Longitudinal Trial Research Articles

Sex differences in the associations between prior weight loss and all-cause or cardiovascular mortality in non-elderly individuals with hyperuricemia: a mortality follow-up study

BackgroundHyperuricemia, a common metabolic condition, is strongly associated with obesity and represents as an independent risk factor for elevated risk of mortality. This observational study aimed to examine the sex-specific associations of prior long-term weight loss (LTWL), defined as a sustained reduction in body weight maintained for at least 12 months, with all-cause and cardiovascular disease (CVD) mortality in non-elderly individuals with hyperuricemia.MethodsNon-elderly individuals with hyperuricemia and a historical maximum body mass index ≥ 25 kg/m2 from the 1999–2018 US National Health and Nutrition Examination Survey were included. Sex-specific associations between prior LTWL (< 5%, 5-9.9%, 10-14.9%, and ≥ 15%) with all-cause and CVD mortality were investigated by weighted multivariable Cox proportional hazard regression analysis and stratified analysis.ResultsAmong 5,130 participants included, 505 all-cause (147 from CVD) deaths occurred during a median follow-up of 113 months. Compared with the LTWL < 5% reference group, the hazard ratios and 95% confidence intervals for the LTWL 5-9.9%, 10-14.9% and ≥ 15% groups were 1.11 (0.72–1.71), 1.34 (0.79–2.26) and 1.85 (1.14–2.92), respectively, for all-cause mortality (P for trend = 0.02) and 1.83 (0.76–4.43), 2.15 (0.76–6.10), and 3.76 (1.51–9.36), respectively, for CVD mortality (P for trend = 0.003). Significant associations between LTWL with all-cause and CVD mortality were observed exclusively in female, not male participants.ConclusionsPrior LTWL ≥ 5% was associated with increased all-cause and CVD mortality in US non-elderly female participants with hyperuricemia. Additional prospective and longitudinal randomized clinical trials are necessary to further examine the current findings.

WHAT IS THE IMPACT OF IATROGENIC MENOPAUSE ON VAGINAL HEALTH AND SEXUALITY? (PRELIMINARY) RESULTS OF “VOLUPTA”; THE MENOPAUSE MICROBIOME STUDY

WHAT IS THE IMPACT OF IATROGENIC MENOPAUSE ON VAGINAL HEALTH AND SEXUALITY? (PRELIMINARY) RESULTS OF “VOLUPTA”; THE MENOPAUSE MICROBIOME STUDY

When less is more: How attentiveness impacts the efficacy of online personalized feedback interventions for college student alcohol use.

Personalized feedback-based interventions for reducing high-risk alcohol use among college students vary in length and intensity. Comprehensive multicomponent personalized feedback interventions (PFIs) include more material and have greater intensity compared to briefer, single-component interventions such as personalized normative feedback (PNF). However, while PFIs may offer more comprehensive support, their lengthiness can potentially reduce attention and engagement with the intervention content, impacting their overall efficacy. This study examines how attentiveness-the degree to which participants engage with and process the intervention material-differs between single- and multicomponent interventions and how this variation moderates the efficacy of PFIs. A secondary analysis of a longitudinal randomized clinical trial was conducted, involving 1137 undergraduates reporting past-month heavy episodic drinking (63% female; mean age = 20.1 years). Assessments occurred at baseline and 3, 6, and 12 months postintervention, with primary outcomes including drinks per week and negative alcohol-related consequences. Intervention conditions included (a) assessment-only control (AOC), (b) multicomponent PFI, and (c) single-component PNFs. Generalized linear mixed models were used to evaluate attentiveness as a moderator of treatment efficacy across multicomponent PFI, single-component PNFs, and AOC conditions. Analysis detected significantly higher attentiveness levels in single-component PNFs compared to the multicomponent PFI (b = 0.35, p < 0.001). A three-way interaction (Time × Condition × Attentiveness) indicated that the efficacy of multicomponent PFI versus AOC on drinks per week was only significant for those reporting moderate-to-high attentiveness levels, not for those with low attentiveness. When comparing multicomponent PFI to single-component PNF, multicomponent PFI outperformed single-component PNF only when attentiveness was high; conversely, when attentiveness was low, single-component PNF outperformed multicomponent PFI. While the simplicity of PNF allows for easy implementation with minimal cognitive effort, multicomponent PFI demonstrates greater efficacy potential, particularly when comprehended thoroughly. Future research could explore strategies to enhance attentiveness with multicomponent PFI, such as sequential delivery across multiple sessions to optimize its benefits.

