Participant Characteristics Research Articles

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.

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.

A Scoping Review of Patient Health-Related Quality of Life Following Surgery or Molecular Testing for Individuals with Indeterminate Thyroid Nodules.

Molecular testing can reduce the need for diagnostic thyroidectomy in cytologically indeterminate thyroid nodules. However, the health-related quality of life in patients managed with molecular testing is not well studied. The objective of this scoping review was to identify and analyze the health-related quality of life outcomes in patients with indeterminate thyroid nodules who are expected to undergo or have undergone surgery or molecular testing. A comprehensive search was conducted on PubMed, Scopus, PsychINFO, and Embase to identify relevant studies. The search terms included "thyroid neoplasms" or "thyroid nodule" and "molecular testing" or "surgery" and "quality of life". The included articles were analyzed for their main study objective, study design, participant characteristics, and main results. Eight studies were included in this scoping review. Four evaluated the quality-adjusted life years for patients with indeterminate thyroid nodules. Three of these studies found that molecular testing slightly improved quality-adjusted life years compared to surgery, while one study found no difference. Two studies assessed surgical health-related quality of life outcomes and reported that patients with indeterminate thyroid nodules who were expected to undergo surgery favored surgical procedures, while those who underwent surgery experienced impaired health-related quality of life. Two studies evaluated molecular testing in patients with indeterminate thyroid nodules and found that the final molecular test result significantly impacted health-related quality of life outcomes. Patients with suspicious/positive molecular test results had worse symptoms of goiter, anxiety, and depression, while those with benign results had preserved health-related quality of life scores. Patients with benign results from molecular testing experience better health-related quality of life within the first year compared to those with benign surgical outcomes. This scoping review highlights the importance of considering health-related quality of life outcomes in the management of patients with indeterminate thyroid nodules. Benign molecular testing results yield better quality of life than benign surgical outcomes within the first year, suggesting molecular testing as a preferable option. Further research comparing the impact of surgery and molecular testing on health-related quality of life is needed to improve shared decision-making and patient outcomes.

The Relationship between Components of Postural Control and Locomotive Syndrome in Older Adults.

Locomotive Syndrome (LS), a condition related to impaired mobility, is influenced by balance control, which comprises six components. Deficiencies in these components can lead to reduced mobility and decreased quality of life. This study aimed to evaluate the relationship between the components of postural control and LS in older adults using the Brief-BESTest. Therefore, this cross-sectional study involved 122 elderly participants from Tha Sala District, Nakhon Si Thammarat Province, both with and without LS. Participants underwent assessments using the Instrumental Activities of Daily Living (IADL) assessment, the Thai Mental State Examination (TMSE), the Two-Step Test, and the Brief-BESTest. The Brief-BESTest covers six balance components: Biomechanical Constraints, Stability Limits, Anticipatory Postural Adjustments, Postural Responses, Sensory Orientation, and Stability in Gait. Descriptive statistics were used to summarize participant characteristics, and Chi-square tests were conducted to examine the relationship between each balance component and LS. Cramer's V was used to assess the strength of the relationships. The results showed the average age of the sample was 67.67 ± 6.01 years with 85.20 percent female and 14.80 percent male. There were significant relationships between LS and three balance components: Biomechanical Constraints (Chi-square = 5.35, p = 0.021, Cramer's V = 0.209), Stability Limits (Chi-square = 5.00, p = 0.025, Cramer's V = 0.204), and Anticipatory Postural Adjustments (left: Chi-square = 4.12, p = 0.042, Cramer's V = 0.213; right: Chi-square = 5.50, p = 0.019, Cramer's V = 0.213). No significant associations were found for Reactive Postural Response, Sensory Orientation, and Stability in Gait. These findings suggest that targeted interventions focusing on specific balance components consist of Biomechanical Constraints, Stability Limits, and Anticipatory Postural Adjustments could help reduce the risk of LS in older adults.

Characterizing the Effects of Concussion and Head Impact Exposure: Design, Methods, and Participant Traits of the CARE 2.0 Study.

This article describes the design, methods, and participant characteristics of the second phase of the Concussion Assessment, Research, and Education (CARE) Consortium study ("CARE 2.0") of the effects of concussion and repetitive head impact exposure on neuropsychiatric health. The authors conducted a prospective multisite observational study of male and female collegiate athletes and military service academy cadets and midshipmen participating in the CARE study. Participants were assessed at three time points: undergraduate baseline (UB), before departure from university or service academy (exit), and up to 6 years following graduation (postgrad) via an online battery of brain health assessments. Participant characteristics were compared across the three time points and four levels of head impact exposure. A total of 4,643 participants completed the exit assessment, and 3,981 completed the postgrad assessment. Relative to the UB assessment cohort, the exit and postgrad assessment cohorts differed with respect to the percentage of women, baseline Wechsler Test of Adult Reading scores, National Collegiate Athletic Association division category, sport contact level, and number of previous concussions. The median standardized difference across balancing variables, assessment time points, and degree of head impact exposure was 0.12 (with 90% of effect sizes ≤0.29). Although there were some statistically significant differences between participants across assessments, the effect sizes were modest, and overall the data suggest that the exit and postgrad cohorts reflect the characteristics of the baseline cohort. The CARE study design and its large, richly characterized sample provide an opportunity to answer important questions about cumulative and persistent effects of concussion and repetitive head impact exposure on neuropsychiatric health.

Adherence to high-frequency ecological momentary assessment in persons with moderate-to-severe traumatic brain injury.

