Participant Characteristics Research Articles

Is Bilinguality an Illusive Concept?

Background and Objective: In an effort to study bilinguality, researchers in this field have often compared bilinguals with monolinguals, generally considering each group to be a homogeneous, monolithic body with no discernable within-group individual differences. This approach overlooks the various levels of proficiency among bilinguals, the age and order of acquisition of each of their languages, as well as their language history, and daily usage. Although monolinguals may not be conversant, some may still at least partially comprehend a second language. By failing to actively consider and collect more details about a variety of participant language attributes, researcher assumptions can lead to conclusions that are not a true reflection of the similarities and differences between monolinguals and bilinguals. A number of studies have found bilingual advantage in health-related outcomes as well as performance on cognitive tasks. All these reported findings are based on the performance of participants who may or may not be true bilinguals consequently impacting the results of this research [9,11]. Recommendations: The impact of considering a wide variable of participant characteristics in bilinguality research, including age and order of acquisition, daily usage, and fluency is examined. In addition, a recently proposed psychometric model that evaluates the above variables is discussed. Finally, recommendations are made on how to further improve the standards of research in bilinguality, including performing objective fluency testing, and asking detailed questions about participants’ complete language history.

The effectiveness and acceptability of physical activity interventions amongst older adults with lower socioeconomic status: a mixed methods systematic review.

Older adults with lower socioeconomic status are less likely to be physically active than those with higher socioeconomic status. To inform future intervention development, this review explored: [i] how effective are physical activity interventions at increasing levels of physical activity amongst older adults with lower socioeconomic status?; [ii] what factors are associated with the acceptability of physical activity interventions amongst older adults with lower socioeconomic status?; [iii] what are the implications for developing physical activity interventions for older adults with lower socioeconomic status? This mixed methods systematic review followed PRISMA guidelines. MEDLINE, CENTRAL, Embase, Scopus, Web of Science, PsycINFO, CINAHL, ASSIA and Sports Medicine and Education Index were searched up to May 2023, to identify quantitative, qualitative and mixed methods primary research studies measuring the effectiveness of and/or experiences of physical activity interventions for older adults (aged ≥ 65 years) with lower socioeconomic status. No limits on country were applied. Included studies were assessed for methodological quality using the Mixed Methods Appraisal Tool. Results were synthesised using a results-based convergent synthesis approach with narrative synthesis of quantitative findings and thematic synthesis of qualitative findings. Thirty studies were included. Mixed effects were found for the effectiveness of physical activity interventions, with positive effects for increases in utilitarian walking (i.e. for transport) but not for leisure, mixed effects for objectively measured physical activity and no effects for self-reported total physical activity or muscle strengthening and flexibility activities. Engaging in physical activity interventions was perceived as offering many benefits, social familiarity was important to intervention acceptability and interventions were seen as more acceptable when they were compatible with the lifestyles of older adults with lower socioeconomic status. Future development of physical activity interventions for older adults with lower socioeconomic status should foster social connections, emphasise health benefits of physical activity, hold interventions in locations that are accessible and familiar to older adults with lower socioeconomic status, minimise costs to participants, employ individuals who share participant characteristics to lead interventions, and combine physical activity with other activities older adults with lower socioeconomic status already do to make more efficient use of time. PROSPERO CRD42023417312; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=417312 .

Serum metabolite signature of the modified Mediterranean-DASH intervention for neurodegenerative delay (MIND) diet.

