Search Results (239)

This paper describes a novel wearable personal uroflowmeter and its use to log urine leakage episodes in women. Consisting of a miniature flow rate sensor attached under the urethral meatus, it recorded both urine flow rate and volume during activities of daily living. The sensor communicated with a determining unit incorporating a microcontroller and an inertial measurement unit worn at the waist, facilitating the post-hoc determination of which activities and changes in pose caused leakage. Six women participated in a feasibility study performed in a clinical setting. The results indicate that the uroflowmeter was 97.5% accurate in assessing micturition flow compared to gold standard uroflowmetry and leakage measurements. The system also provides subject-specific information on the relationship between physical activity and urine leakage, thereby eliminating errors due to missing data and recall bias in bladder leakage diaries and circumventing the limitations of office-based uroflowmeters. Full article

Background/Objectives: Prostate cancer is the most frequent cancer in men, for which Radiotherapy (RT) is used as a radical or post-surgical treatment. Actinic proctitis is one of the most disabling side effects of RT. Intestinal microbiome studies have highlighted the importance of short-chain fatty acids, in particular butyric acid, for their beneficial effects over intestinal epithelial cells. The aim of this prospective study is to evaluate if treatment with micro-encapsulated sodium butyrate (MESB) can reduce the incidence of actinic proctitis during RT in prostate cancer patients. Methods: In total, 122 consecutive patients with prostate cancer treated in Radiotherapy Unit, Centro di Riferimento Oncologico, IRCCS Aviano, were enrolled. Patients received MESB (3 tablets/day) from one week before until four weeks after RT. They completed a diary, tracking daily bowel movements, rectal bleeding, abdominal pain, and perceived health status before, at the end, and one month after RT. Results: Although an improvement in symptoms was observed, when comparing interpatient data before RT vs. one month after the end of RT, statistically significant differences emerged only regarding abdominal pain (94.2% vs. 81.6% vs. 81.6%) (McNemar’s test p < 0.002). Conclusions: MESB appears effective in reducing radiation-induced bowel toxicity during RT, minimizing stool changes, incontinence, and abdominal pain. Although patients’ health perception declined at RT completion, it improved after one month, suggesting MESB may support clinical recovery post-treatment. Full article

Background/Objective: Non-specific chronic neck pain (CNP) greatly affects the social dynamics, the work performance, and the personal independence of patients. Research emphasizes the significant role of sociological factors, psychological stress, and emotional conflicts in the development, regulation, and endurance of chronic pain. This study aims to explore the influence of emotional conflicts on pain experience among CNP patients, drawing from their experiences. Methods: A phenomenological investigation was conducted, grounded in Heideggerian philosophy, involving CNP patients and healthcare professionals in Madrid, Spain. Participants were recruited from Primary Health Care centers. Data collection methods included semi-structured in-depth interviews, focus groups with patients, focus groups with healthcare providers, participant observation, and reflective diaries. Hermeneutic phenomenology guided the data interpretation. Thematic analysis was applied to transcribed audio recordings. Results: This study included 12 patients with CNP who participated in two in-depth interviews conducted at different time points—before and after receiving physiotherapy treatment. Additionally, 23 CNP patients took part in four focus groups, and 46 healthcare professionals (including physicians, nurses, and physiotherapists) participated in three focus groups. A hermeneutic analysis revealed the following three main categories: “Self-concept and pain experience”, “Daily life obligations and pain perception”, and “Emotional conflicts related to CNP”. Patients described themselves as nervous, having communication difficulties, and often prioritizing family or work tasks, leading to stress. They indicated that their interpersonal conflicts with close relations intensified their perceived pain in the neck, head, shoulders, and arms. Conclusions: From the perspective of the participants in this study, interpersonal and emotional conflicts appear to influence their perception of CNP. Full article

