The low dopamine hypothesis: A plausible mechanism underpinning residual urine, overactive bladder and nocturia (RON) syndrome in older patients.

INTRODUCTION: Aging is associated with a combination of several lower urinary tract (LUT) signs and symptoms, including residual urine, overactive bladder and nocturia. One of the mechanisms of this LUT dysfunction that has not been discussed in dept so far is the role of dopamine (DA). METHODS: In this narrative review, we explore the dopaminergic hypothesis in the development of this combination of LUT signs and symptoms in older adults. RESULTS: DA is one of the neurotransmitters whose regulation and production is disrupted in aging. In synucleinopathies, altered DAergic activity is associated with the occurrence of LUTS and sleep disorders. Projections of DAergic neurons are involved in the regulation of sleep, diuresis, and bladder activity. The low dopamine hypothesis could explain the genesis of a set of LUT signs and symptoms commonly seen in this population, including elevated residual urine, Overactive bladder syndrome and Nocturia (discussed as the RON syndrome). This presentation is however also common in older patients without synucleinopathies or neurological disorders and therefore we hypothesise that altered DAergic activity because of pathological aging, and selective destruction of DAergic neurons, could underpin the presentation of this triad of LUT dysfunction in the older population. CONCLUSION: The concept of RON syndrome helps to better understand this common phenotypic presentation in clinical practice, and therefore serves as a useful platform to diagnose and treat LUTS in older adults. Besides recognizing the synucleinopathy "red flag" symptoms, this set of multi-causal LUT signs and symptoms highlights the inevitable need for combination therapy, a challenge in older people with their comorbidities and concomitant medications.

Surface modification of poly(methyl-methacrylate) with farnesol to prevent Candida biofilm formation.

Candida albicans promotes biofilm formation on dentures, which compromises the use of poly(methyl-methacrylate) (PMMA) as a dental material. Farnesol (FAR), a natural compound that prevents C. albicans filamentation and biofilm formation, was incorporated into the PMMA matrix, to obtain antifungal PMMA_FAR materials. The tested concentrations (0·0125% and 0·4%) of FAR, 24 h after incubation on YPD agar, inhibited filamentation of C. albicans. PMMA was modified with different FAR concentrations (3-12%), and physicochemical properties, antifungal activity and cytotoxicity of these modified materials (PMMA_FAR) were tested. The presence of FAR in PMMA_FAR composites was verified by Fourier-transform infrared spectroscopy (FT-IR). Incorporation of FAR into the polymeric matrix significantly decreased hydrophilicity at all tested concentrations and significantly reduced biofilm and planktonic cells metabolic activity in the early stage of biofilm formation at ≥6% FAR in PMMA. PMMA_FAR composites with <9% FAR were non-toxic. Modification of PMMA with FAR is a good strategy for reducing C. albicans biofilm formation on dentures.

Impact of COVID-19 outbreak on hospital admissions and outcome of acute coronary syndromes in a single high-volume centre in southeastern Europe.

BACKGROUND: As coronavirus disease 2019 (COVID-19) has reached pandemic status, authors from the most severely affected countries have reported reduced rates of hospital admissions for patients with acute coronary syndrome (ACS). AIM: The aim of the present study was to investigate the influence of the COVID-19 outbreak on hospital admissions and outcomes in ACS patients in a single high-volume centre in southeastern Europe. METHODS: This retrospective observational study aimed to investigate the number of hospital admissions for ACS, clinical findings at admission, length of hospitalisation, major complications and in-hospital mortality during the COVID-19 outbreak and to compare the data with the same parameters during an equivalent time frame in 2019. For the ST-elevated myocardial infarction (STEMI) subgroup of patients, changes in ischaemic times were analysed as well. RESULTS: There was a significant reduction of 44.3% in the number of patients admitted for ACS during the COVID-19 outbreak when compared with the same period in 2019 (151 vs 271; 95% confidence interval 38.4-50.2, p < 0.01) with a higher mortality rate (13.2% vs 7.2%, p = 0.03). In 2020, patients with non-ST-elevated myocardial infarction presented more often with acute heart failure (3.3% vs 0.7%, p = 0.04). During the COVID-19 outbreak, we observed increases in the total ischaemic time (303 ± 163.4 vs 200.8 ± 156.8 min, p < 0.05) and door-to-balloon time (69.2 ± 58.4 vs 50.5 ± 31.3 min, p < 0.01) in STEMI patients. CONCLUSIONS: These findings should increase the awareness of morbidity and mortality related to missed or delayed treatment of ACS among the public and the healthcare services.