There is a lack of biomarkers of clinically important diets, such as the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet. Our study explored serum metabolites associated with adherence to the MIND diet. In 3,908 Atherosclerosis Risk in Communities (ARIC) study participants, we calculated a modified MIND diet score based on a 66-item self-reported food frequency questionnaire (FFQ). The modified score did not include berries and olive oil, as these items were not assessed in the FFQ. We used multivariable linear regression models in 2 subgroups of ARIC study participants and meta-analyzed results using fixed effects regression to identify significant metabolites after Bonferroni correction. We also examined associations between these metabolites and food components of the modified MIND diet. C-statistics evaluated the prediction of high modified MIND diet adherence using significant metabolites beyond participant characteristics. Of 360 metabolites analyzed, 27 metabolites (15 positive, 12 negative) were significantly associated with the modified MIND diet score (lipids, n = 13; amino acids, n = 5; xenobiotics, n = 3; cofactors and vitamins, n = 3; carbohydrates n = 2; nucleotide n = 1). The top 4 metabolites that improved the prediction of high dietary adherence to the modified MIND diet were 7-methylxanthine, theobromine, docosahexaenoate (DHA), and 3-carboxy-4-methyl-5-propyl-2-furanpropanoate (CMPF). Twenty-seven metabolomic markers were correlated with the modified MIND diet. The biomarkers, if further validated, could be useful to objectively assess adherence to the MIND diet.

Remote Passive Sensing of Older Adults' Activities and Function: User-Centered Design Considerations for Behavioral Interventions Conducted in the Home Setting.

Behavioral intervention studies often lack sufficiently sensitive and frequent measurements to observe an effect. Remote passive sensing offers a highly sensitive, continuous, and ecologically valid method of assessment that increases the ability to detect changes in the daily activities and function of those being monitored. To be most effectively deployed in research studies, applications of remote assessment technology must be designed with the end user in mind. User-centered design (UCD) is especially important in clinical trials where the needs and characteristics of participants and research staff need to be uniquely considered to ensure the feasibility and acceptability of the study. This paper describes UCD issues in remote passive sensing that commonly arise among older adult participants-including those living with dementia-as well as any strategies that were taken to overcome them. Using exemplars from the National Institute on Aging-funded Roybal Center ORCASTRAIT (Oregon Roybal Center for Care Support Translational Research Advantaged by Integrating Technology), as well as other experimental and observational research studies conducted in community settings, this paper brings together our collective experiences with studies using remote passive sensing technology that incorporate a UCD design approach. Although passive sensing eliminates some common UCD issues that arise with higher-touch technology, issues, such as usability, trust, and aesthetic acceptability, still need to be addressed for behavioral interventions using passive sensing technology to be potent and implementable.

General hospital patients’ attitude towards systematic health risk behavior screening and intervention

BackgroundSystematic counseling on behavioral health risk factors (HRFs) may be suitable to promote health among general hospital patients. This study aimed to investigate the openness of patients towards systematic screening and intervention of HRFs, its relation to actual participation in a multi-behavioral intervention, and whether socio-economic characteristics, HRFs and health indicators are related to approval.MethodsAll 18- to 64-year-old patients hospitalized in five medical departments at the University Medicine Hospital Greifswald in Germany were asked between May and July 2022 to participate in a survey and in a subsequent pre-post intervention study. Among all eligible patients, 225 (78.9%) participated in the survey. Patients’ approval of systematic screening and intervention of HRFs was assessed using five statements with a total sum score of 0–20 (i.e., scores of 0–6, 7–13, 14–20 referring to low, medium and high approval). Associations with intervention participation, socio-economic, behavioral and health-related patient characteristics were analyzed using logistic and multivariable linear regression analyses.ResultsThe mean total approval of screening and intervention was 13.8 (SD = 4.8). Of the 125/ 73/ 16 patients with high/ medium/ low approval, 88.0%/ 78.1%/ 50.0% participated in the subsequent intervention, respectively. Approval was independent of socio-demographic and -economic characteristics and self-rated general health. Current tobacco smoking was the only HRF negatively (p = 0.02) and diabetes mellitus was the only disease positively (p = 0.01) associated with approval.ConclusionHigh approval of HRF screening, which was rather independent of socio-economic characteristics and worse self-rated general health, speaks in favor of proactively approaching and motivating all general hospital patients to participate in health behavior change intervention. Tobacco smokers might need higher efforts to motivate participation than non-smokers.Trial registrationClinicalTrials.gov Identifier NCT05365269 on May 9, 2022.