Background and Objectives: The worldwide prevalence of chronic kidney disease (CKD) continues to increase, representing a major concern for public health systems. CKD is associated with gut microbiota dysbiosis, which may exacerbate disease progression by increasing the levels of uremic toxins, systemic inflammation, and oxidative stress. Modulation of the gut microbiota through biotic supplementation has been proposed as a potential therapeutic strategy to slow CKD progression and mitigate its complications. This study aimed to evaluate the effect of 10-month synbiotic supplementation on estimated glomerular filtration rate (eGFR), circulating concentrations of indoxyl sulfate (IS), p-cresyl sulfate (p-CS), interleukin-6 (IL-6), and malondialdehyde (MDA) in patients with stage IV–V CKD not receiving dialysis, in comparison to placebo. Materials and Methods: Fifty non-dialysis CKD IV–V patients were assigned (n = 25 each) via matched, non-randomized allocation (age, sex, and primary disease) to synbiotic or placebo. This single-blind, placebo-controlled trial blinded participants and laboratory personnel. The synbiotic group received daily capsules containing Lactobacillus acidophilus La-14 (2 × 10¹¹ CFU/g) + fructooligosaccharides; controls received identical placebo. Adherence was monitored monthly (pill counts, diaries), with < 80% over two visits resulting in withdrawal. The eGFR, IS, p-CS, IL-6, and MDA were measured at baseline and month 10. Results: Forty-two patients (21/arm) completed the study; eight withdrew (4 per arm). At 10 months, the change in eGFR was −1.2 ± 2.5 mL/min/1.73 m² (synbiotic) vs. −3.5 ± 3.0 mL/min/1.73 m² (placebo); between-group difference in change was 2.3 mL/min/1.73 m² (95% CI: 0.5–4.1; p = 0.014; adjusted p = 0.07). IS decreased by −15.4 ± 8.2 ng/L vs. −3.1 ± 6.5 ng/L; between-group difference in change was −12.3 ng/L (95% CI: −17.8 to −6.8; p < 0.001; adjusted p = 0.005). No significant differences were observed for p-CS, IL-6, or MDA after correction. Conclusions: Synbiotic supplementation over a 10-month period resulted in a trend toward decreased serum IS levels in patients with advanced CKD, suggesting potential benefits of microbiota-targeted therapies. However, no significant effects were observed on renal function, inflammatory, or oxidative stress markers. Further large-scale studies are warranted to confirm these findings and explore the long-term impact of synbiotics in CKD management. Full article

Background and Objectives: This study aimed to assess whether the addition of fractional CO₂ laser therapy to standard pharmacologic treatment with Mirabegron, a β3-adrenoceptor agonist, enhances the clinical outcomes in the management of overactive bladder syndrome (OAB) in postmenopausal women. Materials and Methods: Τhis was a prospective, randomized, double-blind, sham-controlled trial including 50 postmenopausal women with moderate-to-severe OAB symptoms. Participants were randomized (1:1) to receive mirabegron 50 mg daily in combination with either active fractional CO₂ laser therapy (Group A) or sham laser treatment (Group B). Both groups underwent three monthly sessions of vaginal laser treatment and were followed for a total of four months. Clinical assessments were performed at baseline and monthly visits (T0–T3), using validated instruments including the Overactive Bladder Questionnaire (OAB-q), King’s Health Questionnaire (KHQ), Urinary Distress Inventory (UDI-6), Pelvic Floor Impact Questionnaire (PFIQ-7), Patient Global Impression of Improvement (PGI-I), and 3-day voiding diaries. The trial was registered at ClinicalTrials.gov (Identifier: NCT03846895). Results: Significant symptom improvement was observed within both groups over time, with reductions in urinary frequency, urgency, nocturia, and incontinence episodes, as well as improvements in quality-of-life scores. However, intergroup comparisons revealed no statistically significant differences in any primary or secondary outcomes. Both treatment modalities demonstrated similar effectiveness across all measured parameters. Conclusions: In this randomized controlled trial, the adjunctive use of fractional CO₂ laser therapy did not offer additional clinical benefit beyond mirabegron monotherapy in the short-term management of OAB. These findings underscore the need for further investigation into tailored therapeutic strategies, particularly in populations with overlapping genitourinary syndrome of menopause or more refractory OAB symptoms. Full article

Orofacial myofunctional therapy (OMT) for obstructive sleep apnea (OSA) is a promising, new treatment. We aimed to study patients’ experiences and adherence to OMT. Twelve patients with OSA were included in the study, and they engaged in OMT exercises three times daily for 12 weeks. Participants tracked their sleep and OMT exercise activities in an electronic diary. Exercise techniques were guided by a certified therapist. Patients’ experiences with OMT were assessed through semi-structured individual interviews conducted after a 12-week intervention, and the transcripts were analyzed using thematic analysis. The findings revealed an overarching theme that captured both facilitators of and barriers to OMT, organized into three subthemes: (1) motivation, (2) perceived support, and (3) perceived effects. Motivation was driven by a desire to improve general health and avoid continuous positive airway pressure treatment, and was supported by a sense of mastery and perceived effectiveness. Key facilitators included a trusting patient–therapist relationship, as well as developing routines and a sense of control. Barriers involved managing the comprehensive treatment protocol, insecurities around exercise execution and the potential impact of OMT, sickness burden, and previous negative healthcare experiences. These themes were supported by quantitative findings, which demonstrated high treatment adherence, while sleep data indicated modest individual improvements in subjective sleep quality and efficiency. By recognizing facilitators and barriers and addressing the individual differences among OSA patients, healthcare providers can better tailor their approach to meet diverse patient needs. This personalized approach, supported by emerging sleep improvements, may enhance patient engagement and improve adherence to OMT. Full article