Comprehensive environmental monitoring and assessment of protected wetland and lake water quality in Croatia and Serbia.

The irresponsible and uncontrolled use of water bodies for long period of time leads to pollution and water quality degradation, particularly in sensitive protected terrestrial and aquatic areas as lakes and wetlands situated in the vicinity of human habitations. Vulnerable ecosystems, the Lake Zobnatica, Serbia and the Wetlands of Tompojevci, Croatia, are characterized as protected natural areas and are surrounded by agricultural land and developed anthropogenic activities. In the samples of surface, ground water and agricultural runoff the key physicochemical parameters were determined. The results of analysed water characterized the Lake water quality class as IV-V. The measured parameters for the Lake show the high values of nutrients, particularly in ground water and agricultural runoff, pH value higher than 8.5 and lower values of dissolved oxygen (DO) than 5 mg/L in the most of the examined water samples. According to the results and maximal allowable values Wetlands belong to the class V water quality, with high trophic state and poor eco-status according to Croatian and Serbian national Laws and By-Laws. The pH value higher than 8.5 of ground water in Wetlands of Tompojevci signifies alkaline groundwater. The maximum concentrations of orthophosphates in ground water and agricultural runoff (10.875 and 10.886 mg/L, respectively) imply the high level of agricultural pollution. Research study of water samples has been performed from 2017 to 2019 within the Interreg IPA CBC Croatia-Serbia Project AF_HR-RS135_SeNs_Wetlands. This type of parallel and comparative research in Serbia and Croatia was conducted for the first time.

Population pharmacokinetic modelling of intravenous paracetamol in fit older people displays extensive unexplained variability.

AIMS: Paracetamol is the analgesic most used by older people. The physiological changes occurring with ageing influence the pharmacokinetics (PK) of paracetamol and its variability. We performed a population PK-analysis to describe the PK of intravenous (IV) paracetamol in fit older people. Simulations were performed to illustrate target attainment and variability of paracetamol exposure following current dosing regimens (1000 mg every 6 h, every 8 h) using steady-state concentration (Css-mean ) of 10 mg l-1 as target for effective analgesia. METHODS: A population PK-analysis, using NONMEM 7.2, was performed based on 601 concentrations of paracetamol from 30 fit older people (median age 77.3 years, range [61.8-88.5], body weight 79 kg [60-107]). All had received an IV paracetamol dose of 1000 mg (over 15 min) after elective knee surgery. RESULTS: A two-compartment PK-model best described the data. Volume of distribution of paracetamol increased exponentially with body weight. Clearance was not influenced by any covariate. Simulations of the standardized dosing regimens resulted in a Css of 9.2 mg l-1 and 7.2 mg l-1 , for every 6 h and every 8 h respectively. Variability in paracetamol PK resulted in Css above 5.4 and 4.1 mg l-1 , respectively, in 90% of the population and above 15.5 and 11.7, respectively, in 10% at these dosing regimens. CONCLUSIONS: The target concentration was achieved in the average patient with 1000 mg every 6 h, while every 8 h resulted in underdosing for the majority of the population. Furthermore, due to a large (unexplained) interindividual variability in paracetamol PK a relevant proportion of the fit older people remained either under- or over exposed.

[Ethical decision making in dental care for frail older people]. / Ethische kwesties in de mondzorg voor kwetsbare ouderen.

Vurnerable older people often need intensive preventive and curative oral health care. However, their physical and cognitive decline does not always allow for lege artis implementation of dental treatments. This causes practical problems often with related moral issues. Including these moral issues in planning and implementation will make oral healthcare more effective and will also alleviate moral pressure on oral healthcare providers. Mostly the moral issues relate to every day ethics, which can be solved by all persons involved collectively, in open consultation and with an ethics of care approach. This means aiming at 'doing the right thing in the right way', including all the relevant aspects of the person of the patient and his/her environment. To achieve this, oral health care should be embedded in the overall care process for the elderly and care providers should feel involved with the older person and have reflective skills.

[Towards proactive and personalised care for the elderly]. / Op weg naar een proactieve en persoonsgerichte ouderenzorg.

