Longitudinal changes in habitual physical activity in adult people with cystic fibrosis in the presence or absence of treatment with elexacaftor/tezacaftor/ivacaftor

Background

Habitual physical activity (PA) and exercise training are accepted as important aspects of care for people with cystic fibrosis (pwCF) to improve health-related measures of physical fitness, which in turn have a positive impact on quality of life and prognosis. In the last decade, effective CFTR modulator therapies have become a promising treatment for pwCF by targeting the underlying cause of CF. This highly effective therapy improves clinical outcomes and quality of life in people with specific CFTR mutations. Little is known about the longitudinal pattern of PA or the impact of the highly effective modulator therapy with Elexacaftor/Tezacaftor/Ivacaftor (ETI) on PA in adult pwCF. This study assessed the course of device-based PA measurement in adult pwCF and evaluated the effects of ETI on habitual physical activity in those who were eligible for ETI.

Methods

Data from adult pwCF (aged ≥18 years) were analysed at baseline and follow-up, using identical assessments at both time points. Outcome parameters were PA in steps/day and the intensity of PA. The group that received ETI was treated for an average of 33 weeks and not for the entire duration of the period. The data were collected between 2021 and 2022, following the removal of absolute pandemic restrictions/lockdowns.

Results

Follow-up duration was 5.6 years in pwCF with ETI (ETI group, n = 21) and 6.5 years in pwCF without ETI (non-ETI group, n = 6). From baseline to follow-up, pwCF treated with ETI had a significant increase in steps/day (+25%, p = 0.019) and a non-significant increase in moderate-to-vigorous intensity time (+5.6%, p = 0.352). Conversely, individuals in the non-ETI group showed a non-significant decrease in both steps/day -3.2%, p = 0.893) and moderate-to-vigorous intensity time (-25%, p = 0.207). The ETI group showed a significant decrease in percent predicted forced expiratory volume in 1 s (ppFEV1) and FEV1 z-score before the start of ETI treatment, both of which improved significantly after therapy initiation. Body weight and body mass index also improved significantly with ETI use.

Conclusions

These data suggest that ETI treatment has a positive effect on habitual physical activity behavior in the adult pwCF studied.

Marital status over 28 years of parents of individuals with autism and other developmental disabilities

Longitudinal, prospective analyses of marital status in parents of individuals with autism are needed to better understand the types and timing of supports needed to mitigate the impact of divorce on the family. We describe the timing of divorce and the factors that contribute to divorce in a longitudinal sample of families of individuals with autism and other developmental disabilities. Participants included parents of 219 children initially referred for autism and other developmental delays followed to age 30 years. Approximately 36% of individuals in our sample experienced a parental divorce by age 30. Higher rates of divorce were associated with lower maternal education and families of color and moderately associated with younger maternal age at child's birth, autism symptom severity, and ASD diagnosis. Divorces were most common in children's early years (under age 5) and also in the teenage years and beyond (over age 15). After age 15, higher risk was associated with the child's higher cognitive ability and daily living skills, and being a multiplex family. Results suggest that divorce risk in families of children with autism remains high through childhood into early adulthood. Understanding factors related to changes in marital status may help support families across time. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Training augmentation using additive sensory noise in a lunar rover navigation task

Background

The uncertain environments of future space missions means that astronauts will need to acquire new skills rapidly; thus, a non-invasive method to enhance learning of complex tasks is desirable. Stochastic resonance (SR) is a phenomenon where adding noise improves the throughput of a weak signal. SR has been shown to improve perception and cognitive performance in certain individuals. However, the learning of operational tasks and behavioral health effects of repeated noise exposure aimed to elicit SR are unknown.

Objective

We evaluated the long-term impacts and acceptability of repeated auditory white noise (AWN) and/or noisy galvanic vestibular stimulation (nGVS) on operational learning and behavioral health.

Methods

Subjects (n = 24) participated in a time longitudinal experiment to access learning and behavioral health. Subjects were assigned to one of our four treatments: sham, AWN (55 dB SPL), nGVS (0.5 mA), and their combination to create a multi-modal SR (MMSR) condition. To assess the effects of additive noise on learning, these treatments were administered continuously during a lunar rover simulation in virtual reality. To assess behavioral health, subjects completed daily, subjective questionnaires related to their mood, sleep, stress, and their perceived acceptance of noise stimulation.

