Intervention Studies Research Articles

Self-regulated learning processes of advanced musicians: A PRISMA review

This systematic review aimed to provide a comprehensive and up-to-date understanding of the current state of empirical research in self-regulated learning (SRL) and music, investigating learning strategies planned and employed by advanced musicians and evidence to support the benefits of SRL training for this population. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, we initially identified 3323 records related to our search, spanning the period from 2001 to 2023. Inclusion criteria consisted of peer-reviewed empirical articles reporting studies involving the participation of advanced (i.e., undergraduate and postgraduate student and professional) musicians using Zimmerman’s cyclical model of SRL and published in English, Spanish, Portuguese, or French. Forty-eight articles met all the inclusion criteria and were included in the review. We divided them into three types: reports of observational studies, descriptive-correlational, and intervention studies. We discuss the findings according to the three phases of Zimmerman’s cyclical model: forethought, performance/volitional control, and self-reflection, including the processes of goal setting, selection and adaptation of learning strategies, help seeking, time management, and self-evaluation and adaptation. Our analysis identified trends in the behavior of advanced musicians, particularly regarding practice quantity and musical achievement. Suggestions for future research indicate the need to invest in the training of instrumental and vocal teachers, so that they become familiar with SRL learning strategies that they can pass on to their students.

User Engagement With mHealth Interventions to Promote Treatment Adherence and Self-Management in People With Chronic Health Conditions: Systematic Review.

There are numerous mobile health (mHealth) interventions for treatment adherence and self-management; yet, little is known about user engagement or interaction with these technologies. This systematic review aimed to answer the following questions: (1) How is user engagement defined and measured in studies of mHealth interventions to promote adherence to prescribed medical or health regimens or self-management among people living with a health condition? (2) To what degree are patients engaging with these mHealth interventions? (3) What is the association between user engagement with mHealth interventions and adherence or self-management outcomes? (4) How often is user engagement a research end point? Scientific database (Ovid MEDLINE, Embase, Web of Science, PsycINFO, and CINAHL) search results (2016-2021) were screened for inclusion and exclusion criteria. Data were extracted in a standardized electronic form. No risk-of-bias assessment was conducted because this review aimed to characterize user engagement measurement rather than certainty in primary study results. The results were synthesized descriptively and thematically. A total of 292 studies were included for data extraction. The median number of participants per study was 77 (IQR 34-164). Most of the mHealth interventions were evaluated in nonrandomized studies (157/292, 53.8%), involved people with diabetes (51/292, 17.5%), targeted medication adherence (98/292, 33.6%), and comprised apps (220/292, 75.3%). The principal findings were as follows: (1) >60 unique terms were used to define user engagement; "use" (102/292, 34.9%) and "engagement" (94/292, 32.2%) were the most common; (2) a total of 11 distinct user engagement measurement approaches were identified; the use of objective user log-in data from an app or web portal (160/292, 54.8%) was the most common; (3) although engagement was inconsistently evaluated, most of the studies (99/195, 50.8%) reported >1 level of engagement due to the use of multiple measurement methods or analyses, decreased engagement across time (76/99, 77%), and results and conclusions suggesting that higher engagement was associated with positive adherence or self-management (60/103, 58.3%); and (4) user engagement was a research end point in only 19.2% (56/292) of the studies. The results revealed major limitations in the literature reviewed, including significant variability in how user engagement is defined, a tendency to rely on user log-in data over other measurements, and critical gaps in how user engagement is evaluated (infrequently evaluated over time or in relation to adherence or self-management outcomes and rarely considered a research end point). Recommendations are outlined in response to our findings with the goal of improving research rigor in this area. PROSPERO International Prospective Register of Systematic Reviews CRD42022289693; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022289693.