Ecological momentary assessment (EMA) involves repeated collection of real-time self-report data, often multiple times per day, nearly always delivered electronically by smartphone. While EMA has shown promise for researching internal states, behaviors, and experiences in multiple populations, concerns remain regarding its feasibility in samples with cognitive impairments, like those associated with chronic moderate-to-severe traumatic brain injury (TBI). This study examines adherence to a 7-week high-frequency (5x daily) EMA protocol in individuals with moderate-to-severe TBI, considering changes in response rate over time, as well as individual participant characteristics (memory function, education, injury severity, and age). In the sample of 39 participants, the average overall response rate was 65% (range: 5%-100%). Linear mixed-effects modeling revealed a small but statistically significant linear decay in response rate over 7 weeks of participation. Individual trajectories were variable, as evidenced by the significant effect of random slope. A better response rate was positively associated with greater educational attainment and better episodic memory function (statistical trend), whereas the effects of age and injury severity were not significant. These findings shed light on the potential of EMA in TBI studies but underscore the need for tailored strategies to address individual barriers to adherence.

Protein supplementation preserves muscle mass in persons against sleeve gastrectomy.

Sleeve gastrectomy surgery can lead to deficiencies in both macro and micronutrients, with protein being particularly crucial due to its role in muscle mass, physiological, and metabolic functions. Inadequate protein intake due to physiological, psychological, or financial reasons may prevent achieving the recommended intake levels. The significance of this issue is often underappreciated. This study evaluates the impact of protein supplementation on muscle mass in individuals undergoing sleeve gastrectomy and emphasizes the need for more comprehensive dietary training by expert dietitians. Data were collected from 60 participants (15 male, 45 female, aged 20-54) who visited the surgery clinic. Participants were divided into two groups: those receiving the recommended protein supplement (15 g/day) with post-bariatric surgery diet training (BSD + PS), and those receiving only the post-bariatric surgery diet (BSD). A pre-surgery questionnaire gathered health and general information. Daily energy and nutrient intakes were recorded using 24-h food consumption logs on the day before surgery and at 7 days, 1 month, and 3 months postoperatively. Anthropometric measurements, including muscle and fat mass, and International Physical Activity Questionnaire (IPAQ) data were also collected. The characteristics of participants in both groups were similar, although there were more females in the BSD + PS group (86.7%) compared to the BSD group (63.3%). Despite an increase in energy and nutrient intake over time, levels remained below the recommended amounts in both groups. A significant difference was found in protein supplement consumption between the groups (p = 0.000). Repeated measures showed significant differences in body muscle mass percentage over time (F = 202.784; p = 0.000). In individuals who underwent sleeve gastrectomy surgery, deficiencies in macro and micronutrient intake were observed below reference levels. For this reason, the first approach in the treatment of obesity should always be medical nutrition therapy accompanied by a dietician. When designing post-bariatric surgery nutrition programs, it should be taken into consideration that nutrition protocols and trainings should be followed more closely and given in more detail under the supervision of a specialist before supplements are considered.

The Danish National Health Survey 2023: study design and participant characteristics.

To describe the design of the Danish National Health Survey (DNHS) 2023, participants' demographic characteristics and differences in demographic and selected health-related characteristics between respondents invited by web-mode and paper-mode. A sample of 25,000 residents in Denmark aged 16 years or above was invited to participate in the DNHS 2023 using a mixed-mode approach (web/paper mode). Web-mode invited were additionally invited to participate in an accelerometer study. The self-administered questionnaire included 83 questions about health, health behaviour and morbidity. Descriptive statistics were used to describe characteristics associated with response and invitation mode. The response proportion was 40.8%. Non-response was more frequent among men, individuals of the youngest age groups, individuals with non-Western backgrounds, unmarried and individuals from densely populated areas. The response proportion was higher among web-mode invited (42.0%) than paper-mode invited (22.6%). Paper-mode invited respondents were more often women, aged 80 years or older, and widowed compared with web-mode invited respondents. The DNHS 2023 is a national health survey including adult residents in Denmark. Non-response was more pronounced among some subgroups; however, calibrated weights were calculated to minimise non-response bias. The survey is essential for public health surveillance and can be used in health planning and policy development. Furthermore, the data from the survey can be used for research on the population's health and health behaviour. For future waves of the DNHS, it should be considered whether resources should be used to invite people unsubscribed from digital-post due to the low response proportion.

Psychological traits of extreme sport participants: a scoping review.

Extreme sports have increased in popularity, particularly over the past two decades. Theories explaining participation in extreme sports tend to focus on risk. Consequently, extreme sports participants are often characterized by an accentuated desire for risk and abnormal personal traits, but the positive aspects of extreme sports are often neglected in the literature. This scoping review summarizes extreme sport motives, emotions and personal characteristics. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) Checklist, three databases were searched (PubMed, Web of Science, Scopus, SportDiscus and, PsycInfo) on 20th April 2023. Studies were included if they were originally articles written in English and examined psychology traits in extreme sport participants. In total, 39 manuscripts met the inclusion criteria and were analyzed in the present review. There is no unique profile for individuals involved in extreme sports. Risk and fear are considered natural characteristic of participation, and many positive aspects are associated with involvement in extreme sports (e.g., organization, planning, confidence). The quality of experience is often reported to justify extreme sport participation. Changes in emotions and motives characterized the reversal theory, which in combination with the flow approach, could explain the participation in extreme activities. A dynamic ecological approach considering the interaction between individuals and the environment should be adopted to understand individual motives, behaviour and emotions.