Personal smartphone use at work stretches the boundary between professional and personal life, leading to a more fragmented workday. This study investigates how interruptions from personal smartphone use during work hours affect employees’ performance and well-being. Our primary aim is to clarify the pathways through which personal smartphone interruptions impact employee well-being, as reflected in work-related rumination after work (affective rumination, problem-solving pondering, and psychological detachment). Integrating propositions of social role theory and action regulation theory, we hypothesize that such interruptions undermine task accomplishment, which, in turn, increases feelings of frustration. Furthermore, we propose that frustration explains the link between reduced task accomplishment and increased work-related rumination after work. To test these hypotheses, we conducted a quantitative daily diary study with 91 employees from diverse occupations, collecting data over five consecutive workdays, including between 354 and 399 observations per day. Multi-level analyses revealed that interruptions from personal smartphone use indirectly increased frustration by undermining task accomplishment. Additionally, frustration fully mediated the relationship between task accomplishment and work-related rumination in the evening. These findings highlight the importance of managing personal smartphone use at work to protect employee performance and well-being. We conclude by critically examining the broader theoretical significance and practical applications of our findings. Full article

We conducted a diary study to examine how narcissism influences reactions to daily perceived partner phubbing (N = 196). We examined relationships between two facets of narcissism (rivalry and admiration) and personal and relational well-being, reactions to phubbing, reports of retaliation, and motives for retaliation. On average, participants higher in rivalry reported lower self-esteem and higher depressed and anxious mood, whilst participants higher in admiration reported greater relationship satisfaction, higher self-esteem, lower depressed and anxious mood, and lower levels of anger/frustration. These patterns held regardless of whether they were phubbed or not. In response to partner phubbing, participants higher in rivalry reported, on average, greater curiosity, resentment, conflict, and retaliation. On days when participants reported higher phubbing, those with higher rivalry reported greater curiosity, while those higher in admiration reported greater conflict. When retaliating to phubbing, those higher in rivalry did so, on average, to get back at their partner and to seek support and approval from others, whereas those higher in admiration were less likely to report boredom as a reason for retaliating. Our findings contribute to the sparse literature on narcissism and phubbing by showing how narcissists respond to being phubbed. We discuss how phubbing may exacerbate their relational difficulties. Full article

Reflection is considered to be a core component of professional development in teacher education, yet little is known about the motivational determinants of reflective activities in everyday school contexts. Drawing on theories of learning and motivation, we introduce and conceptualise the “need to reflect” as a situationally and personally influenced motivational factor that mediates the relationship between classroom experiences and subsequent reflective processes. We operationalise this construct through a newly developed item and examine it in a diary study involving N = 79 in-service primary school teachers over ten school days. Multilevel analyses reveal that daily classroom-related hassles—especially failed attempts to address disturbances—are positively associated with teachers’ need to reflect, whereas successful classroom management reduces this need. Furthermore, emotional exhaustion moderates this relationship: Teachers with higher levels of emotional exhaustion reported a stronger link between unsuccessful disturbance management and their need to reflect. Self-efficacy in classroom management is not shown to have a moderating effect. These findings suggest that the need to reflect fluctuates across situations and is influenced by individual teacher characteristics, offering new insights into motivational components underlying reflective processes with significant implications for teacher education and professional development. Full article