Recovery at your fingertips: pilot study of an mHealth intervention for work-related stress among nursing students

BackgroundWork-related stress is detrimental to individual health and incurs substantial social costs. Interventions to tackle this problem are urgently needed, with mHealth solutions being a promising way of delivering accessible and standardized interventions on a wide scale. This study pilot tests a low-intensive mHealth intervention designed to mitigate the negative consequences of stress through promoting recovery strategies.MethodsNursing school students (N = 16) used the intervention for a month. Data were collected immediately before, immediately after, and one month after the end of the intervention. Additionally, intensive longitudinal data were collected daily during the time of the intervention. Primary outcome measures include recruitment and retention rates, engagement with and acceptability of the intervention, as well as evaluating the quality of measurement instruments.ResultsRecruitment and retention rates provide a benchmark that we need to invite 10–12 times the intended target sample size. Engagement and acceptability metrics are promising overall, showing key areas that need to be adapted to improve the intervention. Measurement quality is acceptable with instruments mostly functioning as intended.ConclusionResults show that the intervention and study protocol are feasible for conducting a randomized controlled trial given a few adjustments. The randomization algorithm needs to match the sample size in order to allocate evenly distributed experimental groups. Acceptability of the intervention may be improved through adapting the recommended recovery strategies. Some additional outcome measures are suggested to provide a more comprehensive picture of intervention effects.Trial registrationNCT06228495. Registered retrospectively 01/10/2024.

Closing the gaps in alcohol behavior change: A real-world study of a digital intervention.

Closing the gaps in alcohol behavior change: A real-world study of a digital intervention.

The impact of high intensity training and sports on recipients of solid organ transplants: a narrative review

ObjectivesHigh intensity exercise in individuals post solid organ transplant (SOT) remains a largely understudied phenomenon, with potential risks and benefits. Additionally, the optimal training protocols are still unclear. This narrative review aimed to explore the impact of high-intensity exercise training and strenuous sports on solid organ transplant recipients (SOTRs).MethodsWe conducted a narrative review of intervention studies of any design that included high-intensity exercise training and cross-sectional studies of strenuous sports and activities. Additionally, we reviewed individual reports documenting post-SOT performance at highly competitive or physiological levels. We used MEDLINE to search for relevant articles followed by a manual search for additional articles. Data were extracted and results were summarized.ResultsHigh-intensity and strenuous exercise appears to be safe among stable SOTRs. High-intensity protocols consistently demonstrated improvements in VO2peak and a reduction in coronary artery disease prevalence, though findings related to body composition, health-related quality of life outcomes, and cardiovascular exercise variables were inconsistent. Pre-transplant athletes showcase notable achievements and physiological adaptations post-transplantation, highlighting the capacity for athletic performance among this population. However, caution is warranted in interpreting the findings from these studies due to limitations in generalizability and other methodological limitations.ConclusionAs evidenced by current literature, high intensity exercise emerges as a promising exercise method for safely improving various physiological parameters, and reducing the prevalence of coronary heart disease in SOTRs. It can induce similar or greater effects to moderate intensity exercise, however follow-up studies indicate low retention. Further research of higher methodological rigor is warranted in this field to advance understanding, and to guide evidence-based practice.

The Correlation Between Body Mass Index and Health-Related Quality of Life: Data from Two Weight Loss Intervention Studies.

The correlation between body mass index (BMI) and utility in participants with obesity was assessed using health-related quality-of-life data collected in two weight loss intervention studies, SCALE and STEP 1. Short Form Health Survey 36-Item (SF-36) scores from SCALE and STEP 1 were mapped to EuroQoL-5 dimensions-3 levels (EQ-5D-3L) using an established algorithm to derive utilities for the UK. SF-36 scores from STEP 1 were converted into Short Form 6dimension (SF-6D) utilities for Portugal using the tool developed by the University of Sheffield. The correlation between baseline BMI and utility was assessed by multiple linear regression analyses, controlling for demographic and clinical parameters. A higher baseline BMI correlated with lower EQ-5D-3L and SF-6D utilities, although the trend was non-significant. Assuming linearity between BMI ranges 30-40kg/m2, an additional unit of BMI correlated with 0.0041 and 0.0031 lower EQ-5D-3L scores in SCALE and 0.0039 and 0.0047 lower EQ-5D-3L and 0.0027 and 0.0020 lower SF-6D scores in STEP 1 for men and women, respectively. In individuals with comparable demographic characteristics and weight-related comorbidities, a 1 unit change in BMI leads to a difference of up to 0.005 in utility indices. ClinicalTrials.gov identifiers: SCALE (NCT01272219) and STEP 1 (NCT03548935).