The Netherlands, like other Western countries, shows an obvious demography of aging, which is associated with many challenges. People age differently, after all. Some remain vital until very old age, while others become frail and disabled much earlier in life. Because of the indicated demographic trend, morbidity is expected to increase and with it, the number of older people needing care. 'Aging in place' has become a central phenomenon in healthcare policies. This means that older people should be empowered to lead a meaningful life in their own living environment as long as possible, even when they are frail and care dependent. Therefore, in the future, most care for older people will actually occur at home. This article aims to present a meaningful care model for the older people. Starting from the 'definition discussion' about frailty and a revaluation of the concept of' resilience, a basis will be provided for a sustainable, proactive and personalised elderly care, close to the living environment of older people, in which dentists and other oral health professionals play an important role as well.

Clinical, microbiological and cytomorphometric evaluation of low-level laser therapy as an adjunct to periodontal therapy in patients with chronic periodontitis.

OBJECTIVE: A clinical prospective study was designed to evaluate microbiological, cytomorphometric and clinical efficacy of low-level laser therapy (LLLT) as an adjunct to periodontal therapy in the treatment of chronic periodontitis. METHODS: Sixty subjects were included and randomly assigned into 2 groups: SRP (scaling root planning) group (n = 30) and LLLT + SRP group (n = 30). Clinical parameters were measured before intervention, after the fifth treatment, and after a month. All subjects received oral hygiene instructions and full-mouth conservative periodontal treatment (removal of dental plaque followed by SRP). Afterwards, in group II, Kavo LLLT (980 nm, 0.2 W, 6 J/cm2 ) was applied. Subgingival samples were collected at baseline and after the fifth treatment to quantify Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Porphyromonas gingivalis, Tannerella forsythensis and Treponema denticola by polymerase chain reaction (PCR). Gingival swabs were taken, and direct smears were prepared on slides for cytomorphometric analysis. RESULTS: Evaluation using clinical parameters showed better results in LLLT group. A statistically significant decrease in the prevalence of bacteria after treatment in LLLT group was observed for the following: T. forsythensis and T. denticola (P < .001), P. gingivalis (P < .01), A. actinomycetemcomitans and P. intermedia (P < .05). The values of nuclear area, perimeter and Ferret's diameter were significantly lower in both studied groups after treatment, but statistical significance was higher in LLLT group (P < .001) than in the SRP therapy group (P < .05). CONCLUSION: Low-level laser therapy as an adjunct to periodontal therapy demonstrates short-term additional bacteriological, cytological and clinical benefits.

Scanning gate microscopy of magnetic focusing in graphene devices: quantum versus classical simulation.

We compare classical versus quantum electron transport in recently investigated magnetic focusing devices (Bhandari et al 2016 Nano Lett. 16 1690) exposed to the perturbing potential of a scanning gate microscope (SGM). Using the Landauer-Büttiker formalism for a multi-terminal device, we calculate resistance maps that are obtained as the SGM tip is scanned over the sample. There are three unique regimes in which the scanning tip can operate (focusing, repelling, and mixed regime) which are investigated. Tip interacts mostly with electrons with cyclotron trajectories passing directly underneath it, leaving a trail of modified current density behind it. Other (indirect) trajectories become relevant when the tip is placed near the edges of the sample, and current is scattered between the tip and the edge. We point out that, in contrast to SGM experiments on gapped semiconductors, the STM tip can induce a pn junction in graphene, which improves contrast and resolution in SGM. We also discuss possible explanations for spatial asymmetry of experimentally measured resistance maps, and connect it with specific configurations of the measuring probes.

The oral health condition and treatment needs assessment of nursing home residents in Flanders (Belgium).

OBJECTIVES: A study was conducted of nursing home residents with limited access to regular oral health care services to evaluate their oral health status, to perform an assessment of the need for oral treatment and to determine the possible predicting value of age, gender, care dependency and income level on their oral health status and treatment needs. MATERIALS AND METHODS: Three experienced dentists collected clinical oral health data with a mobile dental unit in 23 nursing homes. Socio-demographic data were extracted from the residents' records in the nursing home. Besides the descriptive and bivariate analysis, a general linear mixed model analysis was also performed with the nursing home as random effect. RESULTS: The study sample consisted of 1,226 residents with a mean age of 83.9 years, of which 41.9% were edentulous. The mean D3MFt in the dentate group was 24.5 and 77% needed extractions or fillings. In the group of residents wearing removable dentures, 36.9% needed repair, rebasing or renewal of the denture. The mixed model analysis demonstrated that with each year a resident gets older, the oral health outcomes get worse and that men have worse oral health and higher treatment needs than women. However, the level of income and care dependency had a less extensive role in predicting the oral health outcomes. CONCLUSIONS: The nursing home residents presented a poor overall oral health status and high dental and prosthetic treatment needs. Gender and age were important predicting variables for the oral health outcomes.