Minimal couple intervention to improve psychobiological stress resilience.

This study aimed at evaluating the effects of a minimal couple intervention focusing on positive aspects within the relationship (instructed partnership appreciation task; PAT) in daily life. We hypothesized a stress-buffering effect of this intervention on perceived stress, salivary cortisol and alpha-amylase. N = 40 couples were randomly assigned to either PAT or a no PAT (nPAT) condition. Self-reports and saliva samples were assessed six times per day on five consecutive days. To account for couple interdependencies, multilevel modelling (MLM) approaches were used to test the effects of (a) group assignment (PAT vs. nPAT) and (b) practicing the PAT in everyday life (PAT group only). Overall perceived stress was lower for women in the PAT group as compared with women in the nPAT group (b = -.380, p = .0098). Within the PAT group, daily positive interaction (PAT) significantly reduced cortisol (b = -.127, p = .02) and alpha amylase (b = -.122, p = .037). Sex-specific analyses of within-participants effects in daily life indicate that these results were driven by the men in the sample: Practicing the PAT led to a decrease in perceived stress (b = -.271, p = 001) and sCort (b = -.226, p = .006) in men, but not in women (all p > .05). The findings suggest that a minimal couple intervention can improve individual health-related outcomes in a sex-specific manner, and that effects depend on actually practicing the positive exchange in daily life. The analysis of the present study is based on a sub-sample (placebo group) of a larger neuropharmacological intervention and longitudinal trial 'Oxytocin, Couple Interaction and Wound Healing' (clinicaltrials.gov, identifier NCT01594775).

Linking Metabolic Syndrome to Neurodegeneration Mechanisms and Potential Treatments.

The global rise in both metabolic syndrome (MetS) and neurodegenerative diseases (NDs), particularly dementia and Alzheimer's disease (AD) poses a growing health and socioeconomic burden. MetS affects approximately 25% of the global adult population and is associated with insulin resistance, hypertension, dyslipidemia, and obesity, factors increasingly linked to cognitive impairment and brain atrophy. This review explores the shared pathophysiological mechanisms between MetS and NDs, including neuroinflammation, oxidative stress, insulin resistance in the brain, blood-brain barrier (BBB) dysfunction, mitochondrial damage, gut microbiota dysbiosis, and alterations in the renin-angiotensin system. In terms of substance, MetS patients are four times more likely to develop dementia, with increased markers such as CRP and IL-6 present in the patient populations. The review suggests the role of astrocytic insulin signalling, adipokines, and toll-like receptors as key molecular links. Interventions such as caloric restriction, hydroxytyrosol (HT), and intranasal insulin have shown promising outcomes at preclinical and early clinical stages. Antidiabetic drugs like metformin, liraglutide, and GLP-1 receptor agonists have the potential to modulate neuroinflammation and improve cognition. Angiotensin receptor blockers like losartan and candesartan also exhibit neuroprotection via RAS pathway modulation. The review emphasizes the need for longitudinal studies and clinical trials to confirm these therapeutic agents and develop effective and cost-friendly interventions for the prevention and management of neurodegeneration in patients with metabolic syndrome.

The 4 youth by youth (4YBY) crowdsourced HIV prevention intervention: A stepped-wedge longitudinal trial on HIV self-testing uptake among adolescents and young people in Nigeria.

The 4 youth by youth (4YBY) crowdsourced HIV prevention intervention: A stepped-wedge longitudinal trial on HIV self-testing uptake among adolescents and young people in Nigeria.