Efficacy, Safety, and Tolerability of a Very Low-Calorie Ketogenic Diet in Women with Obesity and Symptomatic Knee Osteoarthritis: A Pilot Interventional Study

Background/Objectives: Obesity is a major risk factor for knee osteoarthritis (OA), and weight loss is crucial for its management. This pilot study explores the effects of a Very Low-Calorie Ketogenic Diet (VLCKD) in women with obesity and symptomatic knee OA. Methods: Women with symptomatic knee OA and obesity, defined as a body mass index (BMI) ≥ 30 kg/m2, were eligible for the VLCKD protocol. The intervention included a ketogenic phase from baseline (T0) to the 8th week (T8), followed by a progressive reintroduction of carbohydrates over the next 12 weeks, ending at the 20th week (T20). Body mass index (BMI), the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, the EuroQol 5D (EQ-5D), and the 36-item Short Form Health Survey (SF-36) were assessed at all time points. Generalized estimating equations were used to analyze the association between BMI and patient-reported outcomes across the study period. Results: Twenty participants started the study, but four discontinued the intervention, with two of these being due to adverse effects. The mean age of the 16 patients who completed the 20-week program was 57.3 ± 5.5 years, and their mean BMI was 40.0 ± 4.8 kg/m2. The mean BMI significantly decreased to 37.5 ± 4.5 at T4, 36.3 ± 4.6 at T8, and 34.8 ± 4.8 at T20 (all p < 0.001 compared to baseline). The total WOMAC score improved from a mean of 43.6 ± 16.9 at T0 to 30.2 ± 12.8 at T4 (p = 0.005) and further to 24.7 ± 10.6 at T8 (p = 0.001) and to 24.8 ± 15.9 at T20 (p = 0.005). The reduction in BMI was significantly correlated with the improvements in WOMAC, EQ-5D, and SF-36 over time. No major adverse effects were observed. Conclusions: A 20-week VLCKD in women with obesity and knee OA significantly reduced their weight and improved their outcomes, warranting further research. This trial is registered with number NCT05848544 on ClinicalTrials.gov.

Comparing E-Cigarettes and Traditional Cigarettes in Relation to Myocardial Infarction, Arrhythmias, and Sudden Cardiac Death: A Systematic Review and Meta-Analysis.

The use of electronic cigarettes (e-cigarettes) as a perceived safer alternative to traditional cigarettes has grown rapidly. However, the cardiovascular risks associated with e-cigarettes compared to regular cigarettes remain unclear. To systematically review and compare the cardiovascular outcomes of e-cigarette use versus traditional cigarette use, focusing on the risks of myocardial infarction, arrhythmias, and sudden death. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Peer-reviewed studies published in English were included if they reported cardiovascular outcomes related to e-cigarette or traditional cigarette use. A total of 20 studies were included, covering observational and interventional studies focusing on heart rate variability, myocardial infarction, arrhythmias, and sudden cardiac events. The quality of the evidence was assessed using the GRADE criteria, and data were extracted and analyzed based on the PICOS (Population, Interventions, Comparisons, Outcomes, and Study designs) framework. The systematic review found that both e-cigarettes and traditional cigarettes pose significant cardiovascular risks, with traditional cigarettes linked to a higher incidence of myocardial infarction, arrhythmias, and sudden cardiac death. E-cigarette users also face increased risks of arrhythmias and myocardial infarction compared to non-smokers, primarily due to the constituents of aerosolized e-liquid, including nicotine and flavorings, which contribute to adverse cardiac effects. Regular e-cigarette use, particularly in combination with traditional cigarette use, was associated with a heightened risk of myocardial infarction. Studies also reported heart function abnormalities, such as systolic and diastolic dysfunction, and reduced ejection fractions. Additionally, changes in heart rate variability, heart rate, and blood pressure were observed, indicating both acute and chronic effects of e-cigarettes on cardiovascular autonomic regulation. While e-cigarettes may present a lower cardiovascular risk compared to traditional cigarettes, they are not without harm. Both products are linked to increased risks of myocardial infarction and arrhythmias, though traditional cigarettes pose a higher overall threat. Given the limitations in the current evidence base, particularly concerning the long-term effects of e-cigarette use, further research is needed to clarify these cardiovascular risks and inform public health guidelines.

