Predictors of Success Using a mHealth Intervention in Adults with Prediabetes: Results of a Pilot Study (Preprint)

2019 ◽  
Author(s):  
Nestoras Mathioudakis ◽  
Estelle Everett ◽  
Noora Al-Hajri ◽  
Mohammed Abusamaan ◽  
Clare Lee ◽  
...  
Keyword(s):  
Pilot Study ◽  
Intervention Program ◽  
Area Deprivation ◽  
Inverse Association ◽  
Small Pilot Study ◽  
Mhealth Intervention ◽  
Increased Risk ◽  
Metabolic Equivalent Of Task ◽  
Mobile Intervention ◽  
The Difference

BACKGROUND About one-third of American adults have prediabetes and are at increased risk of type 2 diabetes. Mobile health (mHealth) technologies provide a scalable approach to diabetes prevention by encouraging physical activity (PA), weight loss, and adherence to a healthy diet in large numbers of patients. OBJECTIVE To identify factors associated with improvements in PA and glycated hemoglobin (A1c) measures among prediabetic adults who received a mobile intervention program (smartphone app in combination with a digital body weight scale) in a previously completed pilot study. METHODS We conducted a post hoc analysis of a 3-month prospective, single-arm, observational study using the Sweetch™ mHealth intervention among adults with prediabetes. Change in A1C was calculated as the difference between the 3-month and baseline A1C measurements and was categorized as decrease vs. no decrease. PA was evaluated using the total minutes and metabolic equivalent of task (MET)-hours per week. Change in MET-hours/week was categorized as increase vs. no increase. Age, sex, race, education, employment status, area deprivation, smartphone usage attitudes, and PA stage of change were compared between groups by outcomes of change in A1C and change in MET-hour/week. RESULTS A total of 37 adults received the final Sweetch mobile intervention and were included in the analysis. 62% were female and 81% were white, with average age of 57 years. The median [IQR] baseline A1C was 6.0% [5.8, 6.2]. A1C measure at 3-month was decreased in 24 (65%) participants when compared to baseline A1C. There was an inverse association between average MET-hours per week and change in A1C. Among participants whose A1C decreased vs. did not decrease, the MET-hours per week in last 2 weeks of study was 18.7 (8.4) and 15.0 (7.1), respectively (P=0.19), and the change in MET-hours per week was 2.1 (7.1) and 4.1(6.1), respectively (P=0.41). There were otherwise no statistically significant differences in participant factors by A1C and PA outcomes. CONCLUSIONS In this small pilot study, Sweetch mHealth intervention achieved comparable A1C response prediabetic adults with different individual, sociodemographic and anthropometric characteristics. CLINICALTRIAL ClincialTrials.gov NCT02896010; https://clinicaltrials.gov/ct2/show/NCT02896010 (Archived by WebCite at http://www.webcitation.org/6xJYxrgse)

scholarly journals Feasibility of a 6-month pilot randomised controlled trial of resistance training on cognition and brain health in Canadian older adults at-risk for diabetes: study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e032047
Author(s):  
Joyla A Furlano ◽  
Lindsay S Nagamatsu
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Pilot Study ◽  
Randomised Controlled Trial ◽  
Resistance Training ◽  
Controlled Trial ◽  
Brain Health ◽  
Small Pilot Study ◽  
Increased Risk ◽  
Randomised Controlled

IntroductionType 2 diabetes (T2D) is associated with cognitive deficits and increased risk of dementia, and thus individuals at high risk for T2D (ie, those who are overweight or prediabetic) are also at greater risk for cognitive decline. Aerobic exercise is known to preserve and improve cognitive function, but the effects of resistance training (RT) are much less known in older adults. Moreover, research on the effects of RT on cognition and brain health (structure and function) in older adults at-risk for diabetes is limited. To address this question, a 6-month RT intervention is needed. Importantly, before conducting a full-scale randomised controlled trial (RCT), we are conducting a feasibility pilot study to assess potential recruitment rates, adherence and retention in this specific population.Methods and analysisWe are conducting a 6-month, thrice-weekly RT RCT. Participants (aged 60–80; sedentary; fasting plasma glucose of 6.1–7.0 mmol/L or body mass index ≥25) are randomised into one of two groups: (1) RT or (2) balance and tone (control). Based on other exercise trials using a similar population, we will consider our trial feasible if we have adherence and retention at 70%. Recruitment rate will be measured as time it takes to enrol 20 participants. To assess behavioural and MRI data, we will report descriptive statistics and estimation using a 95% CI.Ethics and disseminationOur study has received ethics approval from the Health Sciences Research Ethics Board at Western University. As this is a small pilot study, data will only be made available to other researchers on request. Results from this study will be disseminated via academic publication.Trial registration numberNCT03254381