Longitudinal voice monitoring in a decentralized Bring Your Own Device trial for respiratory illness detection

The Acute Respiratory Illness Surveillance (AcRIS) Study was a low-interventional trial that examined voice changes with respiratory illnesses. This longitudinal trial was the first of its kind, conducted in a fully decentralized manner via a Bring Your Own Device mobile application. The app enabled social-media-based recruitment, remote consent, at-home sample collection, and daily remote voice and symptom capture in real-world settings. From April 2021 to April 2022, the trial enrolled 9151 participants, followed for up to eight weeks. Despite mild symptoms experienced by reverse transcription polymerase chain reaction (RT-PCR) positive participants, two machine learning algorithms developed to screen respiratory illnesses reached the pre-specified success criteria. Algorithm testing on independent cohorts demonstrated that the algorithm’s sensitivity increased as symptoms increased, while specificity remained consistent. Study findings suggest voice features can identify individuals with viral respiratory illnesses and provide valuable insights into fully decentralized clinical trials design, operation, and adoption (study registered at ClinicalTrials.gov (NCT04748445) on 5 February 2021).

Is the ligation of the intersphincteric fistula tract (LIFT) procedure truly a sphincter preserving procedure for anal fistula? A scoping review of the literature

IntroductionThe ligation of the intersphincteric fistula tract (LIFT) procedure has garnered popularity with its success rates and purported sphincter–continence preservation. However, there remains a paucity in the literature on the objective evaluation of sphincter integrity and fecal continence after the LIFT procedure.ObjectivesThe present study undertakes a scoping review to systematically explore and map the published literature, to evaluate the sufficiency of data on the impact on continence in patients after the LIFT procedure.DesignA systematic search of MEDLINE, PubMed, EMBASe, CINAHL was performed from January 2007 to April 2020 and 597 publications were identified. Forty-two satisfied the inclusion and exclusion criteria. We performed a scoping review in accordance to the PRISMA–ScR guidelines.ResultsOnly 3 (7.1%) of publications were randomized controlled trials, of which just 1 (2.4%) measured incontinence as a primary outcome. Continence was measured both pre- and post-LIFT in 30 (71.4%), of which 19 (45.2%) had a fixed protocol for continence assessment, which was heterogeneous between the studies. Continence was assessed using subjective scoring systems in 27 (64.3%) and objective measurement was performed in just 6 (14.3%). No studies performed post-operative anatomical assessment of the anal sphincter complex.ConclusionsLong-term continence in post-LIFT patients is not supported with adequately powered prospective longitudinal trials using rigorously protocoled pre- and post-operative assessment of continence. Future research that focuses on a combination of objective assessment using anal manometry as well as anatomical assessment of the sphincter complex on top of subjective evaluation is needed before we can be certain if LIFT is indeed a sphincter and continence preserving technique.

Integrated Behavioral Health and Implementation of the Safe Environment for Every Kid Approach in Pediatric Primary Care: A Mixed Methods Study.

To determine whether the presence of integrated behavioral health care (IBH) in a pediatric practice is associated with improved implementation of Safe Environment for Every Kid (SEEK), an evidence-based approach to prevention of child maltreatment. Pediatric primary care practices across the United States (n = 44) expressed interest in participating in a longitudinal multisite trial. Half of the practices included IBH. Semi-structured interviews were conducted at different points in time with 49 practice leaders, primary care professionals, behavioral health professionals, and nursing and administrative staff. Quantitative data on implementation stage and phase, proportion of activities completed at each stage, and length of time to complete each stage were collected by the Stages of Implementation Completion measure. Qualitative data revealed several instances in which IBH facilitated the adoption and implementation of SEEK and where SEEK supported IBH. However, apart from a longer duration devoted to program startup among IBH practices, none of the quantitative differences in rate of program startup, better completion of implementation activities, more tasks completed within each stage, and greater competency were statistically significant. Integrated behavioral health care in pediatric primary care settings may help to facilitate the implementation of interventions like SEEK designed to address social determinants of health and reduce the risk of child maltreatment. However, the current study did not find evidence, based on quantitative analyses, that IBH significantly affected the uptake of Project SEEK and that more research may be warranted.