In-vitro and in-vivo comparative studies of treatment effects on enamel demineralization during orthodontic therapy: implications for clinical early-intervention strategy.

This study aimed to investigate if CPP-ACP / infiltrating resin was superior in treating enamel demineralization during orthodontic therapy compared with fluoride varnish, in order to provide early-intervention implications for dental professionals. In the in-vitro study, premolars were grouped into four: remineralization with fluoride varnish / CPP-ACP, sealing with infiltrating resin, and negative control. Experimental demineralization of enamel surfaces was analyzed using techniques of QLF, SEM, EDS and micro-hardness testing. An in-vivo intervention study was conducted on patients randomly assigned into three groups. At the baseline and every-3-month follow-up, QLF parameters were compared temporally and parallelly to yield potential implications for promotion in clinical practice. The in-vitro study performed on 48 experimental tooth surfaces demonstrated that sealing with infiltrating resin reduced enamel surface porosity and increased surface micro-hardness significantly. In the in-vivo intervention study on 163 tooth surfaces, it was suggested that for those who meet the criteria of -10 < ΔF < -6 and - 1000 < ΔQ < -20 at the baseline, all these treatment methods could achieve acceptable outcomes; with the rising of absolute values of ΔF and ΔQ, sealing with infiltrating resin showed more evident advantages. For enamel demineralization during orthodontic therapy, all the treatment methods involved in this study showed acceptable effectiveness but had respective characteristics in treatment effects. QLF parameters could be used as indicators for clinical early-intervention strategy with regards to this clinical issue. With QLF parameters, clinical early-intervention strategy for enamel demineralization during orthodontic therapy could be optimized.

Feasibility of a Novel Movement Preference Approach to Classify Case Complexity for Adults with Non-Specific Chronic Low Back Pain

The non-specific nature of low back pain (LBP) poses challenges in its diagnosis and clinical management. Classifying case complexity with an exercise method may help overcome these challenges. The present study proposed a movement-based classification system based on Dance Medicine Australia (DMA) Clinical Pilates for patients with non-specific chronic LBP. To test the feasibility of the proposed system, 40 adults with non-specific chronic LBP were assessed on their movement preference (i.e., movement directions that can relieve pain or are pain-free) through the DMA Clinical Pilates method. The movement preferences could be a combination of each of the following movement directions: (1) flexion or extension, (2) left or right lateral flexion and/or (3) left or right rotation. For cases that had central or bilateral pain, the number of movement preferences identified was used to guide the classification. Using the proposed system, all 40 (100%) LBP cases were successfully classified into basic (n = 8, 20%), intermediate (n = 17, 42.5%), advanced (n = 8, 20%) or expert (n = 7, 17.5%) levels of complexity. In conclusion, this study has demonstrated that the proposed movement-based classification system was a feasible method for classifying case complexity in adults with non-specific chronic LBP. Future clinical intervention studies are needed to confirm if this classification system can enhance therapeutic outcomes in patients.

The Effect of Cardiac Rehabilitation in Paediatric Fontan Circulation Patients: A Prospective Intervention Study

Background and Objectives: The Fontan procedure, a palliative surgery for univentricular heart physiology, often reduces exercise capacity and quality of life. This study aimed to evaluate the impact of cardiac rehabilitation (CR) on improving outcomes in Fontan patients to inform evidence-based care. Materials and Methods: Fontan patients aged 8–30 participated in a structured CR program for at least three months. The program included weekly aerobic and resistance training sessions with educational and nutritional guidance. Baseline and post-CR assessments included cardiac function, fitness, daily activity, and health-related quality of life (HRQOL). Results: The cohort included ten Fontan patients, of whom six had a right systemic ventricle. CR significantly improved cardiorespiratory fitness, as seen in VO2 max (from 27.92 ± 5.15 to 34.69 ± 1.14 mL/kg/min, p = 0.0089) and percent predicted VO2 (from 0.67 ± 0.18 to 0.90 ± 0.02, p = 0.005). VCO2 increased by +8.68 ± 8.59 mL/kg/min but did not reach statistical significance (p = 0.05). Most haemodynamic and ventilatory parameters showed no significant improvement. All the SF-36 questionnaire domains showed significant HRQOL gains (p &lt; 0.001). High adherence (85–93%), no adverse events, and reduced NT-proBNP levels supported the program’s safety. Conclusions: This study’s findings have important implications for the care of Fontan patients. CR significantly improved exercise capacity and HRQOL in Fontan patients across various anatomies, particularly in the right systemic ventricle. Integrating physical conditioning into standard care could reduce long-term morbidity and mortality; however, further research is needed to refine the protocols and confirm sustained benefits.