341 Acute effects of seltorexant, a selective orexin-2 antagonist (JNJ- 42847922), on driving after bedtime administration

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A136-A136
Author(s):  
S Brooks ◽  
R G J A Zuiker ◽  
G E Jacobs ◽  
I Kezic ◽  
A Savitz ◽  
...  
Keyword(s):  
Postural Stability ◽  
Driving Simulator ◽  
Motor Vehicle ◽  
Subjective Effects ◽  
Driving Ability ◽  
Post Dose ◽  
Double Blind ◽  
Increased Risk ◽  
Subjective Sleepiness ◽  
The Difference

Abstract Introduction Seltorexant (JNJ-42847922), a potent and selective antagonist of the human orexin-2 receptor, is being developed for the treatment of major depressive disorder. Seltorexant also has sleep-promoting properties. Investigating the effects of sleep-promoting medications on driving is important because some of these agents (e.g. GABAA receptor agonists) may be associated with increased risk of motor vehicle accidents. We evaluated the effect of seltorexant on driving after forced awakening at night, using a validated driving simulator. Methods This double-blind, placebo and active-controlled, randomized, 3-way cross-over study was conducted in 18 male and 18 female healthy subjects. All subjects received seltorexant 40 mg, zolpidem 10 mg, or placebo 15 minutes before bedtime. Eighteen subjects were awakened at 2- and 6-hours post-dose, and the other 18 at 4- and 8-hours post-dose. At those timepoints, pharmacokinetics, objective (standard deviation of the lateral position [SDLP]) and subjective effects (using Perceived Driving Quality and Effort Scales) on driving ability, postural stability and subjective sleepiness were assessed. Results For seltorexant, the SDLP difference from placebo (95% confidence interval) at 2-, 4-, 6- and 8-hours post-dose was 3.9 cm (1.26, 6.60), 0.9 cm (-1.08, 2.92), 1.1 cm (-0.42, 2.63), and 0.6 cm (-2.75, 1.55), respectively vs. 9.6 cm (6.97, 12.38), 6.6 cm (3.53, 9.60), 4.7 cm (1.46, 7.85), and 1.3cm (-1.16, 3.80), respectively for zolpidem. The difference from placebo was significant at 2-hours after taking seltorexant, while the difference from placebo was significant at 2, 4 and 6-hours after zolpidem. Subjective driving quality was decreased for both drugs at all time points and driving effort was increased up to 4-hours post-dose for both medications. Subjective sleepiness showed a significant increase compared to placebo 2- and 4-hours after administration of either drug. Postural stability was decreased up to 2-hours after administration of seltorexant, and up to 4-hours after administration of zolpidem. Conclusion Compared to zolpidem, objective effects on driving performance were more transient after seltorexant administration and largely normalized by 4–6 hours post-dose. Support (if any) This work was sponsored by Janssen R&D.

scholarly journals Increased risk of preeclampsia after use of paracetamol during pregnancy – causal or coincidence?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hetti von Hellens ◽  
Leea Keski-Nisula ◽  
Heidi Sahlman
Keyword(s):  
Third Trimester ◽  
Retrospective Case ◽  
Reverse Causation ◽  
Gestational Period ◽  
The Third ◽  
Precise Data ◽  
Increased Risk ◽  
Study Population ◽  
The Difference ◽  
Risk Of Preeclampsia