[The development of clinical practice algorithms for the appropriate use of psychotropic drugs in older persons with high risk of falls]. / Ontwikkeling van algoritmes voor oordeelkundig gebruik van psychofarmaca bij ouderen met verhoogd valrisico.

Psychotropic drugs (hypno-sedatives, antidepressants and antipsychotics) are commonly used in the older population. On the long term, psychotropic drug use in older persons is associated with several negative functional outcomes such as an increased risk of falls. Gradual withdrawal of psychotropic drugs in older persons is feasible and leads to a significant reduction of falls. Both withdrawal of psychotropic drugs as well as the initiation of appropriate treatment with psychotropic drugs requires knowledge, consultation and cooperation between disciplines and a mentality change among healthcare professionals. In order to inform and support healthcare professionals, the Centre of Expertise for Fall and Fracture Prevention Flanders developed three clinical practice algorithms for the appropriate use of psychotropic drugs in older persons with high risk of falls and a fact sheet with background information.

Presence of endocrine disruptors in freshwater in the northern Antarctic Peninsula region.

The increasing human presence in Antarctica and the waste it generates is causing an impact on the environment at local and border scale. The main sources of anthropic pollution have a mainly local effect, and include the burning of fossil fuels, waste incineration, accidental spillage and wastewater effluents, even when treated. The aim of this work is to determine the presence and origin of 30 substances of anthropogenic origin considered to be, or suspected of being, endocrine disruptors in the continental waters of the Antarctic Peninsula region. We also studied a group of toxic metals, metalloids and other elements with possible endocrine activity. Ten water samples were analyzed from a wide range of sources, including streams, ponds, glacier drain, and an urban wastewater discharge into the sea. Surprisingly, the concentrations detected are generally similar to those found in other studies on continental waters in other parts of the world. The highest concentrations of micropollutants found correspond to the group of organophosphate flame retardants (19.60-9209ngL(-1)) and alkylphenols (1.14-7225ngL(-1)); and among toxic elements the presence of aluminum (a possible hormonal modifier) (1.7-127µgL(-1)) is significant. The concentrations detected are very low and insufficient to cause acute or subacute toxicity in aquatic organisms. However, little is known as yet of the potential sublethal and chronic effects of this type of pollutants and their capacity for bioaccumulation. These results point to the need for an ongoing system of environmental monitoring of these substances in Antarctic continental waters, and the advisability of regulating at least the most environmentally hazardous of these in the Antarctic legislation.

[Respiratory Muscle Training: State of the Art]. / Atemmuskeltraining: State-of-the-Art.

Specific respiratory muscle training (IMT) improves the function of the inspiratory muscles. According to literature and clinical experience, there are 3 established methods: 1.) resistive load 2.) threshold load and 3.) normocapnic hyperpnea. Each training method and the associated devices have specific characteristics. Setting up an IMT should start with specific diagnostics of respiratory muscle function and be followed by detailed individual introduction to training. The aim of this review is to take a closer look at the different training methods for the most relevant indications and to discuss these results in the context of current literature. The group of neuromuscular diseases includes muscular dystrophy, spinal muscular atrophy, amyotrophic lateral sclerosis, paralysis of the phrenic nerve, and injuries to the spinal cord. Furthermore, interstitial lung diseases, sarcoidosis, left ventricular heart failure, pulmonary arterial hypertension (PAH), kyphoscoliosis and obesity are also discussed in this context. COPD, asthma, cystic fibrosis (CF) and non-CF-bronchiectasis are among the group of obstructive lung diseases. Last but not least, we summarize current knowledge on weaning from respirator in the context of physical activity.

[Medication screening by the community pharmacist in Belgium]. / Revue de la medication par le pharmacien d'officine en Belgique: pourquoi, comment et situation actuelle.