Dual-task performance during the Timed Up and Go test in Parkinson's disease - the impact of freezing and cognition

BackgroundDual-task interference (DTI) on gait is well documented in Parkinson’s disease (PD), but how dual-tasks affect functional mobility is less known. Understanding how cognition and freezing of gait (FOG) further impact dual-task ability is important for risk assessment and subsequent delivery of targeted rehabilitation. Research questionWhat is the DTI on completion time of the Timed Up and Go, and DTI on response rate of a serial subtraction task when performed simultaneously, and is DTI impacted by FOG or cognition? MethodsA cross-sectional study design was used. Demographic and clinical characteristics of participants were collected, including global cognition and self-reported FOG. The TUG test was performed with and without a serial subtraction task. Completion times on TUG and response rates on the serial subtraction task was compared between single and dual-task performance using paired samples t-test or Wilcoxon signed rank test as appropriate. Prioritization between tasks was compared with one-sample Wilcoxon signed rank test. The impact of FOG and cognition was investigated with multiple linear regression, controlling for age, sex, and disease severity. ResultsA total of 77 people with mild to moderate PD were included. Significant DTI was observed for both the gait (TUG) and cognitive (response rate) tasks. No statistically significant pattern of prioritization was observed between motor and cognitive tasks. Global cognition was significantly related to both completion time and response rate in single and dual-tasking, whereas FOG was not found to be associated to the outcomes in either condition. SignificanceCognition appears to significantly relate to performance of functional mobility in single and dual-task conditions, which should be considered during routine mobility assessments in people with PD.

Do Personalized Nutrition Interventions Improve Dietary Intake and Risk Factors in Adults With Elevated Cardiovascular Disease Risk Factors? A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Dietary modifications can improve cardiovascular disease (CVD) risk factors. Personalized nutrition (PN) refers to individualized nutrition care based on genetic, phenotypic, medical, behavioral, and/or lifestyle characteristics. PN may be beneficial in improving CVD risk factors, including diet. However, this has not been reviewed previously. The aim was to evaluate the effectiveness of PN interventions on CVD risk factors and diet in adults at elevated CVD risk. Six databases were searched for randomized controlled trials published between 2000 and 2023 that tested the impact of PN interventions on CVD risk factors in people at elevated risk. Risk of bias was assessed using the Academy of Nutrition and Dietetics Quality Criteria checklist. Data synthesis of eligible articles included participant characteristics, intervention details, and change in primary CVD risk factor outcomes, including blood pressure (BP), plasma lipids, and CVD risk score, and secondary risk factors, including anthropometric outcomes and diet quality. Random-effects meta-analyses were conducted to explore weighted mean differences (WMDs) in change or final mean values for studies with comparable data (studies with dietary counseling interventions) for outcomes including BP, blood lipids, and anthropometric measurements. Of 7676 identified articles, 16 articles representing 15 studies met the inclusion criteria. Studies included between 40 and 563 participants and reported outcomes for CVD risk factors, including hyperlipidemia (n = 5), elevated BP (n = 3), overweight/obesity (n = 1), and multiple risk factors (n = 6). Risk of bias was low. Results suggested potential benefit of PN on systolic BP (WMD: -1.91; 95% CI: -3.51, -0.31 mmHg) and diastolic BP (WMD: -1.49; 95% CI: -2.39, -0.58 mmHg) and dietary intake in individuals at high CVD risk. Results were inconsistent for plasma lipid and anthropometric outcomes. Results were promising for PN interventions that used dietary counseling on CVD risk factors in at-risk individuals. However, further evidence for other personalization methods is required, including improving methodological quality and longer study duration in future PN interventions. OpenScience Framework (https://doi.org/10.17605/OSF.IO/SHVWP).