Effects of 4 weeks of device-induced normobaric intermittent hypoxia/hyperoxia training on the performance of elite cyclists: A pilot study

Introduction &amp; Purpose Classic altitude training and other forms of hypoxia are regularly used in endurance training (Mujika et al., 2019). Due to corona exit restrictions in 2019-2020, device-induced normobaric hypoxia/hyperoxia was suggested as an alternative to classic altitude training. Intermittent hypoxia/hyperoxia training (IHHT) has been studied and used in various forms since the 1940s (Serebrovskaya, 2002) with the advantage to be used at the athlete’s training site (Burtscher, 2005). The aim of this pilot study was to test the effects of a IHHT intervention on aerobic performance, hematological parameters and hypoxia-induced factor-1α (HIF-1α). Method A total of 11 athletes (2 women) from the U23 and elite national squads of the Austrian Cycling Federation completed 16 IHHT units in addition to their normal training program over a period of 4 weeks as part of a randomized cross over intervention study (control – IHHT, IHHT – control). The IHHT units were carried out on a Cellgym CellAir® Gecko Plus device at rest without exercise following a predetermined protocol (Sessions 1-8: 5 min of hypoxia (12.0% oxygen) followed by 3 min of hyperoxia (34.0% oxygen) repeated five times. Sessions 9-16): 6 min of hypoxia (11.0% oxygen) followed by 3 min of hyperoxia (34.0% oxygen). During the 4 weeks of control period, participants should maintain their training schedule. Aerobic performance was determined before and after the intervention by spiroergometry. As secondary outcomes, changes in hematological parameters and protein levels of HIF-1α were determined from venous blood which was processed immediately after collection. Serum was stored at -80 °C until HIF-1 α determination by ELISA technique. Results Eleven out of 13 athletes took part in the pre – post IHHT measurements, but only three of them managed to participate in the measurements planned for the control period, making it impossible to compare the two conditions. Replacement was not possible due to the availability of candidates and the ongoing preparation for the season. After 4 weeks of intervention with 16 IHHT training sessions, no significant changes were observed in performance parameters such as VO2peak, relative VO2max, maximum power (watts) or threshold values (p &gt; 0.05). There were also no significant changes in blood enzymes, lipid and iron metabolism (p &gt; 0.05). However, a tendency towards increased values of haemoglobin (z = 1.738; p = 0.082) and a significant increase of erythrocyte counts (z = 2.193; p = 0.028) were detected. Other haematological parameters and HIF-1α did not change significantly (p &gt; 0.05). Discussion &amp; Conclusion In summary, four weeks of device-induced normobaric IHHT had a modest effect on haematological parameters, but with no detectable transfer to maximal or submaximal endurance performance in highly trained athletes. Although various studies have shown that the difference between normobaric and hypobaric hypoxia exposure is not limited to the partial pressure of oxygen, but Mounier and Brugniaux state that the physiological responses are in fact equivalent (Mounier &amp; Brugniaux, 2012). However, due to the limitations of the competitive setting and the low sample size, the final interpretation of the study remains difficult. References Burtscher, M. (2005). Intermittierende Hypoxie: Höhenvorbereitung, Training, Therapie [Intermittent hypoxia: altitude preparation, training, therapy]. Schweizerische Zeitschrift für Sportmedizin und Sporttraumatologie, 53(2), 61-67. Serebrovskaya, T. V. (2002). Intermittent hypoxia research in the former Soviet Union and the commonwealth of independent states: History and review of the concept and selected applications. High Altitude Medicine &amp; Biology, 3(2), 205-221. https://doi.org/10.1089/15270290260131939 Mounier, R., &amp; Brugniaux, J. V. (2012). Counterpoint: Hypobaric hypoxia does not induce different responses from normobaric hypoxia. Journal of Applied Physiology, 112(10), 1784-1786. https://doi.org/10.1152/japplphysiol.00067.2012a Mujika, I., Sharma, A. P., &amp; Stellingwerff, T. (2019). Contemporary periodization of altitude training for elite endurance athletes: A narrative review. Sports Medicine, 49, 1651-1669. https://doi.org/10.1007/s40279-019-01165-y

