Weight Loss in Short-Term Interventions for Physical Activity and Nutrition Among Adults With Overweight or Obesity: A Systematic Review and Meta-Analysis.

Introduction: Reaching, enrolling, and retaining participants in lengthy lifestyle change interventions for weight loss is a major challenge. The objective of our meta-analysis was to investigate whether lifestyle interventions addressing nutrition and physical activity lasting 6 months or less are effective for weight loss. Methods: We searched for peer-reviewed studies on lifestyle change interventions of 6 months or less published from 2012 through 2023. Studies were screened based on inclusion criteria, including randomized controlled trials (RCTs) for adults with overweight or obesity. We used a random-effects model to pool the mean difference in weight loss between intervention and control groups. We also performed subgroup analyses by intervention length and control type. Results: Fourteen RCTs were identified and included in our review. Half had interventions lasting less than 13 weeks, and half lasted from 13 to 26 weeks. Seven were delivered remotely, 4 were delivered in person, and 3 used combined methods. The pooled mean difference in weight change was -2.59 kg (95% CI, -3.47 to -1.72). The pooled mean difference measured at the end of the intervention was -2.70 kg (95% CI, -3.69 to -1.71) among interventions lasting less than 13 weeks and -2.40 kg (95% CI, -4.44 to -0.37) among interventions of 13 to 26 weeks. Conclusion: Short-term multicomponent interventions involving physical activity and nutrition can achieve weight loss for adults with overweight or obesity. Offering short-term interventions as alternatives to long-term ones may reach people who otherwise would be unwilling or unable to enroll in or complete longer programs.

An Examination of Gender Differences in the National Diabetes Prevention Program's Lifestyle Change Program.

PURPOSE: The purpose of the study was to examine how gender was related to enrollment and number of sessions attended in the National Diabetes Prevention Program's Lifestyle Change Program (DPP LCP). METHODS: To better understand program uptake, a population of those who would be eligible for the LCP was compared to those who enrolled. Estimates of those eligible were computed using data from the National Health and Nutrition Examination Survey, whereas enrollment and sessions attended were computed using data from the Centers for Disease Control and Prevention's Diabetes Prevention Recognition Program. RESULTS: Results revealed that although similar numbers of males and females were eligible for the program, only 39 321 males versus 121 007 females had enrolled in the National DPP LCP by the end of 2017 (odds ratio = 3.20; 95% CI, 3.17-3.24). The gender differences persisted even when stratifying by age or race/ethnicity. In contrast, no significant gender differences were found between the average number of sessions attended for males (14.0) and females (13.8). DISCUSSION: Results of the study can help inform efforts to market and tailor programs to appeal more directly to men and other groups that are underrepresented in the National DPP LCP.

The impact of SafeCare® Dads to Kids program on father maltreatment risk and involvement: Outcomes and lessons learned from an efficacy trial.

Child Maltreatment (CM) is a public health problem, and experts recommend parent training programs as a prevention method. Few programs target fathers, even though male caregivers are involved as perpetrators in approximately 45% of substantiated CM cases. This study examines the efficacy of an adapted version of SafeCare (Dad2K) with marginalized fathers. Participants include a convenience sample of fathers with children ages 2-5 years. Fathers (n=99) were randomized to an 1) intervention group (SafeCare Dad2K) or to a 2) comparison group (receiving parenting information in the mail). Quantitative data were collected at baseline, post-intervention (7-weeks post-baseline), and 3-months post-intervention. Qualitative data (semi-structured interviews) were collected from 11 intervention father completers following the second quantitative data collection timepoint. Multi-level modeling results indicated no statistically significant time-by-treatment findings for father involvement (b=0.03, 95% confidence interval [CI]: -0.03, 0.08, p=0.38), total corporal punishment (b=-0.03, 95% CI: -0.47, 0.41, p=0.89), or neglect (b=-0.13, 95% CI: -1.93, 1.68, p=0.89). Qualitative findings indicated that Dad2K completers exhibited positive knowledge and behavioral change related to parenting. Study limitations, lessons learned from this formative work, and recommendations for future research are discussed.

Comparison of Different Minimal Velocity Thresholds to Establish Deadlift One Repetition Maximum.

The aim of this study was to compare the actual deadlift one repetition maximum (1RM) and the deadlift 1RM predicted from individualised load-velocity profiles. Twelve moderately resistance-trained men participated in three deadlift sessions. During the first, 1RM was assessed; during the second, load-velocity profiles were recorded with six loads (65% to 90% 1RM) using a linear position transducer recording at 1000 Hz; and during the third, minimal velocity thresholds (MVT) were recorded from the velocity of the last repetition during sets to volitional fatigue with 70% and 80% 1RM with a linear position transducer recording at 1000 Hz. Regression was then used to generate individualised load-velocity profiles and the MVT was used as a cut-off value from which to predict deadlift 1RM. In general, velocity reliability was poor to moderate. More importantly, predicted deadlift 1RMs were significantly and meaningfully less than actual deadlift 1RMs (p < 0.05, d = 1.03⁻1.75). The main practical application that should be taken from the results of this study is that individualized load-velocity profiles should not be used to predict deadlift 1RM. Practitioners should not use this method in combination with the application of MVT obtained from the last repetition of sets to volitional fatigue.