Muscle Oxygen Saturation Dynamics During Upper-Body Resistance Exercise

Research examining the changes in muscle oxygen saturation across multiple sets of resistance exercise is limited. The purpose of this study was to describe the physiological response of muscle oxygenation parameters during upper-body resistance exercise and examine the differential effects of relevant participant characteristics on resistance training performance and muscle oxygen saturation dynamics. Sixty-one recreationally trained men (n = 44; 21.8 ± 2.6 years) and women (n = 17; 20.2 ± 1.8 years) completed five-repetition maximum sets of barbell bench presses at a load equal to 75% 1-RM with a 2 min rest interval. Muscle oxygen saturation (SmO2) dynamics within the anterior deltoid were monitored using a portable near-infrared spectroscopy sensor. The percent change in SmO2 (∆%SmO2), the muscle oxygen re-saturation rate (SmO2RecSlope), and the highest measured SmO2 value during recovery periods (SmO2Peak) were measured. Two-way (sex [men, women] x time [sets 1–5]) repeated measures analyses of variance (ANOVA) were performed on muscle saturation variables. To examine the effect of relevant controlling variables, separate analyses of covariance (ANCOVA) with repeated measures were also performed. No differences were seen with ∆%SmO2 across sets. The main effects for sets occurred for SmO2RecSlope, whereby a decline was noted on sets 4 and 5 (p = 0.001) compared to set 1. Additionally, SmO2Peak was the lowest on set 5 (p < 0.001) compared to all other sets. Moreover, body mass (p = 0.013), diastolic blood pressure (p = 0.044), and mean arterial pressure (p = 0.033) for ∆%SmO2 were the only significant covariates noted amongst the muscle oxygenation variables. In conclusion, no sex differences and only a few set differences in muscle oxygen saturation dynamics were seen without employing any covariates. Body mass, diastolic blood pressure, and mean arterial pressure were identified as factors that could influence observed responses.

Evidence-Based Psychosocial Treatments for Disruptive Behaviors in Children: Update.

We reviewed the available evidence on psychosocial treatments for disruptive behaviors in children, as an update to Kaminski and Claussen (2017), focusing on children up to age 12 years. Search strategies, study inclusion, and treatment classification followed the procedures developed by Southam-Gerow and Prinstein (2014). Of the 44 included studies from 2016 to 2021, only 9 impacted previous results, either by increasing the level of evidence (for two treatment families) or documenting evidence for a new treatment family (four new treatment families). All three treatment families classified as Level 1: Well Established are parent-focused and now include Group parent behavior therapy + group child behavior therapy (previously classified as Probably Efficacious), in addition to Group parent behavior therapy and Individual parent behavior therapy with child participation (already classified as Well Established). Fifteen treatment families were classified as Level 2: Probably Efficacious, eight were classified as Level 3: Possibly Efficacious. Given the variability of programs in each treatment family, the evidence is for the overall treatment approach and may not apply to each program with those characteristics. Data were insufficient to examine outcomes in relation to participant characteristics. The information can be used to improve dissemination, implementation, and uptake of effective treatment, and inform research on improving access barriers.

Practices and views about palliative care at the end of life: A survey of oncologists from the Italian region of Liguria.

We conducted an online survey to investigate oncologists' clinical practices and views on palliative care at the end of life in the Italian region of Liguria. The survey included 29 items divided into three sections: participant characteristics (n=6), hospital resources and practices (n=11), participant practices and views (n=12). Twenty-one of the 41 medical oncologists invited completed the survey (51%). Although almost all reported the presence of palliative medicine physicians at their hospitals (90%), nearly half (48%) stated that palliative medicine physicians were not responsible for managing cancer patients at end of life, and 21% reported routine participation of palliative medicine physicians in multidisciplinary meetings. Thirty-eight percent of the respondents stated they never consulted psychologists regarding end of life patient care, and 43% reported they rarely did. Notably, a substantial proportion of participants stated that they administered active treatments to patients with six months life expectancy. Regarding integration between oncology and palliative medicine, an equal proportion felt it had been fully (48%) or partially achieved (48%) at their hospitals. Participants seemed fairly satisfied with the level of integration between oncology and palliative medicine at their hospitals, which contrasts with other findings regarding, for instance, the scant participation of palliative medicine physicians in multidisciplinary meetings. Exploring the impact of the novel regional clinical healthcare pathway for palliative care on practices at hospitals in Liguria will be crucial to ensure that cancer patients at end of life receive quality care.

