Short- and Medium-Term Efficacy of a Web-Based Computer-Tailored Nutrition Education Intervention for Adults Including Cognitive and Environmental Feedback: Randomized Controlled Trial

Background

Web-based, computer-tailored nutrition education interventions can be effective in modifying self-reported dietary behaviors. Traditional computer-tailored programs primarily targeted individual cognitions (knowledge, awareness, attitude, self-efficacy). Tailoring on additional variables such as self-regulation processes and environmental-level factors (the home food environment arrangement and perception of availability and prices of healthy food products in supermarkets) may improve efficacy and effect sizes (ES) of Web-based computer-tailored nutrition education interventions.

Objective

This study evaluated the short- and medium-term efficacy and educational differences in efficacy of a cognitive and environmental feedback version of a Web-based computer-tailored nutrition education intervention on self-reported fruit, vegetable, high-energy snack, and saturated fat intake compared to generic nutrition information in the total sample and among participants who did not comply with dietary guidelines (the risk groups).

Methods

A randomized controlled trial was conducted with a basic (tailored intervention targeting individual cognition and self-regulation processes; n=456), plus (basic intervention additionally targeting environmental-level factors; n=459), and control (generic nutrition information; n=434) group. Participants were recruited from the general population and randomly assigned to a study group. Self-reported fruit, vegetable, high-energy snack, and saturated fat intake were assessed at baseline and at 1- (T1) and 4-months (T2) postintervention using online questionnaires. Linear mixed model analyses examined group differences in change over time. Educational differences were examined with group×time×education interaction terms.

Results

In the total sample, the basic (T1: ES=–0.30; T2: ES=–0.18) and plus intervention groups (T1: ES=–0.29; T2: ES=–0.27) had larger decreases in high-energy snack intake than the control group. The basic version resulted in a larger decrease in saturated fat intake than the control intervention (T1: ES=–0.19; T2: ES=–0.17). In the risk groups, the basic version caused larger decreases in fat (T1: ES=–0.28; T2: ES=–0.28) and high-energy snack intake (T1: ES=–0.34; T2: ES=–0.20) than the control intervention. The plus version resulted in a larger increase in fruit (T1: ES=0.25; T2: ES=0.37) and a larger decrease in high-energy snack intake (T1: ES=–0.38; T2: ES=–0.32) than the control intervention. For high-energy snack intake, educational differences were found. Stratified analyses showed that the plus version was most effective for high-educated participants.

Conclusions

Both intervention versions were more effective in improving some of the self-reported dietary behaviors than generic nutrition information, especially in the risk groups, among both higher- and lower-educated participants. For fruit intake, only the plus version was more effective than providing generic nutrition information. Although feasible, incorporating environmental-level information is time-consuming. Therefore, the basic version may be more feasible for further implementation, although inclusion of feedback on the arrangement of the home food environment and on availability and prices may be considered for fruit and, for high-educated people, for high-energy snack intake.

Trial Registration

Netherlands Trial Registry NTR3396; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3396 (Archived by WebCite at http://www.webcitation.org/6VNZbdL6w).     

Motivating student learning using a formative assessment journey

Providing formative assessment opportunities has been recognised as a significant benefit to student learning. The outcome of any formative assessment should be one that ultimately helps improve student learning through familiarising students with the levels of learning required, informing them about gaps in their learning and providing feedback to guide the direction of learning. This article provides an example of how formative assessments can be developed into a formative assessment journey where a number of different assessments can be offered to students during the course of a module of teaching, thus utilising a spaced-education approach. As well as incorporating the specific drivers of formative assessment, we demonstrate how approaches deemed to be stimulating, interactive and entertaining with the aim of maximising enthusiasm and engagement can be incorporated. We provide an example of a mixed approach to evaluating elements of the assessment journey that focuses student reaction, appraisal of qualitative and quantitative feedback from student questionnaires, focus group analysis and teacher observations. Whilst it is not possible to determine a quantifiable effect of the assessment journey on student learning, usage data and student feedback shows that formative assessment can achieve high engagement and positive response to different assessments. Those assessments incorporating an active learning element and a quiz-based approach appear to be particularly popular. A spaced-education format encourages a building block approach to learning that is continuous in nature rather than focussed on an intense period of study prior to summative examinations.     