Characterizing and validating 12-month reliable cognitive change in Early-Onset Alzheimer's Disease for use in clinical trials.

As literature suggests that Early-Onset Alzheimer's Disease (EOAD) and late-onset AD may differ in important ways, need exists for randomized clinical trials for treatments tailored to EOAD. Accurately measuring reliable cognitive change in individual patients with EOAD will have great value for these trials. The current study sought to characterize and validate 12-month reliable change from the Longitudinal Early-Onset Alzheimer's Disease Study (LEADS) neuropsychological battery. Standardized regression-based (SRB) prediction equations were developed from age-matched cognitively intact participants within LEADS, and applied to clinically impaired participants from LEADS. Participants were recruited from outpatient academic medical centers. Participants were enrolled in LEADS and diagnosed with amyloid-positive EOAD (n = 189) and amyloid-negative early-onset cognitive impairment not related to AD (EOnonAD; n = 43). 12-month reliable change (Z-scores) was compared between groups across cognitive domain composites, and distributions of individual participant trajectories were examined. Prediction of Z-scores by common AD biomarkers was also considered. Both EOAD and EOnonAD displayed significantly lower 12-month follow-up scores than were predicted based on SRB equations, with declines more pronounced for EOAD across several domains. AD biomarkers of cerebral β-amyloid, tau, and EOAD-specific atrophy were predictive of 12-month change scores. The current results support including EOAD patients in longitudinal clinical trials, and generate evidence of validation for using 12-month reliable cognitive change as a clinical outcome metric in clinical trials in EOAD cohorts like LEADS. Doing so will enhance the success of EOAD trials and permit a better understanding of individual responses to treatment.

The mediating role of psychological inflexibility on internalized stigma and patient outcomes in a sample of adults with inflammatory bowel disease.

This study examined the relationship between psychological inflexibility, internalized stigma, and patient outcomes in adults with inflammatory bowel disease (IBD). It aimed to explore if psychological inflexibility mediated the relationship between internalized stigma and patient outcomes. Three hundred and eighty-two participants with IBD took part in a cross-sectional quantitative study conducted via an online survey from May to December 2020. Participants completed questionnaires that assessed psychological inflexibility, committed action, internalized stigma related to IBD, psychological distress, IBD self-efficacy, self-concealment, beliefs about emotions, and fatigue. Participants also completed a sociodemographic and clinical questionnaire in addition to a bespoke Covid-19 questionnaire. Pearson's correlations and exploratory simple mediation analyses were used to examine relationships between variables and the mediating effect of psychological inflexibility. 40.5% of participants experienced internalized stigma. Higher psychological inflexibility was associated with higher internalized stigma, lower committed action, poorer health-related quality of life, lower IBD self-efficacy, higher self-concealment, higher fatigue, and more negative beliefs about emotions. Psychological inflexibility partially mediated the relationship between internalized stigma and several patient outcomes (psychological distress, IBD health-related quality of life, IBD self-efficacy, and self-concealment) and completely mediated the relationship between internalized stigma and fatigue. Psychological inflexibility significantly impacts the quality of life in individuals with internalized stigma related to IBD and mediates the relationship between internalized stigma and patient outcomes. Increasing psychological flexibility in adults with IBD may reduce distress and enhance quality of life. Longitudinal studies and trials of psychological interventions targeting psychological flexibility warrant exploration.