Knowledge, attitude, and food safety practices among university students in Kilimanjaro region, northern Tanzania

Food safety is a public health concern worldwide due to an increased morbidity and mortality risk associated with the outbreak of food-borne diseases. This study aimed to assess knowledge, attitude, and food safety practices (KAP) among university students in northern Tanzania. This is interesting because it allows data to be collected for creating awareness on safety, sanitation, and quality of food available within and outside the university environments.We conducted a cross-sectional study among 407 university students in Kilimanjaro region and all authors participated equally. Participants completed an online, self-administered questionnaire. Data was analyzed using SPSS version 25 and summarized using descriptive statistics. The Chi-squared test compared the proportion of KAP by participant characteristics and the multiple logistic regression model used to determine the associated factors. Participants had a mean age (standard deviation) of 23.2 (2.6) years, 51.4% were males, and 83% were < 25 years. The overall proportion of good knowledge, attitude, and food safety practices were 82.6, 78.4, and 31.9%, respectively. Higher odds of knowledge and attitude on food safety were students from KCMUCo (OR = 2.36; 95% CI 1.33–4.17) and (OR = 4.80; 95% CI 2.67–8.63). Also higher odds of food safety practice were students with good knowledge (OR = 1.80; 95% CI 1.03–3.13).Good food safety knowledge but not attitudes was associated with good food safety practices. This shows the need to introduce practical food safety within college environments to help students improve food hygiene and safety practices.

Limitations in Activities of Daily Living among Individuals with Systemic Lupus Erythematosus.

We aimed to estimate the burden and identify potential correlates of limitations in activities of daily living (ADLs) among persons with systemic lupus erythematosus (SLE). Individuals with SLE were recruited from a population-based cohort (10/2019-5/2022) and reported their ability to independently perform various instrumental ADLs (IADLs) and basic ADLs (BADLs) via survey. Limitations were defined as having at least some difficulty performing at least one of the IADLs or BADLs. Descriptive statistics were calculated, and associations [adjusted odds ratios (aORs)] of various participant characteristics with IADL and BADL limitations were assessed with logistic regression adjusting for age, sex, and race. The mean age of the 436 participants was 46.2 years; most were female (91.7%) and Black (82.8%). More than half (56.2%) reported limitations in IADLs, most commonly housekeeping (50.7%), laundry (37.2%), and shopping (33.0%); 43.8% reported limitations in independently performing BADLs, most commonly transferring (26.6%), bathing (25.3%), dressing (24.4%), and continence (22.0%). Higher disease activity (≥ vs. <median) was most strongly associated with IADLs (aOR=6.49, 95% CI 4.15-10.2) and BADLs (aOR=7.35, 95% CI 4.70-11.5), along with higher depression and perceived stress scores; lower educational attainment and income; and older age. IADL and BADL limitations may be common in SLE and more prevalent among those who report higher disease activity, depressive symptoms, and lower income and among those who are older. Research to support evidence-based strategies for improvement in quality of life and maintenance of independence in the aging SLE population is warranted.

Can Orthodontic Adhesive Systems Inhibit the Formation and Development of White Spot Lesions During Fixed Orthodontic Treatment? A Systematic Review.

