimodal learning, combining visual, auditory, and kinesthetic techniques, as well as task-oriented exercises, play-based activities, and gamified methods to make the learning process more engaging and enjoyable. These varied approaches aimed to enhance students’ spelling skills while maintaining their interest and motivation. The study’s findings demonstrated that both the remedial and compensatory interventions had a positive impact on students' spelling abilities. However, while the phonological and orthographic methods helped build essential skills, they required a longer duration to ensure retention beyond the intervention period. Conversely, the integrated, multimodal approach introduced in the second phase resulted in faster and more substantial improvements. This outcome highlights the benefits of a dynamic, interactive approach in supporting dyslexic learners who are acquiring English as a second language, promoting both skill acquisition and engagement.

Positive Effects of Aerobic-Resistance Exercise and an Ad Libitum High-Protein, Low-Glycemic Index Diet on Irisin, Omentin, and Dyslipidemia in Men with Abdominal Obesity: A Randomized Controlled Trial.

The aim of this research was to evaluate changes in body composition, adipokine levels, and dyslipidemia parameters in males with abdominal obesity following two distinct interventions: exercise alone and exercise combined with an ad libitum diet. This study included 44 males with abdominal obesity (mean age 34.7 ± 5.5 years, waist circumference [WC] 110.3 ± 8.5, BMI 32.0 ± 3.9), who were randomly assigned to three groups: an experimental group engaging in aerobic-resistance exercise (II, n = 16), an experimental group engaging in aerobic-resistance exercise combined with an ad libitum high-protein, low-glycemic index carbohydrate diet (III, n = 16), both interventions lasting 6 weeks, and a control group without interventions (I, n = 12). Body composition metrics (body mass index [BMI], waist circumference [WC], body fat [BF], abdominal fat [ABD]) and fat-free mass [FFM], along with biochemical blood analyses (irisin [IR], omentin [OMEN], glucose [GLU], insulin [INS], LDL- and HDL-cholesterol), were measured at baseline and after the 6-week intervention. The effects of the interventions on the analyzed variables across groups were assessed using mixed ANOVA tests with post-hoc comparisons. Effect size (ES) was also calculated using partial eta squared (ηp2). The intervention in group III resulted in a significant decrease in IR (p < 0.01, ηp2 = 0.03) by 41% and LDL-C (p < 0.01, ηp2 = 0.02) by 14%. These effects were associated with a reduction in BF (p < 0.01, ηp2 = 0.02) by 14%, ABD (p < 0.01, ηp2 = 0.03) by 31%, and WC (p < 0.01, ηp2 = 0.01) by 3%. In group II, decreases after 6 weeks of intervention were noted only in WC (p = 0.02, ηp2 = 0.01) by 1% and in INS (p < 0.01, ηp2 = 0.04) by 47%. No differences were found between groups. The use of low-glycemic index carbohydrates (p < 0.01, ηp2 = 0.06) and increased protein intake (p < 0.01, ηp2 = 0.30) led to changes in the fiber-to-energy value of the diet ratio (p < 0.01, ηp2 = 0.18) and a reduction in dietary energy value (p < 0.01, ηp2 = 0.13) by 23%, resulting in a greater energy deficit than in the II group. These findings highlight the effect of combining dietary and exercise interventions to achieve significant changes in body composition and metabolic parameters, even over a short period of intervention.

Synchronous and asynchronous tele-exercise for older adults: study protocol for a randomized clinical trial

Objective: Multicomponent physical training, carried out via tele-exercise, can contribute to a healthier lifestyle in the elderly. The objective is to present the intervention protocol of the “Idoso Ativo” (Active Older Adult) program via tele-exercise, synchronously and asynchronously. Method: This is a randomized clinical trial with two groups performing tele-exercise. Participant recruitment will be done via digital platforms, social media pages and printed leaflets distributed in the different regions of Distrito Federal. Both groups will perform exercises three times a week, lasting 50 min, and the intervention period will be 12 weeks. Discussion: The hypothesis is that the multicomponent exercise program offered online will provide improvements in muscular strength, balance and mobility in both groups. A higher adherence rate is expected in relation to the asynchronous group, and it is believed that the positive effects on physical health, minimizing the negative outcomes caused by inactivity, are present in participants in both groups.