益髓醒神针联合镜像视觉反馈对脑卒中后单侧空间忽略患者的康复分析

目的：探讨益髓醒神针刺联合镜像视觉反馈（MVF）治疗脑卒中后单侧空间忽略（USN）的康复情况。方法：以2016年6月-2018年12月杭州市中医院康复科脑卒中后左脑偏瘫的患者为研究对象,采用随机数字表法分为两组。对照组（38例）进行镜像视觉反馈（MVF）训练联合常规治疗与康复训练,干预组（39例）在对照组基础上加用益髓醒神针刺治疗,均治疗4周。通过对比两组治疗前及4周后SUN程度、肢体运动功能、日常生活能力、认知功能,焦虑、抑郁情绪,以及生活质量评估患者康复效果。结果：两组一般资料差异均无统计学意义（均P＞0.05）。经过4周治疗后,与治疗前相比,两组患者USN程度均出现明显下降（P<0.01）;肢体运动功能、日常生活能力和精神认知功能均明显提高（P<0.01）;焦虑、抑郁情绪得到缓解（P<0.01）;生活质量得到提高（P<0.05）。并且两组比较,研究组在SUN程度、肢体运动功能、日常生活能力、认知功能,负性情绪各方面均进一步得到改善（P<0.05）;生活质量方面在生理机能、生理职能、精力、社会功能及一般健康维度评分上提高更加明显（P<0.05）。结论：益髓醒神针联合MVF对卒中后USN患者具有协同康复作用,可提高患者USN、肢体运动功能、日常生活能力、精神认知,改善患者负性情绪,提高生活质量,值得临床进一步推广。     

Fluorescence lifetime snapshots reveal two rapidly reversible mechanisms of photoprotection in live cells of Chlamydomonas reinhardtii

Photosynthetic organisms avoid photodamage to photosystem II (PSII) in variable light conditions via a suite of photoprotective mechanisms called nonphotochemical quenching (NPQ), in which excess absorbed light is dissipated harmlessly. To quantify the contributions of different quenching mechanisms to NPQ, we have devised a technique to measure the changes in chlorophyll fluorescence lifetime as photosynthetic organisms adapt to varying light conditions. We applied this technique to measure the fluorescence lifetimes responsible for the predominant, rapidly reversible component of NPQ, qE, in living cells of Chlamydomonas reinhardtii. Application of high light to dark-adapted cells of C. reinhardtii led to an increase in the amplitudes of 65 ps and 305 ps chlorophyll fluorescence lifetime components that was reversed after the high light was turned off. Removal of the pH gradient across the thylakoid membrane linked the changes in the amplitudes of the two components to qE quenching. The rise times of the amplitudes of the two components were significantly different, suggesting that the changes are due to two different qE mechanisms. We tentatively suggest that the changes in the 65 ps component are due to charge-transfer quenching in the minor light-harvesting complexes and that the changes in the 305 ps component are due to aggregated light-harvesting complex II trimers that have detached from PSII. We anticipate that this technique will be useful for resolving the various mechanisms of NPQ and for quantifying the timescales associated with these mechanisms.     