Results

We found that subjects learned the lunar rover task over time, as shown by significantly lower power required for the rover to complete traverses (p < 0.005) and increased object identification accuracy in the environment (p = 0.05), but this was not influenced by additive SR noise (p = 0.58). We found no influence of noise on mood or stress following stimulation (p > 0.09). We found marginally significant longitudinal effects of noise on behavioral health (p = 0.06) as measured by strain and sleep. We found slight differences in stimulation acceptability between treatment groups, and notably nGVS was found to be more distracting than sham (p = 0.006).

Conclusion

Our results suggest that repeatedly administering sensory noise does not improve long-term operational learning performance or affect behavioral health. We also find that repetitive noise administration is acceptable in this context. While additive noise does not improve performance in this paradigm, if it were used for other contexts, it appears acceptable without negative longitudinal effects.

Changes of perceived Neighbourhood environment: A longitudinal study of collective efficacy among vulnerable families

Neighbourhood level factors are associated with individual's behaviours but limited empirical research investigate the long-term changes of neighbourhood factors, especially neighbourhood collective efficacy. Moreover, the longitudinal effects of neighbourhood structural factors on neighbourhood process factors worth further research. Thus, the current study examined the (1) the long-term trajectory of collective efficacy; (2) whether the time-varying neighbourhood structural factors are associated with collective efficacy over time. Using the four waves of FFCWS data (N = 4898), the current research found that neighbourhood social cohesion and informal social control increased over time, and the changes of neighbourhood structural factors are associated with the changes of collective efficacy over time. Identifying the dynamic changes of neighbourhood factors would benefit the further investigations of the influences of neighbourhood factors on individuals, and the implications of the findings were discussed.

Effects of Persistent Exposure to COVID-19 on Mental Health Outcomes Among Trainees: a Longitudinal Survey Study

BACKGROUND

The rapid spread of the coronavirus disease 2019 (COVID-19) has created considerable strain on the physical and mental health of healthcare workers around the world. The effects have been acute for physician trainees-a unique group functioning simultaneously as learners and care providers with limited autonomy.

OBJECTIVE

To investigate the longitudinal effects of physician trainee exposure to patients being tested for COVID-19 on stress, anxiety, depression, and burnout using three surveys conducted during the early phase of the pandemic.

DESIGN

Longitudinal survey study.

PARTICIPANTS

All physician trainees (N = 1375) at an academic medical center.

MAIN MEASURE

Assess the relationship between repeated exposure to patients being tested for COVID-19 and stress, anxiety, depression, and burnout.

KEY RESULTS

Three hundred eighty-nine trainees completed the baseline survey (28.3%). Of these, 191 and 136 completed the ensuing surveys. Mean stress, anxiety, and burnout decreased by 21% (95% confidence interval (CI): - 28 to - 12%; P < 0.001), 25% (95% CI: - 36 to - 11%; P < 0.001), and 13% (95% CI: - 18 to - 7%; P < 0.001), respectively, per survey. However, for each survey time point, there was mean increase in stress, anxiety, and burnout per additional exposure: stress [24% (95% CI: + 12 to + 38%; P < 0.001)], anxiety [22% (95% CI: + 2 to + 46%; P = 0.026)], and burnout [18% (95% CI: + 10 to + 28%; P < 0.001)]. For depression, the association between exposure was strongest for the third survey, where mean depression scores increased by 33% per additional exposure (95% CI: + 18 to + 50%; P < 0.001).

CONCLUSIONS

Training programs should adapt to address the detrimental effects of the "pileup" of distress associated with persistent exposure through adaptive programs that allow flexibility for time off and recovery.

The Roles of Grit and Motivation in Predicting Children's Leisure-Time Physical Activity: One-Year Effects

In this study, we tested two alternative models for investigating the ability of dimensions of personal grit (consistency of interest and perseverance of effort) and autonomous motivation to predict the leisure-time physical activity (LTPA) over a one-year period of 256 youth (aged 11-15 years at the beginning of the study). Specifically, we compared a model in which dimensions of grit were assumed to predict LTPA through autonomous motivation with a model in which autonomous motivation was assumed to predict LTPA through dimensions of grit. We tested the two models using variance-based structural equation modelling with Warp PLS v7.0 software. Both models showed a good fit with the data and equally explained 41% of the variance in LTPA over this one-year time period. However, the model based on the total effect of autonomous motivation (β = 0.448, p < 0.001, ES = 0.229) on LTPA through the dimensions of grit was stronger than the model based on the total effect of perseverance of effort (β = 0.356, p < 0.001, ES = 0.126) on LTPA through autonomous motivation, and the total effect of consistency of interest was not significant (β = -0.029, p > 0.05, ES = 0.003). Our findings underscore the relatively greater importance of the interplay between autonomous motivation and perseverance of effort, versus consistency of interest, in predicting LTPA among youth over a one-year period.