Determinant Factors on Food Therapy in Autism Spectrum Disorder: A Synthesis of Literature Review

The increasing prevalence of Autism Spectrum Disorder (ASD) has spurred interest in alternative therapeutic approaches, including food therapy. This systematic literature review synthesizes existing research on the determinant factors influencing the effectiveness of food therapy in managing symptoms of ASD. The paper explores dietary interventions, such as gluten-free, casein-free (GFCF) diets, micronutrient supplementation, and probiotic use, and examines the biological, psychological, and social determinants that shape the efficacy of these interventions. The findings highlight the importance of personalized dietary plans, the role of the gut-brain axis, and the need for holistic approaches that consider both the physiological and psychosocial dimensions of ASD. Future research directions include longitudinal studies and clinical trials to establish clearer guidelines for food therapy in ASD management.

Ototoxicity and Cognitive Outcomes among Very Young Children Treated for Brain Tumors: Findings from a Multisite, Prospective, Longitudinal Trial.

Brain tumor treatment can result in sensorineural hearing loss (SNHL) that is associated with cognitive declines in school-age children. Young children treated for brain tumors are at heightened cognitive risk. This study examines the unique contribution of treatment-related ototoxicity to cognitive outcomes in young children treated for brain tumors. 135 young children (mean age= 1.7 years) with a newly diagnosed malignant brain tumor were treated with chemotherapy, with or without focal proton or photon radiation therapy. Serial audiology and neurocognitive assessments were conducted for five years as part of a prospective, multisite, longitudinal trial (SJYC07; NCT00602667). SNHL was dichotomized as present versus not present (Chang grade ≥1a vs. 0). Neurocognitive assessments included intellectual functioning and parent ratings of adaptive functioning and attention. 67% of patients experienced mild-to-severe SNHL, which was associated with younger age at diagnosis (p<. 001) but not sex, treatment, or study risk arm (p> .10). Pre-treatment, higher IQ was associated with older age and higher socioeconomic status (p< .01), with a negative change in IQ trajectory after SNHL that was worse for children with supratentorial tumors. Pre-treatment, higher adaptive functioning was associated with older age (p= .0001), with a negative change in adaptive functioning trajectory after SNHL that was worse for those treated at a younger age. Attention problems increased after SNHL for the entire group (p= .0099). SNHL is associated with IQ decline and worsening adaptive functioning and attention in young children treated for brain tumors. These findings have important implications for treatment modifications, interventions, and caregiver education.

The effect of anti-seizure medications on Alzheimer's disease (AD) risk and AD-related symptoms: A scoping review.

BackgroundAs the fastest-growing segment of the population, adults over 65 are at the most significant risk for Alzheimer's disease (AD). Older adults often use anti-seizure medications (ASMs), which can negatively impact cognitive function, mood, and behavior, mimicking AD or its symptoms. Understanding the effects of ASMs across diverse older adults is crucial, given that some ethnoracial groups are at higher risk for AD or more severe symptoms compared to non-Hispanic Whites.ObjectiveTo summarize the current evidence on the association of ASMs with AD risk and AD-related symptoms and explore the inclusion of ethnoracial minority groups in these studies.MethodsData sources included PubMed/MEDLINE, EMBASE, and SCOPUS for English-language studies published between 1990-2024. Selected studies were peer-reviewed, cross-sectional, longitudinal, case-control, and clinical trials on AD dementia or related symptoms and ASMs. Study quality was rated by the Oxford Centre for Evidence-Based Research Medicine.ResultsA total of 27 studies with 1,241,796 participants were included. Data on AD risk from level IB-IIIB evidence studies showed mixed results, with some indicating an increased association with ASM use [OR = 1.05-1.16, 95% CI: 1.01-1.24]. Studies on AD-related symptoms from level IB-IV evidence also showed mixed results. Only three North American studies explicitly included race/ethnicity; most were conducted in European countries.ConclusionsASM use may be modestly associated with an increased risk of AD among the older adult population, but current data are inconclusive. The association of ASMs on AD-related symptoms varied. Future studies should emphasize reporting sociodemographic data and include diverse cohorts to enhance the applicability of findings.

HIV pre-exposure prophylaxis re-initiation among men who have sex with men: a multi-center cohort study in China.

