Effects of Physical Activity and Micronutrients on Cognitive Performance in Children Aged 6 to 11 Years: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background and Objectives: Cognitive performance is essential for children, given this is a critical stage of brain growth and development. This systematic review and meta-analysis aimed to ascertain if physical activity or micronutrients impact cognitive performance in children. Materials and Methods: Electronic databases (PubMed and Scopus®) were searched for relevant articles published between 2012 and 2021. We emphasized randomized controlled trials (RCTs) that examined the effect of physical activity and micronutrients on cognitive performance. Data from eligible studies were gathered and evaluated using random-, fixed- or pooled-effects models with 95% confidence intervals (95% CI). Results: Physical activity appeared to improve both Mathematics (d = 1.12, 95% CI: 0.56, 1.67) and attention (d = 0.65, 95% CI: 0.15, 1.14) performances. The micronutrient vitamin B12 had a positive effect on Mathematics (d = 2.39, 95% CI: 0.79, 3.98), English (d = 5.29, 95% CI: 2.76, 7.83), Geography (d = 5.29, 95% CI: 2.76, 7.83), Science (d = 3.39, 95% CI: 2.62, 4.16) and Arts (d = 3.32, 95% CI: 1.84, 4.79). Zinc was found to positively affect English (d = 3.78, 95% CI: 0.44, 7.13), Geography (d = 4.77, 95% CI: 0.56, 8.98) and Arts (d = 2.39, CI: 0.33, 4.45). Iron positively affected Mathematics (d = 1.29, 95% CI: 0.54, 2.06), English (d = 1.29, 95% CI: 0.44, 7.13), Geography (d = 4.77, 95% CI: 0.56, 8.98) and Arts (d = 2.39, 95% CI: 0.33, 4.45). Conclusions: A more comprehensive intervention with a specific dose/level of physical activity, an increased range of cognitive performance, and a well-designed study design that accounts for dietary intake and other health outcomes are required for future studies.

A Single-Central, Randomized, Double-Blinded, Placebo-Controlled, Crossover Trial Protocol: A Clinical Effect Evaluation Study on the TCM Comprehensive Intervention Program for Chronic Heart Failure

Background. It is known to all the doctors and patients that both the morality and incidence rate of chronic heart failure (CHF) are quite high among various heart diseases. Traditional Chinese medicine (TCM) comprehensive intervention becomes a rising prospective therapy for patients with CHF. Considering the efficacy of TCM, the study aims to test the safety as well as the validity of TCM comprehensive intervention in patients who are struggling with CHF. Methods. The study is an essentially randomized, single-central, placebo-controlled, double-blinded crossover trial. Eighty-two eligible subjects aged 18–75 years with CHF are supposed to be recruited. According to the subject plan, all the patients will be divided into group A and B. The patients in group A will receive oral Qishen Taohong granules (QTGs) combined with TCM external treatment and standard Western medicine for four weeks. After that, a 2-week washout would be proceeded; this group will be reallocated to another four weeks with oral placebo granules combined with TCM external treatment and standard Western medicine. In contrast, group B will perform the opposite protocol. The primary outcome conforms to the classification from the New York Heart Association (NYHA). Meanwhile, the secondary outcomes are echocardiogram, N-terminal pro-B-type natriuretic peptide (NT-proBNP), Chronic Heart Failure Quality of Life Scale of Integrated Chinese and Western Medicine (CHFQLS), TCM syndrome, symptom, sign, six-minute walk test (6MWT), Pittsburgh Sleep Quality Index (PSQI), Montreal cognitive assessment (MoCA), major adverse cardiovascular events (MACEs), and metabolomics. Discussion. Based on conventional treatments, TCM comprehensive intervention may further improve the patients’ cardiac function and then enhance their quality of life. The results will provide high-quality evidence of TCM comprehensive intervention in treating CHF.

Gender-Based Violence in Adolescent Dating from a Medical Perspective: A Qualitative Study of the Needs Felt in Primary Healthcare Centres

Violence in adolescent dating has become a worrying public health problem. Research carried out on the issue has focused on identifying the causes of this phenomenon. However, difficulties have been found in designing and implementing effective prevention programs. In this context, primary healthcare physicians are one of the most important figures in screening for and detecting this phenomenon, since, in many cases, they are the first to have contact with the victims. The present study focuses on the qualitative analysis of a series of interviews carried out with 95 primary healthcare physicians in Extremadura, Spain. These interviews addressed various questions related to the theoretical and practical knowledge that the physicians have about the topic. The analysis of their responses reveals some of the strengths and weaknesses of the Spanish public health system, at the same time as pointing to what is needed to be able to improve comprehensive intervention for the victims, from the moment they arrive for their first consultation until they are treated and referred to different health specialists.

Efficacy of a School-Based Comprehensive Intervention Program for Adolescents With Autism

We tested the efficacy of a comprehensive intervention program designed for high school students across the autism spectrum, the Center on Secondary Education for Students with Autism (CSESA) model, in a cluster randomized control trial involving 60 high schools in three states (California, North Carolina, Wisconsin), with implementation occurring over a 2-year period. We examined outcomes for the schools, students ( N = 547), and families. At the conclusion of the study, CSESA schools had significantly higher program quality than the services-as-usual (SAU) schools. In addition, students in the CSESA schools had significantly higher total attainment of educational goals than students in SAU schools. There were not significant differences between the two groups on standardized assessment outcomes. We discuss implications for intervention implementation and future research with this population in the public school context.