The long-term indirect effect of the early Family Check-Up intervention on adolescent internalizing and externalizing symptoms via inhibitory control

This study examined the long-term effects of a randomized controlled trial of the Family Check-Up (FCU) intervention initiated at age 2 on inhibitory control in middle childhood and adolescent internalizing and externalizing problems. We hypothesized that the FCU would promote higher inhibitory control in middle childhood relative to the control group, which in turn would be associated with lower internalizing and externalizing symptomology at age 14. Participants were 731 families, with half (n = 367) of the families assigned to the FCU intervention. Using an intent-to-treat design, results indicate that the FCU intervention was indirectly associated with both lower internalizing and externalizing symptoms at age 14 via its effect on increased inhibitory control in middle childhood (i.e., ages 8.5-10.5). Findings highlight the potential for interventions initiated in toddlerhood to have long-term impacts on self-regulation processes, which can further reduce the risk for behavioral and emotional difficulties in adolescence.

Teaching orthodontic emergencies using the "flipped classroom" method of teaching-A mixed methods RCT

INTRODUCTION

In the United Kingdom, the General Dental Council requires newly graduated dentists to be competent in managing orthodontic emergencies. Undergraduate students typically receive limited exposure to orthodontics, with teaching primarily delivered via conventional lectures. Flipped teaching involves knowledge being acquired in students' own time, with class time focussing on construction of meaning.

METHODS

A total of 61 undergraduate dental students were randomised into either a flipped or a conventional group. The conventional group (n = 30) attended a lecture describing the management of six common emergencies. The flipped group (n = 31) were given access to six videos via a virtual learning environment and later completed practical tasks related to the material. Both groups completed a single best answer assessment. Perceptions of flipped classroom teaching were explored via focus groups.

RESULTS

For questions on orthodontic emergencies, the conventional group had a mean examination result of 70.5% (SD 8.0%) compared with the flipped group of 72.8% (SD 12.9%). There was no significant difference between the groups (P = .532). For regular orthodontic questions, the conventional group had a mean examination result of 64.8% (SD: 19.9%) compared with 78.3% (SD: 21.7%). There was no significant difference between the groups (P = .083). Thematic analysis identified the following themes: ways in which videos encourages more effective learning, improved engagement, awareness of learning needs and proposed teaching/curriculum changes. The overarching theoretical perspective was facilitating an experiential learning cycle using flipped classroom teaching.

CONCLUSIONS

In the context of this investigation, the flipped classroom method of teaching resulted in comparable examination performance and improved levels of satisfaction.

Longitudinal effects of utilising photography on the accuracy of ergonomic self-assessments amongst dental hygiene students

PURPOSE

The purpose of this study was to determine the longitudinal effects of feedback involving photography and self-assessment on the accuracy of ergonomic self-assessments and ergonomic scores amongst dental hygiene students.

MATERIALS AND METHODS

The study involved an experimental design. Data collection took place over 4 months, divided into weeks 1-4 and after 3 months. At weeks 1 through 4 and 3 months, all participants completed ergonomic self-evaluations, using a Modified-Dental Operator Posture Assessment Instrument. At week 1, week 4 and 3 months, all participants were photographed, and in weeks 2 and 3, only participants in the training group were photographed and used those photographs to complete ergonomic self-assessments. All participants' photographs were evaluated by three faculty raters.

RESULTS

A mixed-design ANOVA of Kappa coefficient values between student and rater scores measured the effects of the feedback with photography on the accuracy of student self-assessments. A main effect for group was not found to be significant (F(1,30) = 2.90, P = .101). A mixed-design ANOVA measured the effects of the feedback with photography on the ergonomic scores. No significant main effects were found (F(1,120) = 1.55, P = .216).

CONCLUSION

Although self-assessment utilising photographs resulted in initial improvements in the accuracy of ergonomic self-assessments and ergonomic scores after 4 weeks, both ergonomic accuracy and scores significantly decreased after 3 months. Improvement in ergonomic accuracy and scores may be sustained by the continual facilitated use of photographs and self-assessment by dental and dental hygiene educators.