This study aims to assess whether orthodontic bonding systems prevent orthodontic-induced white spot lesions (OIWSLs), exploring efficacy and identifying associated factors through a comprehensive systematic review of existing evidence. The study complied to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two evaluators screened records, and data were extracted on orthodontic bonding systems, outcomes, and participant characteristics from PubMed/MEDLINE, Cochrane Library, and EM Premium. The search equation focused on white spot lesions and orthodontic bonding. Only in-vivo studies and clinical trials on humans were included, while in-vitro studies were excluded. The risk of bias was assessed using Cochrane's RoB2 tool for RCTs and ROBINS-I tool for non-randomized studies, evaluating key domains related to bias. The systematic review, including 12 articles with 550 participants and 2,000 teeth, revealed that bonding with nanoparticles of nCaF2-primer and amorphous calcium phosphate-containing adhesives effectively reduced WSLs. In contrast, one-step adhesive without primer (GC Ortho Connect™) was associated with higher and more severe WSLs. Fluoride-releasing primers (Opal Seal™ and Clearfil™) did not exhibit an advantage in demineralization reduction. The inclusion of TiO2 nanoparticles in two studies yielded conflicting results on antibacterial effects. Various nanoparticles incorporated into adhesives or primers exhibit promise in preventing white spot lesions in fixed orthodontic treatment. However, the used evaluation methods, such as clinical examinations or advanced imaging, significantly impact result interpretation. The effectiveness of orthodontic adhesives in preventing WSLs should balance between biocompatibility, bond strength and demineralization control tailored to patient-specific needs.

A randomised controlled trial to determine the effect of genotype-based personalised diet and physical activity advice for FTO genotype (rs9939609) delivered via email on healthy eating motivation in young adults.

The prevalence of obesity continues to rise, and public health dietary recommendations are not being adhered to. The transition to higher education is a period of risk for weight gain in young adults and has been demonstrated as a good time to initiate behaviour change. A genotype-based personalised approach to dietary recommendations may motivate young adults to maintain or adopt positive dietary behaviours. The aim of the present study was to determine the efficacy of genotype-based personalised dietary and physical activity advice on healthy eating motivation in young adults. Participants were young adults (n = 153), aged 18-25 years. Baseline measures (participant characteristics, height, weight, body mass index [BMI], body fat percentage [BF%], healthy eating motivation and physical activity) were collected. Participants were genotyped for a SNP in the FTO gene (rs99396090) and randomly allocated (stratified for genotype) to three different groups (1. Genotype-based personalised advice: dietary and physical activity advice based on genotype, BMI and reported physical activity; 2. Non-genotype-based personalised advice: dietary and physical activity advice based on BMI and reported physical activity; 3. Control: no advice). A week after receipt of advice delivered via email, participants completed the healthy eating motivation questionnaire for a second time. Genotype-based personalised dietary advice did not affect healthy eating motivation: when participants were analysed across the whole group (p = 0.417), when analysed according to those informed of a risk or non-risk-associated genotype (p = 0.287), or when analysed according to those with a BMI (>25 kg/m2; p = 0.336) or BF% (male >18%, female >31%; p = 0.387) outside the healthy range. There was also no significant difference in healthy eating motivation at 1-week in the control or non-genotype-based advice groups. Genotype-based personalised advice for the prevention of obesity did not affect healthy eating motivation in this group of healthy, young adults.

How to make cardiology clinical trials more inclusive.

Cardiovascular clinical trials continue to under-represent children, older adults, females and people from ethnic minority groups relative to population disease distribution. Here we describe strategies to foster trial representativeness, with proposed actions at the levels of trial funding, design, conduct and dissemination. In particular, trial representativeness may be increased through broad recruitment strategies and site selection criteria that reflect the diversity of patients in the catchment area, as well as limiting unjustified exclusion criteria and using pragmatic designs that minimize research burden on patients (including embedded and decentralized trials). Trial communications ought to be culturally appropriate; engaging diverse people with lived experience in the co-design of some trial elements may foster this. The demographics of trialists themselves are associated with participant demographics; therefore, trial leadership must be actively diversified. Funding bodies and journals increasingly require the reporting of sociodemographic characteristics of trial participants, and regulatory bodies now provide guidance on increasing trial diversity; these steps may increase the momentum towards change. Although this Perspective focuses on the cardiovascular trial context, many of these strategies could be applied to other fields.