Abstract Background The maternal use of paracetamol during pregnancy has been associated with the development of preeclampsia. This study aims to clarify whether the connection is causal or whether it is due to reverse causation. Methods This study is a continuation of the retrospective case cohort study examining 2,508 pregnant women using a variety of drugs and the development of preeclampsia (1,252 women with preeclampsia and 1,256 controls). For the purposes of this study, more precise data was collected from several hospital databases of the women among this cohort who had reported taking paracetamol during pregnancy (indications, gestational period etc.); this was evaluated in association with the development of preeclampsia. Results 5.5% (100 cases and 37 controls) of all the study population (2,508) had clearly reported paracetamol use. Women with preeclampsia had used significantly more often paracetamol during pregnancy compared to controls (cases 8.0%, controls 2.9%, p < 0.001). The difference was most evident in the third trimester (after the 29th GW) and the use of paracetamol was associated with both mild and severe preeclampsia. Headache and “general pain” were the most common indications for medication among all paracetamol users. Conclusions The use of paracetamol in the third trimester of pregnancy was associated with preeclampsia. This observation indicates that association between paracetamol use and preeclampsia is probably due to reverse causation, i.e. women with preeclampsia experience more headaches due to preeclampsia symptoms since this association was not detected with the use of paracetamol in earlier stages of pregnancy.

scholarly journals Validating scoring systems for fracture healing in infants and young children: pilot study

2021 ◽  
Author(s):  
Samuel Crompton ◽  
Fabrizio Messina ◽  
Gillian Klafkowski ◽  
Christine Hall ◽  
Amaka C. Offiah
Keyword(s):  
Pilot Study ◽  
Young Children ◽  
Fracture Healing ◽  
Callus Formation ◽  
Femoral Fractures ◽  
Scoring Systems ◽  
Power Calculation ◽  
Small Pilot Study ◽  
Fractures In Children ◽  
Infants And Young Children

Abstract Background Recent studies have analysed birth-related clavicular fractures to propose time frames for healing that could be applied to dating of all fractures in cases of suspected child abuse. Objective To assess differences in healing rates between femoral fractures and birth-related clavicular fractures in infants and young children. Materials and methods A retrospective 5-year pilot study of femoral fractures in children younger than 3 years of age was performed. Anonymised radiographs were independently scored by two radiologists for stages of fracture healing. In cases of reader disagreement, radiographs were independently scored by a third radiologist. Results In total, 74 radiographs (30 children) met the inclusion criteria. Fracture healing evolved over time with subperiosteal new bone formation (SPNBF) appearing first, followed by callus then remodelling. A power calculation for a single proportion, with a level of confidence of 95% and a margin of error of 5%, showed that in a definitive study, 359 radiographs would be required. Conclusion Although the overall pattern of healing is similar, in this small pilot study, the earliest times for SPNBF and callus formation in femoral fractures appeared to lag behind healing of birth-related clavicular fractures. Remodelling appeared earlier than remodelling of clavicular fractures. A power calculation has determined numbers of femoral radiographs (359) required for a definitive study.

scholarly journals Greater cardiorespiratory fitness reduces incidence of atrial fibrillation: a meta-analysis

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
C Verdicchio ◽  
A Elliott ◽  
R Mahajan ◽  
D Linz ◽  
D Lau ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Risk Factor ◽  
Cardiorespiratory Fitness ◽  
Meta Analysis ◽  
Exercise Stress ◽  
Inverse Association ◽  
Exercise Interventions ◽  
Increased Risk ◽  
Statistical Heterogeneity

Abstract Funding Acknowledgements Type of funding sources: None. Introduction  Atrial Fibrillation (AF) is the most common sustained cardiac arrhythmia affecting 1-2% of the global population, with the prevalence of AF increasing dramatically over the past two decades. Although low levels of cardiorespiratory fitness (CRF) and physical activity are predictive of cardiovascular disease onset and mortality, only recently has this emerged as a potential risk factor for AF. Purpose The aim of this meta-analysis was therefore to quantify the relationship between CRF, measured by a symptom limited exercise stress test, and incident AF. We hypothesised that there would be an inverse relationship between CRF and the incidence of AF. Methods The systematic literature review was conducted using PUBMED, MEDLINE and EMBASE databases, with seven studies meeting the inclusion criteria. A random-effects meta-analysis was then used to compare the multivariate risk estimates of the lowest CRF group from each cohort with the group of the highest CRF. Results Data from 206,925 individuals (55.8% males) was used for analysis with a mean age of 55 ± 2.5 years and a mean follow-up period of 10.3 ± 5 years. The total number of AF events across the studies was 19,913. The overall pooled risk of AF in the high-CRF group versus the low-CRF group showed a significant lower risk of incident AF in those with high-CRF (OR: 0.52, 95% CI, 0.44-0.605, p &lt; 0.001). There was evidence of statistical heterogeneity between the studies (I2 = 81%, p &lt; 0.001). AF incidence rates demonstrated an overall decline in rates across the CRF quartiles from low to high. The mean incidence rate for low-CRF was 21 ± 13.4 compared to 6.9 ± 0.7 per 1000 person-years for the high CRF group (p = 0.03). Conclusion There is an inverse association between a lower CRF and an increased risk of AF, with a higher level of CRF protective against AF. This study highlights that low-CRF may be an additional risk factor for AF along with already other established lifestyle-based risk factors such as obesity and hypertension. Exercise interventions should be promoted as a primary prevention strategy in those at risk of developing AF with known risk factors. Future studies are warranted to identify the mechanism(s) through which improved CRF confers a reduction in AF incidence. Abstract Figure. AF risk between high and low-CRF

