Featured Article: Behavior Interventions Addressing Obesity in Rural Settings: The E-FLIP for Kids Trial

Abstract Objective To assess the effectiveness of behavioral parent-only (PO) and family-based (FB) interventions on child weight, dietary intake, glycated hemoglobin, and quality of life in rural settings. Methods This study was a three-armed, randomized controlled trial. Participants were children (age 8–12 years) with overweight or obesity and their parents. A FB (n = 88), a PO (n = 78) and a health education condition (HEC) (n = 83) each included 20 group contacts over 1 year. Assessment and treatment contacts occurred at Cooperative Extension Service offices. The main outcome was change in child body mass index z-score (BMIz) from baseline to year 2. Results Parents in all conditions reported high treatment satisfaction (mean of 3.5 or higher on a 4-point scale). A linear mixed model analysis of change in child BMIz from baseline to year 1 and year 2 found that there were no significant group by time differences in child BMIz (year 2 change in BMIz for FB = −0.03 [−0.1, 0.04], PO = −0.01 [−0.08, 0.06], and HEC = −0.09 [−0.15, −0.02]). While mean attendance across conditions was satisfactory during months 1–4 (69%), it dropped during the maintenance phase (42%). High attendance for the PO intervention was related to greater changes in child BMIz (p < .02). Numerous barriers to participation were reported. Conclusion Many barriers exist that inhibit regular attendance at in-person contacts for many families. Innovative delivery strategies are needed that balance treatment intensity with feasibility and acceptability to families and providers to facilitate broad dissemination in underserved rural settings. ClinicalTrials.gov Identifier: NCT01820338.

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Acute memory and psychotomimetic effects of cannabis and tobacco both ‘joint’ and individually: a placebo-controlled trial

Psychological Medicine ◽

10.1017/s0033291717001222 ◽

2017 ◽

Vol 47 (15) ◽

pp. 2708-2719 ◽

Cited By ~ 48

Author(s):

C. Hindocha ◽

T. P. Freeman ◽

J. X. Xia ◽

N. D. C. Shaban ◽

H. V. Curran

Keyword(s):

Verbal Memory ◽

Mixed Model ◽

Linear Mixed Model ◽

Controlled Trial ◽

Subjective Effects ◽

Preliminary Evidence ◽

Interactive Effects ◽

Double Blind ◽

Mixed Model Analysis ◽

Psychotomimetic Effects

BackgroundCannabis and tobacco have contrasting cognitive effects. Smoking cannabis with tobacco is prevalent in many countries and although this may well influence cognitive and mental health outcomes, the possibility has rarely been investigated in human experimental psychopharmacological research.MethodThe individual and interactive effects of cannabis and tobacco were evaluated in 24 non-dependent cannabis and tobacco smokers in a randomized, placebo-controlled, double-blind, 2 (cannabis, placebo) × 2 (tobacco, placebo) crossover design. Verbal memory (prose recall), working memory (WM) performance including maintenance, manipulation and attention (N-back), psychotomimetic, subjective and cardiovascular measures were recorded on each of four sessions.ResultsCannabis alone impaired verbal memory. A priori contrasts indicated that tobacco offset the effects of cannabis on delayed recall. However, this was not supported by linear mixed model analysis. Cannabis load-dependently impaired WM. By contrast, tobacco improved WM across all load levels. The acute psychotomimetic effects and ratings of ‘stoned’ and ‘dizzy’ induced by cannabis were not altered by tobacco. Cannabis and tobacco had independent effects on increasing heart rate and interacting effects on increasing diastolic blood pressure.ConclusionsRelative to placebo, acute cannabis impaired verbal memory and WM. Tobacco enhanced performance on WM, independently of cannabis. Moreover, we found some preliminary evidence that tobacco may offset the effects of cannabis on delayed, but not immediate, verbal recall. In contrast, the psychotomimetic and subjective effects of cannabis were unaffected by tobacco co-administration. By reducing the cognitive impairment from cannabis, tobacco co-administration may perpetuate use despite adverse health consequences.

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Robot-Assisted Arm Training in Chronic Stroke: Addition of Transition-to-Task Practice

Neurorehabilitation and Neural Repair ◽

10.1177/1545968319862558 ◽

2019 ◽

Vol 33 (9) ◽

pp. 751-761 ◽

Cited By ~ 3

Author(s):

Susan S. Conroy ◽

George F. Wittenberg ◽

Hermano I. Krebs ◽

Min Zhan ◽

Christopher T. Bever ◽

...