The Impact of Tele-Stewardship on Rural Antibiotic Prescribing Practices

Abstract Background Antibiotic prescribing for children is highest in rural areas. Tele-stewardship allows for implementation of antimicrobial stewardship (AS) via telecommunication with providers. There has been limited research on the effectiveness of tele-stewardship in the outpatient setting. In this study, we address the need for better AS in rural areas by developing, implementing, and evaluating AS interventions using tele-stewardship. Methods We employed bundled outpatient AS implementation strategies in rural pediatric primary care (PC) clinics and emergency departments (EDs) affiliated with Vanderbilt University Medical Center (VUMC) using tele-stewardship. The bundle includes (1) patient/guardian educational materials, (2) antibiotic use commitment posters (3) provider education through quarterly teaching pearls on common pediatric infections, communication skills training (DART modules), app-based microlearning modules (QuizTime), and implicit/explicit bias education and (4) quarterly audit and feedback with peer comparison on guideline-concordant antibiotic use. Participants are pediatric prescribers (physician, physician assistant, nurse practitioner). We compared antibiotic prescription data for children &amp;lt;18 years collected during the “baseline” period (Jan-Dec 2022) to the intervention period (Jan-Sept 2023). Two academic urban primary care clinics and one academic urban ED at which the interventions were not implemented were included as “control” sites. The primary outcome is percent of all encounters that result in an antibiotic prescription. Pre- and post-intervention data were analyzed in aggregate (not at the provider-level). Significance was determined via calculating a 95% confidence interval (CI) for the difference of proportions. Results To date, there have been 140,077 PC patient encounters (98,409 baseline and 41,065 intervention) and 94,205 ED encounters (61759 baseline and 32,446 intervention) across all sites. Change from baseline to intervention periods in academic PC sites was 0.9 percentage points (95% CI 0.556 to 1.243; 6.6% baseline, 7.5% intervention) while change in rural intervention sites was -1.05 percentage points (95% CI -0.409 to -1.667; 11.8% baseline, 10.75% intervention; Figure 1a). Only 1 of 3 rural EDs had a decrease in percent of encounters with an antibiotic prescription (Figure 1b). Overall the academic ED showed a 3.1 percentage point increase (95% CI 2.430 to 3.769; 18.0% baseline, 21.1% intervention) while the rural sites showed a 1.0 percentage point increase (95% CI -0.817 to 2.817; 24.2% baseline, 25.2% intervention). Conclusion Interim analysis shows that bundled implementation strategies using tele-AS led to significantly decreased overall antibiotic use in rural primary care clinics compared to urban academic control sites. The study is ongoing and will continue to evaluate outcomes over a longer intervention period to reduce seasonal bias.

Effect of the consumption of probiotic foods in overweight/obese individuals: A systematic review and meta-analysis

This study aimed to assess whether the consumption of probiotic foods reduces anthropometric measurements in overweight and obese individuals through a systematic review and meta-analysis of randomized controlled trials. Of the 4370 identified studies, eight were eligible and included in the meta-analysis, which showed that there was a significant reduction in the variables body mass index, visceral fat area, subcutaneous fat area, body fat mass, fat percentage, waist circumference, hip circumference, and waist-to-hip ratio in the probiotic food consumption group compared to the control group. There was no significant reduction in body weight and lean mass. When evaluating meta-analyses of subgroups of microorganisms, positive outcomes in Lactobacillus gasseri (Lg2 and Lg3) are observed. Regarding the intervention period, the longer the duration of the intervention with probiotic foods, the better the outcome. In subgroup analyses, promising results were observed with the probiotic microorganism strain Lactobacillus gasseri SBT2055.

Examining the effectiveness of promotional nudges increasing plant-based food choices in a post-secondary education dining hall: a pilot study.

To evaluate nudge strategies that increase the consumption of plant-based foods, defined as vegetarian or vegan food items, compared with meat-based options in post-secondary dining hall settings. A pilot study. This study took place in the University of British Columbia Vancouver Campus's Gather Dining Hall (GDH) over a 6-week intervention period and two control periods. The intervention incorporated several nudges (proportion increases, item placement, taste-focused labelling, Chef's featured special verbal prompts, social media and promotional posters) into the menu and dining hall area with the goal of increasing the purchases of plant-based items. Sales data from meals that were purchased during the intervention period were compared with sales data from the two control periods. Students and staff who purchased meals in the GDH. The proportion of plant-based items sold significantly increased during the intervention period (56·7 %; P < 0·01) compared with the last 6 weeks of term one (53·6 %) and the first 6 weeks of term two (53·4 %). The proportion of plant-based 'main' menu items was significantly higher in the intervention period (46·4; P < 0·01) when compared with the last 6 weeks of term one (40·9 %) and the first 6 weeks of term two (41·7 %). The combination of nudges was effective at significantly increasing the selection of plant-based options over meat-based options in a post-secondary dining hall setting.

Construction of an Adolescent Spinal Health Intelligent Early Warning and Intervention System under the Proactive Health Model

This study explores the construction of an intelligent early warning and intervention system for adolescent spinal health and its application under a proactive health model. The research demonstrates that through real-time monitoring and personalized interventions, the Spinal Health Index of adolescents in the intervention group significantly improved, increasing from 65 to 85 points, while the control group's index slightly decreased from 60 to 58 points. Personalized intervention strategies, such as the combination of exercise and nutritional interventions, were found to be the most effective, indicating that daily activity levels significantly impact spinal health. The system plays a crucial role in the management of adolescent spinal health by facilitating real-time monitoring, personalized interventions, and modifications in health behaviors. Despite limitations including constraints in sample size and geographical scope, a relatively short intervention period, and insufficient data diversity, future research can enhance universality and model generalizability by expanding sample sizes, prolonging the intervention period, and increasing data diversity. Looking forward, the integration of multimodal data, optimization of the user interface, and establishment of long-term tracking mechanisms will further enhance system performance and promote the improvement of spinal health management in adolescents.