No Effect of Hunger on the Memory of Food Images and Prices

Abstract Purpose Food acquisition is an adaptive problem resolved via both physiological and psychological processes. Hunger could serve as a coordinating mechanism for these processes. When hunger increases, it may be beneficial to shift cognitive resources away from other adaptive problems and towards functions that increase the chances of acquiring food, such as memory for food information. However, there is limited research exploring the impacts of hunger on food-related memory, and the results are mixed. We conducted two studies investigating whether increased hunger levels improve memory for food images and prices – but not non-food images and prices – in image recognition and price recall tasks, respectively. Methods Study 1 was an online, observational study (N = 91) using self-reported hunger as a continuous measure. Study 2 was an in-person, between-subjects interventional study (N = 102) where participants were randomly allocated to a hungry or sated condition. We predicted that higher levels of hunger would improve participants’ ability to discriminate between food images they have and have not seen before and correctly recall food prices. Results We found no evidence of a hunger-related memory enhancement for food stimuli in either study in image recognition or price recall tasks. Conclusion Our findings contrast with older research but support more recent work, suggesting that the effect of hunger on food memory may be sensitive to study design and not as broadly generalisable as first thought.

Early life factors that affect obesity and the need for complex solutions.

The prevalence of obesity increases with age but is apparent even in early life. Early childhood is a critical period for development that is known to influence future health. Even so, the focus on obesity in this phase, and the factors that affect the development of obesity, has only emerged over the past two decades. Furthermore, there is a paucity of iterative work in this area that would move the field forward. Obesity is a complex condition involving the interplay of multiple influences at different levels: the individual and biological level, the sociocultural level, and the environmental and system levels. This Review provides a brief overview of the evidence for these factors with a focus on aspects specific to early life. By spotlighting the complex web of interactions between the broad range of influences, both causal and risk markers, we highlight the complex nature of the condition. Much work in the early life field remains observational and many of the intervention studies are limited by a focus on single influences and a disjointed approach to solutions. Yet the complexity of obesity necessitates coordinated multi-focused solutions and joined-up action across the first 2,000days from conception, and beyond.

Pathways of Socioeconomic Disadvantage and Peer Bullying in Children and Youth: A Scoping Review

Growing up in socioeconomic disadvantage increases risk of peer bullying at school. Both socioeconomic status and involvement in bullying are predictive of a range of adverse developmental outcomes. However, neither (a) the mechanisms whereby disadvantage increases bullying risk nor (b) the developmental outcomes for which bullying may mediate disadvantage are clear. This review scoped the literature on the relationships between socioeconomic disadvantage, bullying, and health and developmental outcomes for school-aged children and adolescents. Four databases were searched up to June 3, 2023 with 565 studies retrieved, of which 17 met criteria. Most studies were cross-sectional, and studies varied greatly in their definition and measurement of both bullying involvement and disadvantage. No intervention studies were found. Mediators of the disadvantage-bullying association ranged from individual level (e.g., depression) to the national level (e.g., homicide rate); only two studies examined bully–victim status. Of studies where bullying was a mediator, none examined bullying perpetration; the range of outcomes examined was narrowly focused on mental health, failing to capture the full range of developmental outcomes associated with either socioeconomic disadvantage or bullying involvement. This review highlights that future research is needed on identifying and understanding the mediators of the association between disadvantage and bullying victimization, and on the developmental outcomes mediated by bullying perpetration for disadvantaged children. These insights are critical to increase the effectiveness of community- and school-based bullying prevention, particularly in communities with high proportions of socioeconomically disadvantaged families.

Epigenetic Modifications Among Children with Autism in Response to Phoenix dactylifera: An Intervention Study.

Epigenetic Modifications Among Children with Autism in Response to Phoenix dactylifera: An Intervention Study.