Keyword(s):

Mixed Model ◽

Linear Mixed Model ◽

Controlled Trial ◽

Chronic Stroke ◽

Secondary Outcome ◽

Motor Deficits ◽

Robot Assisted ◽

Robotic Training ◽

Mixed Model Analysis ◽

Task Training

Background. Robot-assisted therapy provides high-intensity arm rehabilitation that can significantly reduce stroke-related upper extremity (UE) deficits. Motor improvement has been shown at the joints trained, but generalization to real-world function has not been profound. Objective. To investigate the efficacy of robot-assisted therapy combined with therapist-assisted task training versus robot-assisted therapy alone on motor outcomes and use in participants with moderate to severe chronic stroke-related arm disability. Methods. This was a single-blind randomized controlled trial of two 12-week robot-assisted interventions; 45 participants were stratified by Fugl-Meyer (FMA) impairment (mean 21 ± 1.36) to 60 minutes of robot therapy (RT; n = 22) or 45 minutes of RT combined with 15 minutes therapist-assisted transition-to-task training (TTT; n = 23). The primary outcome was the mean FMA change at week 12 using a linear mixed-model analysis. A subanalysis included the Wolf Motor Function Test (WMFT) and Stroke Impact Scale (SIS), with significance P <.05. Results. There was no significant 12-week difference in FMA change between groups, and mean FMA gains were 2.87 ± 0.70 and 4.81 ± 0.68 for RT and TTT, respectively. TTT had greater 12-week secondary outcome improvements in the log WMFT (−0.52 ± 0.06 vs −0.18 ± 0.06; P = .01) and SIS hand (20.52 ± 2.94 vs 8.27 ± 3.03; P = .03). Conclusion. Chronic UE motor deficits are responsive to intensive robot-assisted therapy of 45 or 60 minutes per session duration. The replacement of part of the robotic training with nonrobotic tasks did not reduce treatment effect and may benefit stroke-affected hand use and motor task performance.

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Dose–response to 3 months of quercetin-containing supplements on metabolite and quercetin conjugate profile in adults

British Journal Of Nutrition ◽

10.1017/s0007114512003972 ◽

2012 ◽

Vol 109 (11) ◽

pp. 1923-1933 ◽

Cited By ~ 26

Author(s):

Lynn Cialdella-Kam ◽

David C. Nieman ◽

Wei Sha ◽

Mary Pat Meaney ◽

Amy M. Knab ◽

...

Keyword(s):

Vitamin C ◽

Repeated Measures ◽

Mixed Model ◽

Linear Mixed Model ◽

Controlled Trial ◽

Partial Least Square ◽

Least Square ◽

Metabolic Effects ◽

Mixed Model Analysis ◽

Metabolite Profiles

Quercetin, a flavonol in fruits and vegetables, has been demonstrated to have antioxidant, anti-inflammatory and immunomodulating influences. The purpose of the present study was to determine if quercetin, vitamin C and niacin supplements (Q-500 = 500 mg/d of quercetin, 125 mg/d of vitamin C and 5 mg/d of niacin; Q-1000 = 1000 mg/d of quercetin, 250 mg/d of vitamin C and 10 mg/d of niacin) would alter small-molecule metabolite profiles and serum quercetin conjugate levels in adults. Healthy adults (fifty-eight women and forty-two men; aged 40–83 years) were assigned using a randomised double-blinded placebo-controlled trial to one of three supplement groups (Q-1000, Q-500 or placebo). Overnight fasted blood samples were collected at 0, 1 and 3 months. Quercetin conjugate concentrations were measured using ultra-performance liquid chromatography (UPLC)-MS/MS, and metabolite profiles were measured using two MS platforms (UPLC-quadrupole time-of-flight MS (TOFMS) and GC-TOFMS). Statistical procedures included partial least square discriminant analysis (PLS-DA) and linear mixed model analysis with repeated measures. After accounting for age, sex and BMI, quercetin supplementation was associated with significant shifts in 163 metabolites/quercetin conjugates (false discovery rate, P< 0·05). The top five metabolite shifts were an increase in serum guaiacol, 2-oxo-4-methylthiobutanoic acid, allocystathionine and two bile acids. Inflammatory and oxidative stress metabolites were not affected. PLS-DA revealed a clear separation only between the 1000 mg/d and placebo groups (Q2Y= 0·763). The quercetin conjugate, isorhamnetin-3-glucuronide, had the highest concentration at 3 months followed by quercetin-3-glucuronide, quercetin-3-sulphate and quercetin diglucuronide. In human subjects, long-term quercetin supplementation exerts disparate and wide-ranging metabolic effects and changes in quercetin conjugate concentrations. Metabolic shifts were apparent at the 1000 mg/d dose; further research is required to understand the health implications of these shifts.