Background Data on persistent use of HIV pre-exposure prophylaxis (PrEP) is limited among Chinese men who have sex with men (MSM). This study aimed to explore factors associated with the re-initiation of PrEP among Chinese MSM from a longitudinal PrEP demonstration trial. Methods A multi-center cohort study was conducted in Guangzhou and Wuhan, China (September 2021-2024), providing 1134 MSM participants with a 12-month dosage of tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) as oral PrEP. Following the trial, a subgroup of participants were invited to complete a 3-month post-trial follow-up survey. These participants were categorized on the basis of self-reported PrEP use patterns into (1) continued PrEP use, (2) discontinued without re-initiation, and (3) re-initiated after discontinuation. Log-binomial regression models were used to assess factors associated with PrEP re-initiation. Results Out of 408 participants who completed the 3-month post-trial follow-up survey, 70.1% (n =286/408) reported discontinuing PrEP, and 50.7% (n =145/286) of those who discontinued subsequently re-initiated PrEP. Participants who had concurrent sexual partnerships (adjusted risk ratio [aRR]=1.47, 95% CI: 1.11-1.96), used drugs during sex (aRR=1.34, 95% CI: 1.09-1.65), or lived alone (aRR=1.29, 95% CI: 1.03-1.61) were more likely to re-initiate PrEP. The Likert scale analysis indicated that perceived partner influence, specifically the expectation of condomless sex, played a significant role in re-initiation decisions (P =0.03). Conclusion Individuals engaging in higher-risk behaviors are more likely to re-initiate PrEP, highlighting the dynamic nature of risk perception. Future interventions should focus on promoting both re-initiation and consistent condom use, emphasizing partner-related dynamics and substance use as key factors in PrEP decisions among MSM.

Lung cancer associated autoantibody responses are detectable years before clinical presentation.

The EarlyCDT-Lung® test detects elevated levels of tumour-associated autoantibodies generated in response to immune recognition of cancerous cells, and these autoantibodies have previously been shown to precede clinical presentation of lung cancer. Using a longitudinal cohort from the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) study, we have established that elevated autoantibodies can be detected an average of four years in advance of clinical presentation, and in some cases up to 8 years prior to clinical presentation. This is the first study to establish pre-diagnostic elevation of autoantibodies using samples from a longitudinal prospective clinical trial using a clinically validated and commercially available biomarker panel.

Rethinking Osteoarthritis Management: Synergistic Effects of Chronoexercise, Circadian Rhythm, and Chondroprotective Agents.

Osteoarthritis (OA) is a chronic and debilitating joint disease characterized by progressive cartilage degeneration for which no definitive cure exists. Conventional management approaches often rely on fragmented and poorly coordinated pharmacological and non-pharmacological interventions that are inconsistently applied throughout the disease course. Persistent controversies regarding the clinical efficacy of chondroprotective agents, frequently highlighted by pharmacovigilance agencies, underscore the need for a structured evidence-based approach. Emerging evidence suggests that synchronizing pharmacotherapy and exercise regimens with circadian biology may optimize therapeutic outcomes by addressing early pathological processes, including low-grade inflammation, oxidative stress, and matrix degradation. Recognizing the influence of the chondrocyte clock on these processes, this study proposes a 'prototype' for a novel framework that leverages the circadian rhythm-aligned administration of traditional chondroprotective agents along with tailored, accessible exercise protocols to mitigate cartilage breakdown and support joint function. In addition, this model-based framework emphasizes the interdependence between cartilage chronobiology and time-of-day-dependent responses to exercise, where strategically timed joint activity enhances nutrient and waste exchange, mitigates mitochondrial dysfunction, supports cellular metabolism, and promotes tissue maintenance, whereas nighttime rest promotes cartilage rehydration and repair. This time-sensitive, comprehensive approach aims to slow OA progression, reduce structural damage, and delay invasive procedures, particularly in weight-bearing joints such as the knee and hip. However, significant challenges remain, including inter-individual variability in circadian rhythms, a lack of reliable biomarkers for pharmacotherapeutic monitoring, and limited clinical evidence supporting chronoexercise protocols. Future large-scale, longitudinal trials are critical to evaluate the efficacy and scalability of this rational integrative strategy, paving the way for a new era in OA management.