Regional drought-induced reduction in the biomass carbon sink of Canada's boreal forests

The boreal forests, identified as a critical "tipping element" of the Earth's climate system, play a critical role in the global carbon budget. Recent findings have suggested that terrestrial carbon sinks in northern high-latitude regions are weakening, but there has been little observational evidence to support the idea of a reduction of carbon sinks in northern terrestrial ecosystems. Here, we estimated changes in the biomass carbon sink of natural stands throughout Canada's boreal forests using data from long-term forest permanent sampling plots. We found that in recent decades, the rate of biomass change decreased significantly in western Canada (Alberta, Saskatchewan, and Manitoba), but there was no significant trend for eastern Canada (Ontario and Quebec). Our results revealed that recent climate change, and especially drought-induced water stress, is the dominant cause of the observed reduction in the biomass carbon sink, suggesting that western Canada's boreal forests may become net carbon sources if the climate change-induced droughts continue to intensify.     

Virtual reality-based paediatric interactive therapy system (PITS) for improvement of arm and hand function in children with motor impairment—a pilot study

Objective: Rehabilitation of upper-limb sensorimotor function in children with motor dysfunctions is primarily based on movement training. This study developed a virtual-reality based, paediatric interactive therapy system (PITS) that allows children to practice specific movements of the upper limbs with immediate feedback about their motor performance.

Methods: The system was tested on five children with motor dysfunctions over 3 weeks of training. Pre- and post-assessment was conducted before and after the training period.

Results: Results of the pilot study show improvements of hand function in the test scores (except one patient). Patient motivation was high and maintained over the course of the therapy sessions.

Conclusion: PITS is an applicable VR-system which can be feasibly applied during the rehabilitation of children with upper limb motor dysfunctions. Further investigation is necessary to determine if the system provides significantly improved results compared to conventional therapies, both in terms of motor function outcomes and patient motivation.     

Training with a mirror in rehabilitation of the hand

Treatment with a mirror gives an illusion of function in a missing or non-functioning hand. The method is based on the concept that the central representation of phantoms and body image can change rapidly, and has been described in the treatment of phantom pain and stroke. We show in three pilot cases new applications for the use of the mirror in rehabilitation after hand surgery.     

Ultrasound as visual feedback in speech habilitation: Exploring consultative use in rural British Columbia,Canada

Ultrasound has shown promise as a visual feedback tool in speech therapy. Rural clients, however, often have minimal access to new technologies. The purpose of the current study was to evaluate consultative treatment using ultrasound in rural communities. Two speech‐language pathologists (SLPs) trained in ultrasound use provided consultation with ultrasound in rural British Columbia to 13 school‐aged children with residual speech impairments. Local SLPs provided treatment without ultrasound before and after the consultation. Speech samples were transcribed phonetically by independent trained listeners. Eleven children showed greater gains in production of the principal target // after the ultrasound consultation. Four of the seven participants who received more consultation time with ultrasound showed greatest improvement. Individual client factors also affected outcomes. The current study was a quasi‐experimental clinic‐based study. Larger, controlled experimental studies are needed to provide ultimate evaluation of the consultative use of ultrasound in speech therapy.     

Feedback-controlled bolus plus infusion (FC-B/I) method for quantitative drug assessment in living brain with PET

We have developed a feedback-controlled bolus plus infusion (FC-B/I) method for monitoring the interaction between positron emission tomography (PET) ligands and their specific target molecules with PET. The usefulness of the FC-B/I method was evaluated by the direct interaction between [¹¹C]raclopride, a dopamine D₂ receptor (D₂R) ligand, and cold raclopride (10 and 100 μg/kg) in the brains of conscious monkeys. The present results demonstrated that the FC-B/I method could achieve the equilibrium state of [¹¹C]raclopride in the striatum of monkey brain, and also that the cold raclopride-induced reduction of [¹¹C]raclopride binding to D₂R was observed in a dose-dependent manner. Good correlations of distribution volume ratio of the striatum to cerebellum between the conventional bolus plus infusion (B/I) method and the FC-B/I method as well as between the conventional bolus injection method and the FC-B/I method were observed. These results indicated that the system could be a useful tool for the evaluation of interaction between drug candidates and their target molecules like enzymes, receptors, and transporters by using of their specific PET ligands.