Nursing Research on Comprehensive Intervention of Pleural Reaction Undergoing Thoracentesis

Objective To explore the influence of different postures for pleural reaction in patients undergoing thoracic interventional operations. Methods The 695 patients with pleural effusion or hydro-pneumothorax underwent thoracic interventional operations (thoracentesis and thoracic catheter drainage) by ultrasound guidance from May, 2018 to February, 2021 were involved in this study. Two groups were divided in randomly，one was sitting posture group, 312 patients was preformed operations in this postures, the other group included 383 patients who were in supine or lateral positions. The pleural reaction rates of the two groups were compared. Results The pleural reaction rates were 18.5% (58/312) in sitting posture group and 2.8% (11/383) in supine group, there were statistically significant difference between the two groups. Conclusion Postures of patients can affect the occurrence of pleural reaction, supine position can reduce the incidence of pleural reaction.

Forecast the Supply of General Practitioners in Shanghai: Using an Agent-based Model

BackgroundGeneral practitioners (GPs), as one important human resource for health, is facing a supply shortage in China. The diversity of individual decision-making behaviors of GPs and medical students increases the difficulty of supply forecasting. Agent-based simulation, as a bottom-up approach, has the potential to address this challenge.MethodsAn agent-based model was developed to forecast the supply of GPs in Shanghai, China. Based on the theory of working life cycle, we analyzed the life cycle of GPs and developed the framework. Publicly available data were used to parameterize the model. Several scenarios were conducted to test hypotheses and examine intervention stratigies. NetLogo 6.1.0 was used for model implemtation. ResultsThe model was run over a nearly 20-year time span from 2016 to 2035 in Shanghai. Simulated results showed that GPs in Shanghai will rise from 8,000 to 15,375 during this period. Sensitivity analysis showed that parameters of the health system had a greater impact on the results than those of the education system. ConclusionsReliable forecasting of the supply and demand is a prerequisite for solving the shortage of GPs. Comprehensive intervention strategies are needed to address the supply shortage. For example, as indiciated by our study, regions should increase their attractiveness to GPs and retain them more effectively, instead of just increasing the number of medical students enrolled.

930Development and feasibility of a mHealth supported Comprehensive Intervention Model (“CIMmH”) for esophageal cancer patients

Background Esophageal cancer patients often experience a clinically relevant deterioration of quality of life (QoL) after esophagectomy due to malnutrition, lack of physical exercise, and psychological problems. This study aims to evaluate the feasibility and efficacy of a comprehensive intervention model using the mHealth system (CIMmH) on the mobile platform that offers accessible nutritional, exercise, and psychosocial support to esophageal cancer patients after esophagectomy. Methods Twenty esophageal cancer patients were invited to join the CIMmH for 12 weeks. The CIMmH included an online component and an offline consultation component. The participants were assessed before surgery and at 1-month and 3-month intervals after esophagectomy. QoL, depressive symptoms, anxiety, stress, nutrition, and physical fitness were measured. Results Sixteen out of 20 (80%) completed the program. One month after esophagectomy, the global health scale significantly decreased while fatigue, pain, and dyspnea increased. At the 3-month follow-up, only pain, difficulty with eating, dry mouth and trouble with talking were significantly worse than the baseline. All other dimensions in the QoL returned to the preoperative level. Weight and BMI were reduced throughout the study and no significant changes were observed in physical fitness. Depressive symptoms significantly increased one month after surgery. Conclusions The CIMmH had good feasibility and demonstrated encouraging preliminary efficacy for enhancing recovery after surgery among esophageal cancer patients in China. Key messages Esophageal cancer, Quality of life, Nutrition, Physical exercise, Psychological support, Mobile Health (mHealth)

1511CIMmH, an mHealth Comprehensive Intervention Model for esophageal cancer patients: A Multi-center RCT Protocol

Background Post-esophagectomy patients often experience a clinically relevant deterioration of quality of life after esophagectomy due to malnutrition, impaired exercise capacity, and psychological problems. The widespread use of mobile health (mHealth) has been increasingly promising for interdisciplinary healthcare givers to deliver efficient and potential cost-effective interventions in cancer patients. However, comprehensive interventions delivered by mHealth with a rigorous design of randomized controlled trial in post-esophagectomy patients were scarce. Methods This study developed the first comprehensive intervention model by mHealth with a parallel RCT design, providing nutrition, physical exercise, and psychological support for post-esophagectomy patients. A total of 120 patients will be randomized into the intervention group or the control group receiving treatment as usual. Participants in the intervention group will receive the 3-month intervention of the CIMmH program via the enhanced WeChat platform and by specialists (offline). The online program includes nutrition guidelines, physical exercise instructions, and psychological courses. All participants will be assessed at baseline, 1, and 3 months after esophagectomy. The primary outcomes are health-related QOL, weight, and physical fitness measured by 6-minute walking distance. Secondary outcomes include nutritional biomarkers, body composition, strength, interleukin-6, depressive symptoms, anxiety, and coping. Discussion This study is among the first efforts to innovatively develop a comprehensive intervention program to prompt rehabilitation in post-esophagectomy patients. Once proven effective, CIMmH could be integrated into the management of post-esophagectomy patients. Key messages Esophageal cancer, QOL, Nutrition, Physical exercise, Psychological support, mHealth

Initial Evaluation of a Public Transportation Intervention Program for Individuals With Developmental Disabilities

Date Presented 04/8/21 People with developmental disabilities (DD) often face transportation challenges that impede community participation. The purpose of this study was to examine the impact of a comprehensive intervention program on the travel skills of individuals with DD to increase community mobility. Primary Author and Speaker: Elizabeth Pfeiffer Contributing Authors: Allison Smith