From Dependent to Self-Directed Learning in Medical Education: Can Online Modular Intervention Facilitate the Transition?

Background: Indian medical graduates are expected to be lifelong learners, and medical teachers need to find newer and more engaging ways to help them hone their lifelong learning skills. Online learning can be a stepping stone toward this goal. Methods: We conducted a pre-post design interventional study in which 22 phase two MBBS students rated their self-directedness in learning using the Self-Rating Scale of Self-directed Learning (SRSSDL) at two points in time—before and after completing a 10-week online basic psychopharmacology module. Participant feedback was obtained regarding various aspects of the online modular learning experience. Results: The participants’ mean SRSSDL scores before and after the intervention were 231.31 ± 26.64 and 227.31 ± 31.33. The difference is not significant. The students’ scores at both points in time placed them in the “high” range of level of self-directed learning, leaving less realistic scope for a large change in the given time frame. Participant feedback was encouraging, with 19 out of 22 reporting that the overall learning experience was a “positive” one. Conclusions: Second-year medical students’ self-reported self-directedness is high. Online modular learning may be a feasible addition to medical education, even though it may not increase self-directedness in the short term. A limited sample size can lead to type 2 errors.

Abstract B143: Associations between the food environment and food insecurity on fruit and vegetable intake among urban-dwelling Latina breast cancer survivors participating in the Mi Vida Saludable trial

Abstract Socioeconomic disparities prevalent in Hispanic populations may cause inequities in cancer outcomes and risk factors. We explored the association of access to healthy foods (AHF) and food insecurity (FI) with changes in fruit and vegetable (FV) intake in Latina breast cancer (BC) survivors living in New York City who participated in the Mi Vida Saludable trial. Mi Vida Saludable was a 2x2 factorial trial (n=167) that tested the effects of an in-person and/or eHealth intervention on FV intake and physical activity (PA). Main study results showed only the in-person intervention had modest increases in FV intake. Eligibility criteria included being female, self-identifying as Latina/Hispanic, ³18 years old, history of stage 0-III BC, &amp;gt;3 months post-treatment, &amp;lt;5 daily serving of FV and/or &amp;lt;150 minutes/week of moderate-vigorous PA. FV intake was assessed via 3 24-hour diet recalls at baseline and 12 months. AHF was from a modified validated Access to Healthy Food scale. FI was assessed via questions about eating less or going hungry due to lack of money. Generalized estimating equations examined whether baseline AHF and FI were associated with change in daily FV intake, adjusting for baseline age, marital status, education, and study arm. Three-way interaction terms (AHF or FI with time and study arm) were included to test if associations of AHF and FI with change in FV intake varied by intervention arms. FV intake was log-transformed due to a non-normal distribution; percent changes from baseline were described. AHF was measured in 86 women with 58% and 42% reporting low-medium and high access, respectively. Women with high AHF were more likely to be older (59 vs. 53 years, p=.002) and scored lower on a 5-point acculturation scale (higher score suggests higher acculturation, 1.8 vs. 2.1, p=.01). FI, measured in 157 participant, was prevalent in 23% of women. Women with FI were more likely to be single (44% vs. 16%, p=.003), renting (100% vs. 86%, p=.02), and have higher mean BMI (31 vs. 29 kg/m2, p=.02). 3-way interactions were not statistically significant, though analyses were likely underpowered. In the control group, the adjusted daily FV intake decreased by 79% (p=.01) from baseline to 12 months for women with low-medium AHF and by 49% (p=.10) for those with high AHF; similarly, daily FV intake decreased by 64% (p=.01) for women with FI and by 58% (p=.01) for women without FI. Most Latina BC survivors in New York City who participated in a 12-month diet and PA intervention trial had low-medium AHF at baseline; nearly 1/4 had FI. Associations of AHF or FI with changes in FV intake did not vary significantly by study arm, although sample sizes across strata were small. In the control arm, women with low-medium AHF and FI had larger decreases in FV intake after 12 months. Future dietary intervention studies in Latina BC survivors, and other underserved or under-resourced populations, should account for AHF and FI in the study design, and develop strategies to connect people to healthy food resources. Citation Format: Zachary O. Kadro, Eileen Rillamas-Sun, Blake Langley, Pam Koch, Isobel Contento, Ann Ogden Gaffney, Allison Meisner, Heather Greenlee. Associations between the food environment and food insecurity on fruit and vegetable intake among urban-dwelling Latina breast cancer survivors participating in the Mi Vida Saludable trial [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B143.