Equity-Focused Evaluation of a Medicaid-Funded Statewide Diabetes Quality Improvement Project Collaborative.

To evaluate the Ohio Diabetes Quality Improvement Project (QIP) equity aim to reduce the percentage of Non-Hispanic Black (NHB) and Hispanic patients with A1C >9% by ≥20% over 2 years. The Ohio Department of Medicaid, Ohio Colleges of Medicine Government Resource Center, Ohio Medicaid managed care plans, and seven medical schools in Ohio formed the Diabetes QIP collaborative using the collective impact model to improve diabetes outcomes and equity in 20 practices across 11 health systems. The quality improvement (QI) strategies included data audit and feedback, peer-to-peer learning, QI coaching/practice facilitation, and subject matter expert consultation through coaching calls, monthly webinars, and annual virtual learning sessions. Electronic health record data were collected for preintervention (2019-2020) and intervention (2020-2022) periods. Assessments of improvements in A1C were based on prevalence of A1C >9% from preintervention, year 1, and year 2 with stratification by race and ethnicity. The Diabetes QIP included 7,689 (54% female) sociodemographically diverse patients, self-identifying as non-Hispanic White (NHW) (42%), NHB (43%), Hispanic (8%), non-Hispanic Asian (4%), or other (3%). In year 2 compared with baseline, there were decreases in the proportion of patients with A1C >9% among NHW, NHB, and Hispanic patients (NHW from 19% to 12% [37% reduction], NHB 23% to 18% [22% reduction], and Hispanic 29% to 23% [20% reduction]). The Ohio Diabetes QIP, focused on multisector collaborative approaches, reduced the percentage of patients with A1C >9% by ≥20% among NHW, NHB, and Hispanic populations. Given the persistence of disparities, further equity-focused refinements are warranted to address disparities in diabetes control.

Effects of dim-evening lighting optimised for geographical orientation versus standard lighting on mental health: protocol paper for a quasiexperimental study in a psychiatric hospital

IntroductionResearch has provided novel insights into how light stimulates circadian rhythms through specialised retinal ganglion cells to the suprachiasmatic nucleus. In addition, there has been a revolution in light-emitting diode...

Tracking the Risk of Cardiovascular Disease after Almond and Oat Milk Intervene or Statin Medication with a Powerful Reflex SH-SAW POCT Platform.

Cardiovascular disease (CVD) represents the leading cause of death worldwide. For individuals at elevated risk for cardiovascular disease, early detection and monitoring of lipid status is imperative. The majority of lipid measurements conducted in hospital settings employ optical detection, which necessitates the use of relatively large-sized detection machines. It is, therefore, necessary to develop point-of-care testing (POCT) for lipoprotein in order to monitor CVD. To enhance the management and surveillance of CVD, this study sought to develop a POCT approach for apolipoprotein B (ApoB) utilizing a shear horizontal surface acoustic wave (SH-SAW) platform to assess the risk of heart disease. The platform employs a reflective SH-SAW sensor to reduce the sensor size and enhance the phase-shifted signals. In this study, the platform was utilized to monitor the impact of a weekly almond and oat milk or statins intervention on alterations in CVD risk. The SH-SAW ApoB test exhibited a linear range of 0 to 212 mg/dL, and a coefficient correlation (R) of 0.9912. Following a four-week intervention period, both the almond and oat milk intervention (-23.3%, p < 0.05) and statin treatment (-53.1%, p < 0.01) were observed to significantly reduce ApoB levels. These findings suggest that the SH-SAW POCT device may prove a valuable tool for monitoring CVD risk, particularly during routine daily or weekly follow-up visits.

Paradoxical intention as a treatment for insomnia disorder: study protocol for a mixed-methods pilot trial

IntroductionParadoxical intention (PI) is an insomnia treatment developed in the 1970s, which instructs patients to gently attempt to remain awake while in bed at night with the lights off. Previous...

Quality of Life in Adolescent Athletes With Sport-Related Concussion Prescribed Heart Rate-Targeted Aerobic Exercise Within 10 Days of Injury.

Individualized aerobic exercise treatment prescribed within 10 days of injury facilitates recovery in adolescents after sport-related concussion (SRC) and reduces incidence of persisting post-concussive symptoms (PPCSs) beyond 4 weeks. The effect of aerobic exercise treatment on quality of life symptoms is, however, unknown. This planned secondary aim of a published randomized controlled trial found that while adolescents prescribed aerobic exercise recovered faster, there was no difference on the Pediatric Quality of Life (PedsQL) questionnaire scores during the 4-week intervention period. Nevertheless, adolescents who experienced PPCS reported significantly worse initial visit (within 10 days of injury) symptoms on the PedsQL than those who recovered within 4 weeks. Higher scores on the PedsQL correlated with greater initial visit concussion symptom burden and more abnormalities on a concussion-relevant visio-vestibular examination. Thus, the PedsQL captures the clinical severity of concussion and is prognostic of risk for delayed recovery when administered early after SRC in adolescents.