Clinical Evaluation of Lithium Disilicate Chairside CAD/CAM Crown after 10-years.

This longitudinal clinical trial studied the clinical performance of chairside CAD/CAM fabricated lithium disilicate crowns (IPS e.max CAD; Ivoclar) over ten years of service. 100 CAD/CAM lithium disilicate crowns were fabricated using the CEREC 3 system (Dentsply Sirona). The crowns were adhesively bonded in consecutive groups with one of three cements. ML = self-etching bonding agent and resin cement (MultiLink-Automix; Ivoclar), EC = self-adhesive resin cement (Experimental Cement; Ivoclar), and SC =self-adhesive, light-cured resin cement (SpeedCem; Ivoclar). Mild sensitivity was reported on 15% of the teeth at 1 week. All sensitivity resolved by 4 weeks. At 6 months, 2 (8.7%) of the crowns cemented with ML and 3 (7.7%) of the crowns cemented with EC were described as slightly sensitive by the patient. No patient required treatment for sensitivity and there was no reported sensitivity at any subsequent recalls. The percent alpha scores were above 95% for color match and margin adaptation at all recall intervals. Four crowns debonded, 3 cemented with EC (13, 20 and 36 months) and 1 with ML (36 months). A second MultiLink crown debonded at 110 months (9 years, 2 months). There were four reported cases of crown fracture between 6 years 3 months and 9 years 9 months. There were two biological failures; one due to endodontic treatment and one due to fracture and loss of the core. The lithium disilicate crowns performed very well over 10 years. This study was supported by a grant from Ivoclar.

Social capital and maternal mental health: Findings from secondary data analyses of two linked longitudinal trials in Australia.

Low social capital has been identified as an important risk factor in the development of postpartum mental illness. Evidence suggests that new and expectant mothers with higher levels of support have lower rates of maternal mental illness, yet few studies examine this relationship longitudinally. This study investigated the association between social capital in late pregnancy and maternal mental health up to 5 years postpartum. Secondary analysis of Communicating Healthy Beginnings Advice by Telephone trial data was conducted. Participants included women in late pregnancy recruited from seven Australian hospitals across New South Wales (n=1155). Outcomes were maternal stress at 6 months postpartum, and psychological distress at 3, 4, and 5 years postpartum. Data on demographics and maternal cognitive, structural, and total social capital were collected in late pregnancy. Multiple logistic regression was conducted at 6 months postpartum, and longitudinal analysis with multilevel mixed-effects logistic regression conducted from 3 to 5 years postpartum. Lower total social capital was associated with an increased likelihood of having higher stress at 6 months postpartum (AOR 1.61, 95 % CI 1.21-2.14). Lower total social capital was also associated with anxiety (AOR 1.44, 95 % CI 1.01-2.05) and higher levels of psychological distress (AOR 1.50, 95 % CI 1.15-1.95) at 3 to 5 years postpartum. Findings suggest that improving social capital in late pregnancy can mitigate postpartum mental health symptoms. Efforts to increase the social capital of new and expectant mothers should be made to prevent their mental illness postpartum.

The Effects of Training on Older Volunteers’ Skill Competency, Volunteer Motivation, Self-Efficacy, and Work Satisfaction: A Cluster Randomized Trial

ABSTRACT This longitudinal cluster-randomized trial investigated older volunteers’ changes following a 3-month training program. A total of 156 older Taiwanese volunteers in the community care centers participated in this study (n training = 80, n control = 76). Older volunteers’ skills/competency and psychosocial variables were assessed at baseline, one and three months. Results showed that trained volunteers significantly improved skills, motivation, self-efficacy, and work satisfaction, while untrained volunteers showed no improvements in self-efficacy or work satisfaction and experienced a decline in motivation . The results hightlighted that training is crucial for maximazing the positive impact of volunteering on older adults.