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Impact of Be EPIC on Person-Centered Communication

Innovation in Aging ◽

10.1093/geroni/igaa057.1912 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 575-575

Author(s):

Marie Savundranayagam ◽

Kristine Williams ◽

Shalane Basque ◽

Joseph Orange ◽

Marita Kloseck ◽

...

Keyword(s):

Mixed Model ◽

Linear Mixed Model ◽

Control Group ◽

Significant Group ◽

Mixed Model Analysis ◽

Personal Support ◽

Time Interaction ◽

The Impact

Abstract This study assessed the impact of Be EPIC, a dementia-focused, person-centered communication intervention for personal support workers (PSWs). Video-recorded conversations between PSWs and simulated persons with dementia assessed whether Be EPIC participants (n=13) (versus a wait-list control group, n=8) reported a greater proportion of person-centered communication utterances (recognition, negotiation, facilitation, validation). We used linear mixed model analysis to investigate if Be EPIC influenced PSWs’ person-centered communication. Group (Be EPIC versus control group), time (pre-, post-, and 3-months) and their interaction were included in the model. There was a significant group by time interaction. Follow-up tests showed that participants who took Be EPIC showed significant increases in person-centered utterances from pre- to post-training and pre-training to 3 months later. Participants in the control group showed no changes in person-centered communication. These findings show that Be EPIC enhanced person-centered communication, which is essential for quality of care.

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Reducing Aggression by Developing Emotional and Inhibitory Control

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105263 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5263

Author(s):

Miriam Romero-López ◽

María Carmen Pichardo ◽

Ana Justicia-Arráez ◽

Judit Bembibre-Serrano

Keyword(s):

Psychosocial Development ◽

Mixed Model ◽

Linear Mixed Model ◽

Generalized Linear Mixed Model ◽

Emotional Control ◽

Control Group ◽

Post Intervention ◽

Mixed Model Analysis ◽

Intervention Measures ◽

Experimental Group

The objective of this study is to measure the effectiveness of a program on improving inhibitory and emotional control among children. In addition, it is assessed whether the improvement of these skills has an effect on the reduction of aggressive behavior in pre-school children. The participants were 100 children, 50 belonging to the control group and 50 to the experimental group, aged between 5 and 6 years. Pre-intervention and post-intervention measures of inhibitory and emotional control (BRIEF-P) and aggression (BASC) were taken. A Generalized Linear Mixed Model analysis (GLMM) was performed and found that children in the experimental group scored higher on inhibitory and emotional control compared to their peers in the control group. In addition, these improvements have an effect on the decrease in aggressiveness. In conclusion, preventive research should have among its priorities the design of such program given their implications for psychosocial development.

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Association of Cognitive Function Screening Results with Adherence and Performance in a Pedometer-Based Intervention

American Journal of Nephrology ◽

10.1159/000516130 ◽

2021 ◽

pp. 1-9

Author(s):

Anoop Sheshadri ◽

Piyawan Kittiskulnam ◽

Cynthia Delgado ◽

Rebecca L. Sudore ◽

Jennifer C. Lai ◽

...