Longitudinal effect of deactivating stimulation sites based on low-rate thresholds on speech recognition in cochlear implant users

Objective: The objective of the current study was to examine the longitudinal effect of deactivating stimulation sites estimated to produce broad neural excitation on speech recognition. Design: Spatial patterns of neural excitation were estimated based on a previously established psychophysical measure, that is, detection threshold for low-rate pulse trains. Stimulation sites with relatively poor thresholds were deactivated in an experimental map. The acute effect was evaluated, in quiet and in noise, immediately after the experimental map was created (baseline), after the subjects practiced with the experimental map for two months (treatment), and after the subjects' daily map was switched back again to the clinical map for another two months (withdrawal). Study sample: Eight Cochlear Nucleus device users participated in the study. Results: For both listening in noise and in quiet, the greatest effect of deactivation was observed after the subjects were given time to adapt to the new frequency allocations. The effect was comparable for listening in fluctuating and steady-state noises. All subjects benefited from deactivation for listening in noise, but subjects with greater variability in thresholds were more likely to benefit from deactivation for listening in quiet. Conclusion: The benefit of electrode deactivation for speech recognition can increase with practice.

The Longitudinal Effects of Electroconvulsive Therapy on Ictal Interhemispheric Coherence and Its Associations With Treatment Outcome: A Naturalistic Cohort Study

OBJECTIVES

Electroconvulsive therapy (ECT) is an effective treatment for severe depression. Electroencephalogram (EEG) measures between ECT sessions seem to be related to the antidepressant efficacy of ECT. In this naturalistic cohort study, we examine longitudinal effects of ECT on interhemispheric EEG coherence measures during seizure activity and its relation to the antidepressant efficacy.

METHODS

This study included 65 patients diagnosed with severe depressive disorder. Depressive symptoms were rated according to the Montgomery-Åsberg Depression Rating Scale before and after the course of ECT. Frequency-specific ictal interhemispheric (fp1-fp2) EEG coherence measures were established during the first and each consecutive sixth treatment session. Linear mixed-effect models were used to determine longitudinal changes in ictal coherence measures during the course of ECT and its relation to treatment efficacy.

RESULTS

Ictal interhemispheric coherence in the theta and alpha frequency bands increased over the course of treatment, whereas no significant change was found for the delta and beta frequency bands. A main effect of treatment efficacy on the interhemispheric coherence in the delta and theta band was revealed. However, the longitudinal effects of ECT were not associated with treatment efficacy.

CONCLUSION

The current study suggests that interhemispheric coherence during ECT-induced seizures increases over the course of treatment. Furthermore, these longitudinal effects seem to be unrelated to the antidepressant efficacy of ECT. These findings contribute to the understanding of the mechanism of action of ECT.

Intensive Reading Remediation in Grade 2 or 3: Are There Effects a Decade Later?

Despite data supporting the benefits of early reading interventions, there has been little evaluation of the long-term educational impact of these interventions, with most follow-up studies lasting less than two years (Suggate, 2010). This study evaluated reading outcomes more than a decade after the completion of an 8-month reading intervention using a randomized design with second and third graders selected on the basis of poor word-level skills (Blachman et al., 2004). Fifty-eight (84%) of the original 69 participants took part in the study. The treatment group demonstrated a moderate to small effect size advantage on reading and spelling measures over the comparison group. There were statistically significant differences with moderate effect sizes between treatment and comparison groups on standardized measures of word recognition (i.e., Woodcock Basic Skills Cluster, d = 0.53; Woodcock Word Identification, d = 0.62), the primary, but not exclusive, focus of the intervention. Statistical tests on other reading and spelling measures did not reach thresholds for statistical significance. Patterns in the data related to other educational outcomes, such as high school completion, favored the treatment participants, although differences were not significant.

Longitudinal effects of adaptability on behavior problems and maternal depression in families of adolescents with autism

Research on families of individuals with autism has tended to focus on child-driven effects utilizing models of stress and coping. The current study used a family systems perspective to examine whether family level adaptability promoted beneficial outcomes for mothers and their adolescents with autism over time. Participants were 149 families of children diagnosed with autism who were between the ages of 10 and 22 years during the 3-year period examined. Mothers reported on family adaptability, the mother-child relationship, their own depressive symptoms, and the behavior problems of their children at Wave 1, and these factors were used to predict maternal depression and child behavior problems 3 years later. Family level adaptability predicted change in both maternal depression and child behavior problems over the study period, above and beyond the contribution of the dyadic mother-child relationship. These associations did not appear to depend upon the intellectual disability status of the individual with autism. Implications for autism, parent mental health, family systems theory, and intervention with this population are discussed.