The Effectiveness of a MOOC as a Form of Professional Learning: An Examination of an Adolescent Learner Social and Emotional Well-Being Course

Massive Open Online Courses (MOOCs) provide borderless opportunities to engage with content and ideas, with prospective participants from around the globe being able to easily register. The course featured in this study focused on the social and emotional well-being of adolescents, selected because of a recognized need for professional learning related to this topic. It was purposely designed for delivery as a MOOC and was designed as a 6h program around four topics to be completed over two weeks in asynchronous mode. It was delivered seven times from 2019 to 2023, with 32,969 individuals enrolled across these deliveries. The effectiveness of engaging in the course for professional learning purposes is of particular interest to this study. To that end, a convergent mixed methods study was conducted. First, quantitative and qualitative survey data collected at various course stages were examined to reveal the demographic characteristics of participants and their experiences in the course using data from surveys and comments about their experiences. The findings revealed, among other factors, that 65% were female, with just under half (47%) aged 45 years or less, nearly half (44%) held a bachelor’s degree as their highest level of qualification, and 48% were employed within the teaching and education sector. The most active learners were from Europe (48%) and Asia (27%), with active learners from a total of 178 countries. The course has a high course retention index, with 51% of learners completing 51% of the course and 8383 learners completing 90% or more of the course. The qualitative findings reveal the strongly positive experiences reported by the active participants. Secondly, we examined the effectiveness of the MOOC for participants’ professional learning needs by assessing the course using a framework with ten domains related to its core design features, modified for use by the course designers as a self-reflective tool. We found that the domains that scored the lowest were collaboration, interactivity, and, to a lesser extent, pedagogy. The study’s limitations include the incomplete data provided as part of the MOOC protocols, and the use of a self-reflection tool, which may inadvertently incorporate bias. This study points to these gaps in the data, including the need to access longitudinal data that go beyond a focus on the design of courses to extend to the impact and outcomes of the experience.

Physician preferences for Online and In-person continuing medical education: a cross-sectional study

BackgroundThe worldwide market for continuing medical education (CME) was severely affected by the COVID-19 pandemic, which precipitated an increase in web-based CME course attendance. Virtual education methods may be effective for engaging learners and changing behaviors. However, more information is needed about physician preferences for in-person vs. livestreamed CME courses in the postpandemic era. Because of the paucity of data regarding this topic, the current study was designed to evaluate CME participant characteristics, preferences, engagement, and satisfaction with traditional in-person vs. virtual educational methods.MethodsA cross-sectional study was performed of attendees of two large internal medicine CME courses held in 2021. Both CME courses were offered via in-person and livestream options, and were taught by Mayo Clinic content experts. Participants, who consisted of practicing physicians seeking CME, completed a 41-question survey after CME course completion. Statistical comparisons were performed by using Fisher exact tests for all survey items, except for those with ordinal response sets, which were compared with Cochran-Armitage trend tests.ResultsA total of 146 participants completed the survey (response rate, 30.2%). Among the 77 respondents who attended in-person courses, the most frequent reasons indicated were the opportunity to travel (66%) and collaboration/networking with others (25%). Among the 68 respondents who attended the livestream courses, the most frequent reasons indicated included COVID-19–related concerns (65%), convenience (46%), and travel costs (34%). The percentage of respondents who indicated that they would choose the same mode of attendance if given the option again was higher for those who attended in person than for those who attended via livestream (91% vs. 65%, P < .001).ConclusionsThese data suggest that in-person course offerings will continue to be a preferred learning method for some physicians. However, most respondents who attended virtually preferred that method. Therefore, hybrid CME models offering both in-person and virtual options may be most beneficial for meeting the needs of all CME learners.