scholarly journals Bystander Intervention Efficacy to Reduce Teen Dating Violence Among High School Youth Who Did and Did Not Witness Parental Partner Violence: A Path Analysis of A Cluster RCT

2021 ◽  
Author(s):  
Annelise Mennicke ◽  
Heather M. Bush ◽  
Candace J. Brancato ◽  
Ann L. Coker
Keyword(s):  
High School ◽  
High School Students ◽  
Dating Violence ◽  
Partner Violence ◽  
Intervention Program ◽  
Teen Dating Violence ◽  
Bystander Intervention ◽  
School Students ◽  
Increased Risk ◽  
Teen Dating

AbstractYouth who witness parental intimate partner violence (IPV) are at increased risk of teen dating violence (DV). This analysis of secondary data investigated whether a bystander intervention program, Green Dot, was effective at reducing physical and psychological DV victimization and perpetration among youth who had and had not previously witnessed parental IPV. The parent RCT assigned 13 schools to control and 13 schools to the Green Dot intervention. Responses from 71,797 individual surveys that were completed by high school students were analyzed across three phases of a 5-year cluster randomized control trial. Multigroup path analyses revealed that students in intervention schools who witnessed parental IPV had a reduction in psychological (p < .001) and physical DV (p < .01) perpetration and psychological DV victimization (p < .01) in Phase 2 of the intervention, while those who did not witness parental IPV had a significant reduction in psychological DV victimization (p < .01). Individuals in the intervention received more training (p < .001), which was associated with lower levels of violence acceptance (p < .001). Violence acceptance was positively associated with DV victimization and perpetration (p < .001), especially for individuals who previously witnessed parental IPV. Green Dot is an effective program at reducing DV victimization and perpetration among the high-risk group of youth who previously witnessed parental IPV, largely operating through violence acceptance norms. This underscores the bystander intervention approach as both a targeted and universal prevention program.

scholarly journals Good Idea But Not Here! A Pilot Study of Swedish Tourism Stakeholders’ Perceptions of Halal Tourism

2021 ◽  
Vol 13 (5) ◽  
pp. 2646
Author(s):  
Saeid Abbasian
Keyword(s):  
Content Analysis ◽  
Pilot Study ◽  
Tourism Industry ◽  
Target Group ◽  
Exploratory Research ◽  
Swedish Study ◽  
Increased Risk ◽  
Insight Into

The following study is the first Swedish study on Halal tourism in Sweden. The purpose of this exploratory research is to get insight into the perception of Halal tourism in Sweden among representatives of tourism stakeholders. The overall methodology approach in this research is qualitative, consisting of 25 qualitative questionnaires, 21 short letters, four follow-up interviews, and a web observation, and content analysis was employed. The results indicate that there is a low knowledge of Halal tourism in Sweden including Swedish tourism industry. The concept is very challenging, and profits are low. It might result in problem scenarios such as detrimental effects on non-Halal tourism, cultural difficulties and increased risk of xenophobia, anti-Islamism, and tension in the society. There is low interest for Sweden among Muslim tourists as the interest and priority for Halal tourism is rather low from Swedish tourism industry. Despite Halal tourism’s importance internationally, these representatives are rather cautious and doubtful about promotion of Sweden towards this niche. Still, a majority seems to be positive to a lighter version of Muslim-friendly tourism with secular/moderate Muslims as a target group.