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Physical Performance ◽

Mixed Model ◽

Linear Mixed Model ◽

Controlled Trial ◽

Cognitive Status ◽

Dialysis Patients ◽

Exercise Interventions ◽

And Performance

Introduction: A randomized, controlled trial of a pedometer-based walking intervention with weekly activity goals led to increased walking among dialysis patients. We examined whether impairment per cognitive function screening is associated with adherence and performance in the intervention. Methods: Thirty dialysis patients were randomly assigned to a 3-month pedometer-based intervention with weekly goals. Participants were administered the Telephone Interview of Cognitive Status (TICS), a test of global mental status. We examined the association of levels of impairment on the TICS (≥33: unimpaired, 26–32: ambiguous impairment, 21–25: mild cognitive impairment [MCI]) with adherence, achieving weekly goals, and increasing steps, physical performance (Short Physical Performance Battery, SPPB), and self-reported physical function (PF) through multivariable linear mixed-model and logistic regression analyses adjusted for age, sex, BMI, dialysis modality, baseline steps, baseline SPPB, and stroke status. Results: One-third of participants were unimpaired, and 13% had MCI. Participants with worse results on cognitive function screening missed more calls and completed fewer weekly goals than participants with better results. During the intervention, a worse result on cognitive function screening was associated with smaller increases in steps compared to those without impairment: (ambiguous: −620 [95% CI −174, −1,415], MCI: −1,653 [95% CI −120, −3,187]); less improvement in SPPB (ambiguous: −0.22 points [95% CI −0.08, −0.44], MCI: −0.45 [95% CI −0.13, −0.77]); and less improvement in PF (ambiguous: −4.0 points [95% CI −12.2, 4.1], MCI: −14.0 [95% CI −24.9, −3.1]). During the postintervention period, a worse result on cognitive function screening was associated with smaller increases in SPPB (ambiguous: −0.54 [95% CI −1.27, 0.19], MCI: −0.97 [95% CI −0.37, −1.58]) and PF (ambiguous: −3.3 [95% CI −6.5, −0.04], MCI: −10.5 [95% CI −18.7, −2.3]). Discussion/Conclusion: Participants with worse results on cognitive function screening had worse adherence and derived less benefit from this pedometer-based intervention. Future exercise interventions should be developed incorporating methods to address cognitive impairment, for example, by including caregivers when planning such interventions.

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Methods to Assess Fat Mass in Infants and Young Children: A Comparative Study Using Skinfold Thickness and Air-Displacement Plethysmography

Life ◽

10.3390/life11020075 ◽

2021 ◽

Vol 11 (2) ◽

pp. 75

Author(s):

Stefanie M. P. Kouwenhoven ◽

Nadja Antl ◽

Jos W. R. Twisk ◽

Berthold V. Koletzko ◽

Martijn J. J. Finken ◽

...

Keyword(s):

Young Children ◽

Fat Mass ◽

Mixed Model ◽

Linear Mixed Model ◽

Correlation Coefficients ◽

Skinfold Thickness ◽

Limited Information ◽

Air Displacement Plethysmography ◽

Mixed Model Analysis ◽

Infants And Young Children

Background: Traditionally, fat mass is estimated using anthropometric models. Air-displacement plethysmography (ADP) is a relatively new technique for determining fat mass. There is limited information on the agreement between these methods in infants and young children. Therefore we aimed to longitudinally compare fat mass percentage values predicted from skinfold thicknesses (SFTs) and ADP in healthy infants and young children. Methods: Anthropometry and body composition were determined at the ages of 1, 4, and 6 months and 2 years. We quantified the agreement between the two methods using the Bland–Altman procedure, linear mixed-model analysis, and intra-class correlation coefficients (ICC). Results: During the first 6 months of life, fat mass% predicted with SFT was significantly different from that measured with ADP in healthy, term-born infants (n = 245). ICCs ranged from 0.33 (at 2 years of age) and 0.47 (at 4 months of age). Although the mean difference (bias) between the methods was low, the Bland–Altman plots showed proportional differences at all ages with wide limits of agreement. Conclusions: There is poor agreement between ADP and SFTs for estimating fat mass in infancy or early childhood. The amount of body fat was found to influence the agreement between the methods.

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A Randomized Controlled Trial Evaluating Integrative Psychotherapeutic Group Treatment Compared to Self-Help Groups in Functional Vertigo/Dizziness

Journal of Clinical Medicine ◽

10.3390/jcm10102215 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2215

Author(s):

Karina Limburg ◽

Katharina Radziej ◽

Heribert Sattel ◽

Peter Henningsen ◽

Marianne Dieterich ◽

...

Keyword(s):

Group Treatment ◽

Mixed Model ◽

Linear Mixed Model ◽

Controlled Trial ◽

Clinical Psychologist ◽

Control Group ◽

Attrition Rates ◽

Randomized Controlled ◽

Self Help ◽

Self Help Groups

We tested the efficacy of an integrative psychotherapeutic group treatment (IPGT) in reducing vertigo/dizziness-related impairment along with depression, anxiety, and somatization by conducting a randomized controlled superiority trial comparing IPGT to self-help groups moderated by a clinical psychologist (SHG). Adult patients with functional vertigo and dizziness symptoms were randomly allocated to either the IPGT or SHG as active control group. Outcomes were assessed at baseline (t0), after treatment lasting 16 weeks (t1), and 12 months after treatment (t2). A total of 81 patients were assigned to IPGT and 78 patients were assigned to SHG. Vertigo-related impairment was reduced in both conditions (IPGT: t0–t1: d = 1.10, t0–t2: d = 1.06; SHG: t0–t1: d = 0.86, t0–t2: d = 1.29), showing the efficiency of both IPGT and SHG. Clinically relevant improvements were also obtained for depression in both groups. Linear mixed model analyses revealed no differences between groups for all outcomes (effect of group for the primary outcome: b = −1.15, SE = 2.13, t = −0.54, p = 0.59). Attrition rates were higher in SHG (52.6%) than in IPGT (28.4%). Both conditions improved primary and secondary outcomes while IPGT was better accepted by patients than SHG. Trial registration: ClinicalTrials.gov, Identifier: NCT02320851.