About 20% of the European population is older than 65 years. Because of multimorbidity (i.e. multiple chronic condition within a patient), older patients are often prescribed multiple drugs [i.e. polypharmacy). Both older age and polypharmacy significantly increase the risk for adverse drug events. International research showed that more or less 5% of all unplanned hospital admissions is related to the use of medication. About 70% of these drug related admissions happened in patients older than 65 years. Moreover, about half of the admissions could have been avoided. These preventable hospital admissions were caused by the intake of medication without an indication, problems with medication adherence, interactions and/or insufficient monitoring. We define this as (potential Drug Related Problems [DRPI. DRPs can occur on multiple occasions during the medication management process: prescribing, dispensing, intake and monitoring. When DRPs can be detected in an early stage, significant consequences can be avoided. To accomplish this, multiple strategies are possible. One of the possibilities is performing a periodic medication screening by the community pharmacist in patient groups at risk. During such a medication screening, the pharmacotherapy is critically evaluated in a systematic and structured way. The implementation of medication screening in first-line health care is currently limited. The community pharmacist is nevertheless ideally placed to perform this task. There is an important relation of trust between him and the patient and the community pharmacist has access to a full medication history. Furthermore, as an expert in drug-related issues, he possesses all necessary knowledge to perform the pharmacotherapeutic analysis.

Discriminative power of the advanced activities of daily living (a-ADL) tool in the diagnosis of mild cognitive impairment in an older population.

BACKGROUND: Mild cognitive impairment (MCI) is characterized by subjective and objective memory impairments in the absence of manifest functional decline. Mild changes in activities of daily living (ADL) can be present and probably predict conversion to dementia. A new advanced (a)-ADL tool was developed, evaluating high-level activities and, taking each participant as their own reference, distinguishing a global Disability Index (a-ADL-DI), a Cognitive Disability Index (a-ADL-CDI), and a Physical Disability Index (a-ADL-PDI), based on the number of activities performed and the severity and causes of the functional problem. This study evaluates the discriminative validity of the a-ADL in MCI. METHOD: Based upon clinical evaluation and a set of global, cognitive, mood, and functional assessments, 150 community-dwelling participants (average age 80.3 years (SD 5; 66-91)) were included and diagnosed as (1) cognitively healthy participants (n = 50); (2) patients with a-MCI (n = 48), or (3) mild to moderate AD (n = 52). The a-ADL tool was not a part of the clinical evaluation. RESULTS: The a-ADL-DI and the a-ADL-CDI showed a sensitivity and specificity ranging from 70% to 94.2%, Positive Predictive Value ranging from 70% till 93.8%, and Negative Predictive Value from 64.4% and 93.8%, an area under the curve (AUC) ranging from 0.791 to 0.960. Functional decline related to physical deficits, as assessed by the a-ADL-PDI, did not discriminate between the different groups. CONCLUSION: The a-ADL tool has a good ability to distinguish normal and pathological cognitive aging. Its discriminative power for underlying causes of limitations may be an advantage.

[Major drug related problems leading to hospital admission in the elderly]. / Principaux problèmes liés aux médicaments conduisant a une hospitalisation chez les personnes âgées.

Drug related problems represent an important problem in geriatric patients, and contribute to hospitalization in 15 to 30% of the admissions. In most cases this concerns adverse drug reactions (normal dose and overdose) but also drug therapy failures (e.g. undertreatment) are common. The main pharmacological classes involved are cardiovascular drugs and drugs for the central nervous system. Drug related problems can be prevented by regular medication review to decide if all drugs have to be continued, and to check for adverse drug reactions. Clinical pharmacists in hospitals can detect drug related problems (over-, under- and misuse using a systematic approach) and recommend changes to improve pharmacotherapy. The community pharmacist can help by elaborating drug schemes, by screening for medication interactions, and by resolving practical problems.

[Prosthetic rehabilitation in patient with forced class III malocclusion].

The paper presents clinical case of 63 years old edentulous patient with slight class III malocclusion. For 15 years he was using inadequately fabricated dentures causing forced severe class III malocclusion. Forced progeny was corrected by newly fabricated dentures which restored normal orofacial function and facial harmony.

The effects of abrupt antipsychotic discontinuation in cognitively impaired older persons: a pilot study.