Substance use during the COVID-19 pandemic among persons with traumatic spinal cord injury: A cross-sectional perspective

Study design: Analysis of data from two cohorts of Spinal Cord Injury Model Systems Database (SCIMS) participants, pre-pandemic (2017–2019, n = 6368) and during pandemic (2020, n = 1889). Objectives: To examine differences in substance use during the pandemic compared to the years prior to the pandemic. Setting: 19 SCIMS Centers. Methods: Participant characteristics, wellness (depression, life satisfaction, resilience), participation, and substance use between the two cohorts were compared. Multiple logistic regression examined the association of the pandemic with substance use after accounting for other factors. Results: Characteristics of the two cohorts were similar. Cannabis and sedative uses were not greatly different (28.8% vs 25.1%, and 8.3% vs 6.6%) but did reach statistical significance. Non-prescribed opioid use was double for the pandemic group (6.6% vs 3.3%). Alcohol use patterns were similar across the two cohorts. Measures of wellness were similar, while the pandemic group reported lower participation. The odds of use of cannabis, sedatives, and opioids were 1.3, 1.3, and 2.2 times greater, respectively, for the pandemic cohort after accounting for demographics, wellness, and participation. Greater use of non-prescribed opioids was reported during the pandemic in the South compared to prior to the pandemic (13.8% vs 6.1%). Conclusions: The pandemic may have been associated with increased use of non-prescribed substances in the traumatic spinal cord injury population. Efforts to pursue longitudinal investigations would be warranted for definitive analysis of trends. The provision of demonstrably effective substance use treatment resources delivered via accessible methods will likely be needed in this population, particularly opioid treatment.

Non-Medical Treatments of Drooling by Speech and Language Pathologists in Cerebral Palsy Children: A Systematic Review

Background: Drooling, commonly observed in cerebral palsy children, negatively impacts different aspects of their lives. There are several treatment options for drooling, with no consensus on a single method as the most effective one. The current systematic review provides an overview of the evidence of the different non-medical intervention methods used by speech and language pathologists to reduce drooling in cerebral palsy children. Methods: A comprehensive and systematic search was conducted in the following electronic databases for publications from 2010-22: PubMed, Scopus, Science Direct, Web of Science, Cochrane Database of Systematic Reviews, and Google Scholar. The National Health and Medical Research Council (NHMRC)and the Physiotherapy Evidence Database (PEDro-P) scale were respectively used to determine the level of evidence and the methodological quality of articles. Results: Out of 2740 articles identified, 15 records met the inclusion criteria and were included in the study. The studies considered in this systematic review differed in the following criteria: design, participant characteristics, types of assessments and treatments, and follow-up periods. Non-medical interventions for drooling were found to be effective in alleviating the severity and decreasing the frequency of drooling. Conclusion: The results showed the effectiveness of nonmedical interventions for drooling in cerebral palsy children. The treatments provided by SLPs can be classified into three categories: oromotor and sensory interventions, behavioral interventions, and the use of Kinesio-tape. Among these, the use of oromotor interventions and oral sensory interventions, alone or combined with other approaches, was the most widely used method.

DOKTER KECIL: STUDENT EMPOWERMENT THROUGH LEARNING FIRST AID SKILL AND KNOWLEDGE

Introduction: Knowledge and skills of simple first aid are packaged by the UKS program through the role of Dokter Kecil. Interactive learning using video, demonstration and simulation activities has increased first aid knowledge and skills in primary school students. The aim of this community service program was to increase first aid knowledge and skills of wound care, nosebleed and syncope in school age children. Methods: The community service was conducted at SDN Komplek Kenjeran II in Surabaya, Indonesia, involving 40 students from grades 3 to 5. The intervention was provided in a 4-hour session, using video demonstrations and hands-on simulation. Pre-test and post-test questionnaires measured students' knowledge and attitudes before and after the training. Data were analyzed using descriptive statistics. Results: The demographic characteristics of participants were dominated by the age 10 years (37.5%), in fourth grade (42.5%) and female (62.5%). The average pre-test knowledge score was 65 and pre-test attitude score was 76.4. After doing interactive learning, demonstrations and simulations, the average student post-test score experienced a significant increase, namely 84.5 in the knowledge and 89.7 in the attitude. Conclusion: The Dokter Kecil program significantly improved students’ skills and knowledge in managing wound care, nosebleeds, and syncope. This empowerment program demonstrates the effectiveness of interactive learning in fostering critical first aid skills in school-aged children. Regular updates to the training content are recommended to ensure ongoing relevance and efficacy.