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Factors influencing the occurrence of high ultimate pH in three muscles of lamb carcasses in Australia

Animal Production Science ◽

10.1071/an14315 ◽

2014 ◽

Vol 54 (10) ◽

pp. 1853 ◽

Cited By ~ 8

Author(s):

N. G. McPhail ◽

J. L. Stark ◽

A. J. Ball ◽

R. D. Warner

Keyword(s):

Mixed Model ◽

Linear Mixed Model ◽

Rectus Femoris ◽

Carcass Weight ◽

Mixed Model Analysis ◽

Factors Influencing ◽

South Wales ◽

Generalised Linear Mixed Model ◽

Processing Plants ◽

Few Data

Chilled lamb meat exported from Australia has, on occasions, been rejected by importing countries due to greening, after only 6 weeks of storage time. Greening is known to be more prevalent in high ultimate pH (pHu) beef meat (>5.9). There are few data available for lamb carcasses in Australia on the occurrence of high pHu meat, which may have an impact on the understanding and control of quality and greening during storage. The aim of this project was to determine the prevalence of, and influencing factors for, high pHu meat in a range of muscle types in lamb carcasses in Australia. Muscle pHu data were collected from a total of 1614 carcasses from 78 lots at four lamb processing plants in Victoria and New South Wales in autumn and spring of 2013. The pHu of the knuckle (rectus femoris), rack (longissimus) and blade (infraspinatus) was measured and data on carcass and lot characteristics were recorded. Data were subjected to restricted maximum likelihood and generalised linear mixed model analysis. The mean pHu of the knuckle, rack and shoulder were 6.06, 5.79 and 6.12 respectively, and the main factors influencing muscle pHu and occurrence of dark-cutting were breed, season, electrical stimulation and carcass weight. Merino lambs had a higher pHu in the blade and knuckle than did other breeds (P < 0.05, P < 0.01 respectively). Lambs processed in autumn had a higher predicted pHu in the blade and knuckle and a higher percentage dark-cutting (DC; pHu >6.0) for those muscles, than did those processed in spring (P < 0.05). Carcasses that had been electrically stimulated had a higher %DC and a higher pHu in all three muscles (P < 0.05). Carcass weight had a significant effect on the pHu of all three muscles (P < 0.001), with heavier carcasses having a lower pHu and lower %DC. The pHu of the rack was not a reliable predictor for the pHu in other muscles of the lamb carcass. In conclusion, the high occurrence of DC in the muscles, particularly the blade and knuckle, suggests that these muscles may be at risk for producing greening in the vacuum bag during storage.

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Size-related boldness is not altered by stomach flushing in a terrestrial salamander

Amphibia-Reptilia ◽

10.1163/15685381-bja10054 ◽

2021 ◽

pp. 1-6

Author(s):

Sebastiano Salvidio ◽

Andrea Costa ◽

Fabrizio Oneto

Keyword(s):

Body Condition ◽

Mixed Model ◽

Linear Mixed Model ◽

Animal Personality ◽

Model Analysis ◽

Mixed Model Analysis ◽

Linear Mixed Model Analysis ◽

Before And After ◽

Trophic Strategy ◽

The Relationship

Abstract Animal personality is a relatively neglected field in amphibian research. In this study we assessed the influence of stomach flushing, a non-lethal technique used in amphibian dietary studies, on the boldness behaviour of the cave salamander Speleomantes strinatii. The time of emergence from a shelter located in an unfamiliar environment (a proxy for individual boldness) was measured in 26 cave salamanders before and after stomach flushing, while 14 non-flushed salamanders were tested as controls. Boldness was a repeatable behaviour for salamanders and larger individuals emerged from their shelter more rapidly than smaller ones. Linear mixed model analysis showed that flushing, sex and body condition had no effect on this behaviour. These findings are promising in the framework of the study of salamander personality. In particular, our results will be useful when exploring the relationship between individual trophic strategy and boldness, aggression or exploration behaviours in terrestrial salamanders.

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