BACKGROUND: Antipsychotic use for behavioural and psychological symptoms of dementia (BPSD) is controversial. Guidelines advise to reduce antipsychotics given the adverse effects and limited efficacy, to limit dose and treatment duration as well as to undertake discontinuation. METHODS: A pilot study with 40 hospitalised geriatric cognitively impaired patients, in which the effects of abrupt antipsychotic discontinuation were investigated, using neuropsychiatric inventory (NPI) scores before and one month after discontinuation. Withdrawal symptoms were monitored thrice a day with a checklist during five consecutive days. RESULTS: Participants (n = 40) had a mean age of 84 years (range 67-95) and 53% were male. The total mean baseline NPI score was 21 (SD 12) with predominantly behavioural rather than psychological disturbances. After abrupt discontinuation, mild withdrawal symptoms were observed in 72% of the patients, with frequencies of symptoms peaking on day 2 (53%) and day 3 (48%). After one month, 31 patients (85%) were still off antipsychotics and improved on the majority of NPI domains, with a total mean NPI score decreasing from 18 (SD 13) to 12 (SD 8, p = 0.003). In the relapse group, there was no deterioration associated with the abrupt discontinuation and subsequent resumption of therapy with a total mean NPI score decreasing from 31 (SD 12) at baseline to 27 (SD 8) at one-month follow-up (p = 0.345). CONCLUSION: Abrupt antipsychotic discontinuation appears to be feasible in older individuals with BPSD. Systematically performed discontinuation efforts in clinical practice are needed to differentiate between patients where antipsychotics have no added value and patients where the benefits outweigh the risks.

Development of a novel instrument for assessing intentional non-adherence to official medical recommendations (iNAR-12): a sequential mixed-methods study in Serbia.

OBJECTIVES: We aimed to (1) develop a novel instrument, suitable for the general population, capturing intentional non-adherence (iNAR), consisting of non-adherence to prescribed therapy, self-medication and avoidance of seeking medical treatment; (2) differentiate it from other forms of non-adherence, for example, smoking; and (3) relate iNAR to patient-related factors, such as sociodemographics, health status and endorsement of irrational beliefs (conspiratorial thinking and superstitions) and to healthcare-related beliefs and experiences ((mis)trust and negative experiences with the healthcare system, normalisation of patient passivity). DESIGN: То generate iNAR items, we employed a focus group with medical doctors, supplemented it with a literature search and invited a public health expert to refine it further. We examined the internal structure and predictors of iNAR in an observational study. SETTING: Data were collected online using snowball sampling and social networks. PARTICIPANTS: After excluding those who failed one or more out of three attention checks, the final sample size was n=583 adult Serbian citizens, 74.4% female, mean age 39.01 years (SD=12.10). PRIMARY AND SECONDARY OUTCOME MEASURES: The primary, planned outcome is the iNAR Questionnaire, while smoking was used for comparison purposes. RESULTS: Factor analysis yielded a one-factor solution, and the final 12-item iNAR Questionnaire had satisfactory internal reliability (alpha=0.72). Health condition and healthcare-related variables accounted for 14% of the variance of iNAR behaviours, whereas sociodemographics and irrational beliefs did not additionally contribute. CONCLUSIONS: We constructed a brief yet comprehensive measure of iNAR behaviours and related them to health and sociodemographic variables and irrational beliefs. The findings suggest that public health interventions should attempt to improve patients' experiences with the system and build trust with their healthcare practitioners rather than aim at specific demographic groups or at correcting patients' unfounded beliefs. STUDY REGISTRATION: The design and confirmatory analyses plan were preregistered (https://osf.io/pnugm).

Tracking variations in daily questionable health behaviors and their psychological roots: a preregistered experience sampling study.

People resort to various questionable health practices to preserve or regain health - they intentionally do not adhere to medical recommendations (e.g. self-medicate or modify the prescribed therapies; iNAR), or use traditional/complementary/alternative (TCAM) medicine. As retrospective reports overestimate adherence and suffer from recall and desirability bias, we tracked the variations in daily questionable health behaviors and compared them to their retrospectively reported lifetime use. We also preregistered and explored their relations to a wide set of psychological predictors - distal (personality traits and basic thinking dispositions) and proximal (different unfounded beliefs and biases grouped under the term irrational mindset). A community sample (N = 224) tracked daily engagement in iNAR and TCAM use for 14 days, resulting in 3136 data points. We observed a high rate of questionable health practices over the 14 days; daily engagement rates roughly corresponded to lifetime ones. Both iNAR and TCAM were weakly, but robustly positively related. Independent of the assessment method, an irrational mindset was the most important predictor of TCAM use. For iNAR, however, psychological predictors emerged as relevant only when assessed retrospectively. Our study offers insight into questionable health behaviors from both a within and between-person perspective and highlights the importance of their psychological roots.