scholarly journals Endocrine disrupting chemical-associated hair product use during pregnancy and gestational age at delivery: a pilot study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Emma V. Preston ◽  
Victoria Fruh ◽  
Marlee R. Quinn ◽  
Michele R. Hacker ◽  
Blair J. Wylie ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Black Women ◽  
Pilot Study ◽  
Gestational Age ◽  
Endocrine Disrupting Chemical ◽  
Product Use ◽  
Frequent Use ◽  
Increased Risk ◽  
Endocrine Disrupting ◽  
Gestational Age At Delivery

Abstract Background Prenatal endocrine disrupting chemical (EDC) exposure has been associated with increased risk of preterm birth. Non-Hispanic Black women have higher incidence of preterm birth compared to other racial/ethnic groups and may be disproportionately exposed to EDCs through EDC-containing hair products. However, research on the use of EDC-associated hair products during pregnancy and risk of preterm birth is lacking. Therefore, the objective of this pilot study was to estimate associations of prenatal hair product use with gestational age at delivery in a Boston, Massachusetts area pregnancy cohort. Methods The study population consisted of a subset of participants enrolled in the Environmental Reproductive and Glucose Outcomes (ERGO) Study between 2018 and 2020. We collected self-reported data on demographics and hair product use using a previously validated questionnaire at four prenatal visits (median: 12, 19, 26, 36 weeks’ gestation) and abstracted gestational age at delivery from medical records. We compared gestational age and hair product use by race/ethnicity and used linear regression to estimate covariate-adjusted associations of product use and frequency of use at each study visit with gestational age at delivery. Primary models were adjusted for maternal age at enrollment and delivery method. Results Of the 154 study participants, 7% delivered preterm. Non-Hispanic Black participants had lower mean gestational age at delivery compared to non-Hispanic White participants (38.2 vs. 39.2 weeks) and were more likely to report ever and more frequent use of hair products. In regression models, participants reporting daily use of hair oils at visit 4 had lower mean gestational age at delivery compared to non-users (β: -8.3 days; 95% confidence interval: -14.9, -1.6). We did not find evidence of associations at earlier visits or with other products. Conclusions Frequent use of hair oils during late pregnancy may be associated with shorter gestational duration. As hair oils are more commonly used by non-Hispanic Black women and represent potentially modifiable EDC exposure sources, this may have important implications for the known racial disparity in preterm birth.

scholarly journals Iodine Excretion and Intake in Women of Reproductive Age in South Australia Eating Plant-Based and Omnivore Diets: A Pilot Study

2021 ◽  
Vol 18 (7) ◽  
pp. 3547
Author(s):  
Jane S. Whitbread ◽  
Karen J. Murphy ◽  
Peter M. Clifton ◽  
Jennifer B. Keogh
Keyword(s):  
Pilot Study ◽  
Urinary Iodine ◽  
Group Versus ◽  
Iodine Intake ◽  
Reproductive Age ◽  
World Health ◽  
Urinary Iodine Concentration ◽  
Women Of Reproductive Age ◽  
Increased Risk ◽  
Iodine Excretion

Women consuming a strictly vegan/plant-based diet may be at increased risk of low iodine intake due to avoidance of animal products containing iodine. The aim of this pilot study was to determine the iodine excretion and intake in women consuming vegan/plant based diets compared with women consuming omnivore diets. Fifty-seven women (n = 31 plant-based, n = 26 omnivores), provided two spot urine samples to assess urinary iodine concentration (UIC). Two days of dietary intake were also recorded by participants. As the data were not normally distributed results are reported as median (IQR). UIC was significantly different between groups, 44 (26–66) µg/L in the vegan/plant-based group versus 64 (40–88) µg/L in omnivores (p < 0.05). UIC did not meet the >100 µg/L level recommended by the World Health Organization. Iodine intake was also significantly different, 78 (62–91) µg/day in the vegan/plant-based group and 125 (86–175) µg/day in the omnivores (p = 0.000). Iodine intake and bread intake were correlated with iodine excretion (CC 0.410–4.11, p = 0.003). These data indicate iodine insufficiency in both groups of women as the median values were below the minimum WHO recommendation. A larger study assessing iodine excretion in the Australian women of reproductive age who are not pregnant or breastfeeding is needed to confirm these findings.

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