Abstract B044: Assessing Native Americans’ readiness for lung cancer screening and smoking cessation

Abstract Introduction: Among all U.S. racial/ethnic populations, Native Americans (American Indians) experience the highest rates of commercial tobacco use and lung cancer incidence and mortality. The goal of the Native American Commercial Tobacco and lung cancer screening InterventiON Study (NACTIONS) is to address these disparities by measurably increasing lung cancer screening (LCS) in the context of smoking cessation. Building off a history of collaborations, the University of California, Davis (UCD) reached out to two Native-serving Federally Qualified Health Centers (FQHCs) in its catchment area to co-design means to improve lung health among their Native patients. Methods: In recognition of the extra time and effort involved, the UCD offered modest funding to these two FQHCs in inland northern California as well as gift cards for providers in sharing their practices in offering smoking cessation and LCS as well as interviews with their Native patients. Eligibility criteria for LCS were based on the 2021 US Preventive Services Task Force Recommendations that specified age: 50-80 years old and smoking history of 20 pack years for current smokers or those who quit within the past 15 years. We interviewed 14 providers and two categories of Native patients: both who had completed LCS (n=9) and those who are eligible but had not yet been screened (n=8) to understand facilitators, barriers, and solutions. A Native leader provided us with a conceptual framework to understand Native resiliency in addressing addiction to guide our approach. We also convened monthly meetings to discuss observations and co-design next steps. Findings: Both FQHCs reported approximately 400 Native patients eligible for LCS, but the readiness levels for interventions to promote smoking cessation and LCS were not the same. Each FQHC is under-resourced and each FQHC’s electronic medical system was not originally formulated for research. However, IT directors were willing to increase their scope to document patients’ readiness for intervention and their smoking histories through the LCS process. Common to both FQHCs is the essentiality of earned trust with their patients; adapting each FQHC’s electronic health system for precisely identifying eligible patients and longitudinally following them; assessing their social determinants of health; and the need to provide lung health education for the entire community. For instance, the high prevalence of diabetes, substance abuse, homelessness, etc. must be considered and the need to have tribal, friends, and family support for lung health can be reinforced through community-wide health education and patient navigation. Conclusions: This needs assessment documented factors that will enhance efforts for promoting LCS and smoking cessation at two Native-serving FQHCs. Promoting lung health through smoking cessation and increased completions of LCS can be better achieved through collaboration, addressing both social and physiological determinants of health, and earned trust. Citation Format: Julie Dang, Mayra Sandoval, David Cooke, Miriam Nuno, Carla Martin, Bobbi Jo Simmons, Teresa Martens, Elisa Tong, Moon S. Chen Jr. Assessing Native Americans’ readiness for lung cancer screening and smoking cessation [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B044.

Differences in human and commercial hybrid pig platelet activation induced by borosilicate glass beads in a modified chandler loop-system.

The pig (Sus scrofa) is the most widely used large animal model in Europe, with cardiovascular research being one of the main areas of application. Adequate refinement of interventional studies in this field, meeting the requirements of Russell and Burch's 3 R concept, can only be performed if blood-contacting medical devices are hemocompatible. Because most medical devices for cardiovascular interventional procedures are developed for humans, they are tested only for compatibility with human blood. The aim of this study was therefore to determine whether there are differences in behavior of human and porcine platelets from commercial hybrid pigs when they come into contact with borosilicate glass, which was used as an exemplary thrombogenic material. For this purpose, changes in platelet count, platelet volume and platelet expression of the activation markers CD61, CD62P and CD63 were measured using a modified chandler loop-system simulating the fluidic effects of the bloodflow. Commercial hybrid pig and human platelets showed significant adhesions to borosilicate glass but the commercial hybrid pigs platelets showed a significantly higher tendency to adhere to borosilicate glass. In contrast to human platelets the platelets of commercial hybrid pigs showed significant activation after 4 to 8 minutes exposure to borosilicate glass and there were differences among the ratios of surface and activation markers in between the platelets of both species.