Effect of a Hexagonal Barbell on the Mechanical Demand of Deadlift Performance.

This study compared typical mechanical variables of interest obtained directly from barbell motion during deadlift performance with a conventional (CBD) and a hexagonal barbell (HBD). Eleven men, proficient with both deadlift variations, volunteered to participate in the study (age: 20.3 ± 0.6 years; height: 175.5 ± 8.5 m; mass: 88.7 ± 19.0 kg; CBD 1RM: 183 ± 22 kg; HBD 1RM: 194 ± 20 kg). During the first session, CBD and HBD 1RM was assessed; during the second session, they performed 3 sets of 1 CBD repetition with 90% 1RM; and in session three, they repeated this process with the HBD. Barbell displacement was recorded at 1000 Hz and mechanical parameters derived from this. Significantly heavier loads were lifted during HBD (6%, p = 0.003). There were no significant differences between barbell displacement (p = 0.216). However, HBD was performed significantly faster (15%, p = 0.012), HBD load was accelerated for significantly longer (36%, p = 0.004), and significantly larger mean forces underpinned this (6%, p < 0.001), with more work having been performed (7%, p < 0.001) at greater power outputs (28%, p < 0.001). The results of this study showed that heavier HBD loads can be lifted through the same range of motion faster, and that this load is accelerated for significantly longer. The strategies used to achieve these differences could have a significant effect on training outcomes.

Signatures of early frailty in the gut microbiota.

BACKGROUND: Frailty is arguably the biggest problem associated with population ageing, and associates with gut microbiome composition in elderly and care-dependent individuals. Here we characterize frailty associations with the gut microbiota in a younger community dwelling population, to identify targets for intervention to encourage healthy ageing. METHOD: We analysed 16S rRNA gene sequence data derived from faecal samples obtained from 728 female twins. Frailty was quantified using a frailty index (FI). Mixed effects models were used to identify associations with diversity, operational taxonomic units (OTUs) and taxa. OTU associations were replicated in the Eldermet cohort. Phenotypes were correlated with modules of OTUs collapsed by co-occurrence. RESULTS: Frailty negatively associated with alpha diversity of the gut microbiota. Models considering a number of covariates identified 637 OTUs associated with FI. Twenty-two OTU associations were significant independent of alpha diversity. Species more abundant with frailty included Eubacterium dolichum and Eggerthella lenta. A Faecalibacterium prausnitzii OTU was less abundant in frailer individuals, and retained significance in discordant twin analysis. Sixty OTU associations were replicated in the Eldermet cohort. OTU co-occurrence modules had mutually exclusive associations between frailty and alpha diversity. CONCLUSIONS: There was a striking negative association between frailty and gut microbiota diversity, underpinned by specific taxonomic associations. Whether these relationships are causal or consequential is unknown. Nevertheless, they represent targets for diagnostic surveillance, or for intervention studies to improve vitality in ageing.

Adding new tools to the black bag--introduction of ultrasound into the physical diagnosis course.

INTRODUCTION: Ultrasound, a versatile diagnostic modality that permits real-time visualization at the patient's bedside, can be used as an adjunct in teaching physical diagnosis (PD). AIMS: (1) to study the feasibility of incorporating ultrasound into PD courses and (2) determine whether learners can demonstrate image recognition and acquisition skills. PROGRAM DESCRIPTION: Three hundred seven second-year medical students were introduced to cardiovascular and abdominal ultrasound scanning after training in the physical examination. This consisted of a demonstration of the ultrasound examination, followed by practice on standardized patients (SPs). Pre-post tests were administered to evaluate students' knowledge and understanding of ultrasound. Students performed an ultrasound examination during the PD final examination. PROGRAM EVALUATION: Pre-post test data revealed significant improvements in image recognition. On the final exam, the highest scores (98.4%) were obtained for the internal jugular vein and lowest scores (74.6%) on the Focused Assessment with Sonography for Trauma images. Eighty-nine percent of students' surveyed felt ultrasound was a valuable tool for physicians. DISCUSSION: An introductory ultrasound course is effective in improving medical students' acquisition and recognition of basic cardiovascular and abdominal ultrasound images. This innovative program demonstrates the feasibility of incorporating portable ultrasound as a learning tool during medical school.

The effectiveness of streaming video on medical student learning: a case study.

