Lifestyle interventions delivered by eHealth in chronic kidney disease: A scoping review.

A method of overcoming barriers associated with implementing lifestyle interventions in CKD may be through the use of eHealth technologies. The aim of this review was to provide an up-to-date overview of the literature on this topic. Four bibliographical databases, two trial registers, and one database for conference proceedings were searched from inception to August 2023. Studies were eligible if they reported a lifestyle intervention using eHealth technologies. A narrative synthesis of the findings from the included studies structured around the type of eHealth intervention was presented. Where a sufficient number of studies overlapped in terms of the type of intervention and outcome measure these were brought together in a direction of effect plot. There were 54 included articles, of which 23 were randomised controlled trials (RCTs). The main component of the intervention for the included studies was mobile applications (n = 23), with the majority being in the dialysis population (n = 22). The majority of eHealth interventions were reported to be feasible and acceptable to participants. However, there was limited evidence that they were efficacious in improving clinical outcomes with the exception of blood pressure, intradialytic weight gain, potassium, and sodium. Although eHealth interventions appear acceptable and feasible to participants, there is insufficient evidence to make recommendations for specific interventions to be implemented into clinical care. Properly powered RCTs which not only demonstrate efficacy, but also address barriers to implementation are needed to enhance widespread adoption.

Congruence couple therapy for alcohol use and gambling disorders with comorbidities (part I): Outcomes from a randomized controlled trial.

A nonblinded randomized trial was conducted at two Canadian provincial outpatient addiction clinics that tested the effectiveness of a systemic congruence couple therapy (CCT) versus individual-based treatment-as-usual (TAU) on nine clinical outcomes: (1) primary outcomes-alcohol use and gambling, psychiatric symptoms, and couple adjustment; (2) secondary outcomes-emotion regulation, substance use, depression, post-traumatic stress symptoms, and life stress. Data of primary clients and partners (N = 46) were analyzed longitudinally across baseline, posttreatment (5 months), and follow-up (8 months). Alcohol use disorder (95%) and gambling disorder (5%) were in the severe range at baseline, and co-addiction was 27%. Psychiatric comorbidity was 100%, and 18% of couples were jointly addicted. Between-group comparison favored CCT in primary outcomes with medium-to-large effect sizes (Cohen's h = 0.74-1.44). Secondary outcomes were also significantly stronger for CCT (Cohen's h = 0.27-1.53). Within-group, for all primary outcomes, a significant proportion of symptomatic CCT clients and partners improved, converging with ANOVA results of large effect sizes (0.14-0.29). All secondary outcomes improved significantly in CCT with large effect sizes (0.14-0.50). TAU showed significant within-group improvement in alcohol use, other substance use, and life stress with large effect sizes (0.16-0.40). Primary clients and partners made largely equivalent improvement within CCT and within TAU. Results were triangulated with clients' satisfaction ratings and counselors' reports. Overall, significant within-group effects were detected for CCT both clinically and statistically and between-group difference favored CCT. Future trials are required to validate these promising findings.

Current status of undergraduate orthodontic education in Canada.

PURPOSE: This study evaluated teaching hours and mode of instruction of undergraduate orthodontic education dental students in Canada receive, changes implemented by each educational dental institution (EDI) in response to the COVID-19 pandemic, and plans for mode of orthodontic education delivery post-COVID-19. METHODS: An electronic survey was administered to the program directors of undergraduate orthodontics at each EDI to reveal details regarding the (i) time and details of didactic, preclinical, and clinical experience provided to students and (ii) perceptions of undergraduate program directors about the adequacy of the current curricula. RESULTS: All 10 Canadian EDIs participated in the survey during the year 2021. Most EDIs deliver their orthodontic curricula beginning in the second year of the program (7, 70.0%), continuing through third (7, 70.0%) and fourth (6, 60.0%) years. The number of hours of didactic, preclinical, and clinical instruction varied by as much as 50 h per academic year across different EDIs. In response to the COVID-19 pandemic, almost all EDIs (9, 90.0%) maintained the same amount of didactic lecture time yet most switched to synchronous (5, 50.0%) or asynchronous (3, 30.0%) online delivery format. Most EDIs (8, 80.0%) indicated the quality of education was maintained during the pandemic. CONCLUSIONS: There exists significant variation in undergraduate orthodontic time allotment among Canadian EDIs. During the COVID-19 pandemic, most Canadian EDIs maintained a consistent amount of teaching hours while transitioning to some form of online course delivery. Most program directors indicated they believed students received the same quality of education after the change in mode of course delivery. The future of undergraduate orthodontic education will likely continue the accelerated trend toward online education.

Pain thresholds in alcohol preferring and non-preferring rats: diurnal and repeated trial line differences.

BACKGROUND: Studies in humans and animals suggest that those with a genetic predisposition toward high levels of alcohol consumption have decreased pain thresholds. The present study explores this association in rat lines selectively bred for alcohol preference or nonpreference. METHODS: 13 HAD1, 11 LAD1, 16 iP5C, and 16 iNP1 rats were tested in the Ugo Basile Plantar Analgesiometer and the IITC Tail Flick device. Five trials were conducted in each test session with one session per device conducted in the light and one in the dark. Trial one latency represents baseline latency. Decline in Latency over Repeated Trials (DLRT) was analyzed using linear regression. RESULTS: Testing in the Plantar Analgesiometer revealed no significant line differences in baseline latency (iP5C versus iNP1; HAD1 vs. LAD1). The alcohol preferring lines (iP5C and HAD1), however, both demonstrated an increase in baseline latency in the dark phase compared to the light phase (p < 0.05). The iNP1 line demonstrated highly significant DLRT in both the light phase (p < 0.001) and dark phase (p < 0.01) while the iP5C line demonstrated a significant DLRT only at night (p < 0.01). In the tail flick apparatus, the HAD1 line demonstrated a significantly increased baseline latency compared to the LAD1 line in both the light (p < 0.05) and dark (p < 0.01) phases. The HAD1 line also demonstrated a significant increase in baseline latency in the dark compared to the light phase (p < 0.05) and a significant DLRT in the light (p < 0.01) and the dark phase (p < 0.001). CONCLUSIONS: The alcohol preferring HAD1 line demonstrates a significantly increased baseline tail latency compared to the nonpreferring LAD1 line in both light and dark phases. There is a significant diurnal rhythm of paw and tail latency in both of the alcohol preferring lines (iP5C and HAD1) but not in the nonpreferring lines (iNP1 and LAD1). A novel finding of Decline in Latency with Repeated Trials (DLRT) was found in both alcohol preferring and nonpreferring lines; degree of DLRT differed as a function of line and circadian period.