Information technology helps meet today's medical students' needs by providing multiple curriculum delivery methods. Video streaming is an e-learning technology that uses the Internet to deliver curriculum while giving the student control of the content's delivery. There have been few studies conducted on the effectiveness of streaming video in medical schools. A 5-year retrospective study was conducted using three groups of students (n = 1736) to determine if the availability of streaming video in Years 1-2 of the basic science curriculum affected overall Step 1 scores for first-time test-takers. The results demonstrated a positive effect on program outcomes as streaming video became more readily available to students. Based on these findings, streaming video technology seems to be a viable tool to complement in-class delivery methods, to accommodate the needs of medical students, and to provide options for meeting the challenges of delivering the undergraduate medical curriculum. Further studies need to be conducted to continue validating the effectiveness of streaming video technology.

Surviving cave bats: auditory and behavioural defences in the Australian noctuid moth, Speiredonia spectans.

The Australian noctuid moth, Speiredonia spectans shares its subterranean day roosts (caves and abandoned mines) with insectivorous bats, some of which prey upon it. The capacity of this moth to survive is assumed to arise from its ability to listen for the bats' echolocation calls and take evasive action; however, the auditory characteristics of this moth or any tropically distributed Australian moth have never been examined. We investigated the ears of S. spectans and determined that they are among the most sensitive ever described for a noctuid moth. Using playbacks of cave-recorded bats, we determined that S. spectans is able to detect most of the calls of two co-habiting bats, Rhinolophus megaphyllus and Miniopterus australis, whose echolocation calls are dominated by frequencies ranging from 60 to 79 kHz. Video-recorded observations of this roost site show that S. spectans adjusts its flight activity to avoid bats but this defence may delay the normal emergence of the moths and leave some 'pinned down' in the roosts for the entire night. At a different day roost, we observed the auditory responses of one moth to the exceptionally high echolocation frequencies (150-160 kHz) of the bat Hipposideros ater and determined that S. spectans is unable to detect most of its calls. We suggest that this auditory constraint, in addition to the greater flight manoeuvrability of H. ater, renders S. spectans vulnerable to predation by this bat to the point of excluding the moth from day roosts where the bat occurs.

A pilot study of comprehensive ultrasound education at the Wayne State University School of Medicine: a pioneer year review.

OBJECTIVE: Ultrasound is a versatile diagnostic modality used in a variety of medical fields. Wayne State University School of Medicine (WSUSOM) is one of the first medical schools in the United States to integrate an ultrasound curriculum through both basic science courses and clinical clerkships. METHODS: In 2006, 25 portable ultrasound units were donated to WSUSOM. First-year medical students were provided an ultrasound curriculum consisting of 6 organ-system sessions that addressed the basics of ultrasound techniques, anatomy, and procedural skills. After the last session, students were administered 2 anonymous and voluntary evaluations. The first assessed their overall experience with the ultrasound curriculum, and the second assessed their technical skills in applying ultrasound techniques. RESULTS: Eighty-three percent of students agreed or strongly agreed that their experience with ultrasound education was positive. On the summative evaluation, nearly 91% of students agreed or strongly agreed that they would benefit from continued ultrasound education throughout their 4 years of medical school. Student performance on the technical assessment was also very positive, with mean class performance of 87%. CONCLUSIONS: As residency programs adopt ultrasound training, medical school faculty should consider incorporating ultrasound education into their curriculum. Portable ultrasound has the potential to be used in many different settings, including rural practice sites and sporting events. The WSUSOM committee's pilot ultrasound curriculum will continue to use student feedback to enhance the ultrasound experience, helping students prepare for challenges that they will face in the future.

Wireless Handheld Computers in the Undergraduate Medical Curriculum.

Wayne State University Medical School has implemented wireless handheld computers or PocketPCs (PPCs) into all four years of the undergraduate curriculum. A transition from a passive to an interactive learning environment in the classroom, as well as administrative solutions for monitoring patient encounter data by students in their clinical rotations was fostered by this educational technology. Implementation of the wireless devices into the curriculum will be described in this report. This will include the technical specifications and justification for the required device, as well as a detailed discussion of the different applications used for educational and administrative purposes by the preclinical and clinical students. Outcomes from the educational and administrative aspects of the project will also be presented in this report.

Wireless Handheld Computers in the Preclinical Undergraduate Curriculum.

This report presents the results of a pilot project using wireless PDAs as teaching tools in an undergraduate medical curriculum. This technology was used to foster a transition from a passive to an interactive learning environment in the classroom and provided a solution for the implementation of computer-based exams for a large class. Wayne State Medical School recently provided model e570 Toshiba PocketPCs® (personal digital assistants or PDAs), network interface cards, and application software developed by CampusMobility® to 20 sophomore medical students. The pilot group of preclinical students used the PDAs to access web-based course content, for communication, scheduling, to participate in interactive teaching sessions, and to complete course evaluations. Another part of this pilot has been to utilize the PDAs for computer-based exams in a wireless environment. Server authentication that restricted access during the exams and a proctoring console to monitor and record the PDA screens will be described in this report. Results of a student satisfaction survey will be presented.