Recent research has suggested that strength and conditioning (S&C) coach development should consider constructivist learning theories to promote coach development and learning of psychosocial coaching competencies. Reflective practice can encourage holistic learning through promoting an internal dialogue of the meaningfulness of an individual’s experiences. Our study aimed to examine the efficacy of a facilitated, guided, and longitudinal reflective process to promote coach learning of psychosocial coaching practice using Moon’s reflective framework. Over a four-week period, six elite S&C coaches engaged in a guided process reflection process with a facilitator. This included daily journaling in an e-diary with the facilitator providing feedback at the end of each week. At the end, each S&C coach participated in an exit interview. Data were analysed using interpretative phenomenological analysis. Findings revealed that there were potential benefits for the S&C coach’s process of reflection such as providing accountability through developing a close relationship with the facilitator, which enabled the S&C coaches to more critically link learning to behaviour change. Furthermore, S&C coaches’ learning resulted in developing awareness of self/athlete’s needs, increased flexibility, and enhanced confidence. This resulted in S&C coaches developing psychosocial coaching competencies that enabled them to change their practice to become more athlete centred. Full article

Background: Proper nutrition is crucial for optimizing performance and recovery in elite young football players. This study aimed to assess sports nutrition knowledge, adherence to the Mediterranean diet (MD), and carbohydrate intake across different training phases, evaluating their relations with match performance. Methods: Thirty-three male HNK Hajduk academy players (15–19 years) completed a nutrition questionnaire and a seven-day food diary, while performance metrics were analyzed using GPS tracking. Results: The results showed that sports nutrition knowledge was generally low (43.0 ± 17.0%), with significant misconceptions about carbohydrate fueling strategies. Players significantly overestimated their MD adherence, with a self-reported KIDMED index (6.06 ± 2.41) notably higher than the corrected score derived from food diaries (4.21 ± 2.53, p < 0.001). Carbohydrate intake was suboptimal on match-related days (3.64 g/kg on match day, 4.45 g/kg on the day before), failing to meet the recommended minimum of 6 g/kg per day. Regression analysis predicted that energy (β = 0.83; p = 0.02) and carbohydrate intake (β = 0.69; p = 0.03) on match day significantly predicted distance covered per minute, with a positive relationship observed for both outcomes, highlighting its impact on endurance. However, no significant relationship was found between carbohydrate intake and maximum sprint speed. Conclusions: These findings underscore the need for structured nutrition education within football academies to enhance players’ dietary habits and performance outcomes. Future research should focus on longitudinal interventions to assess how improved nutrition knowledge influences dietary adherence and athletic performance over time. Although knowledge of sports nutrition is fundamental, practical training and education to improve dietary competencies are crucial for athletes to effectively apply this knowledge in daily training and match preparations. Full article

Background/Objectives: Analyzing the carbon footprint of diets in various populations is important as it can help identify more sustainable food choices that reduce the overall impact of human activities on ongoing warming of the global climate. This pilot exploratory study analyzed the carbon footprint (measured in kg of CO₂ equivalent, eq.) using food diaries collected from Polish individuals with varying levels of animal-derived product exclusion in their diets. Methods: The study employed a food diary method, where participants from four dietary groups (vegan, vegetarian, fish-eater, and meat-eater) recorded all meals and beverages consumed over a 7-day period, including portion sizes and packaging details. These diaries were then analyzed to assess dietary adherence and calculate carbon footprints, utilizing standardized CO₂ equivalent emission data from publicly available databases. Results: The analysis revealed a decreasing trend in the carbon footprint corresponding to the degree of elimination of animal-derived products from the diet (R² = 0.96, p = 0.0217). The mean daily footprint in the vegan group was 1.38 kg CO₂ eq., which was significantly lower than in the vegetarian (2.45), fish-eater (2.72), and meat-eater groups (3.62). For each 1000 kcal, the meat-eater diet generated 39.7, 58.3, and 93.9% more CO₂ eq. than in the case of fish-eaters, vegetarians, and vegans, respectively. Over a week, a group of 10 vegans had a total carbon footprint lower than vegetarians, fish-eaters, and meat-eaters by 42.9, 52.2, and 61.8%, respectively. Hard and mozzarella cheese had the highest contribution to the carbon footprint in vegetarians, fish, and seafood in fish-eaters, and poultry, pork, and beef had the highest contribution in meat-eaters. Conclusions: Dietary carbon footprints vary considerably by dietary pattern, with lower consumption of animal-derived products associated with lower emissions. Additionally, identifying specific high-impact food items within each diet may inform strategies for reducing environmental impact across various eating patterns. Full article

Botulinum toxin A (BTX-A) injection into the detrusor vesicae is an established therapy for neurogenic lower urinary tract dysfunction as well as idiopathic overactive bladder. Pelvic radiotherapy causes comparable lower urinary tract symptoms (LUTS) in a third of radiated patients. Little is known about the effects of BTX-A injections into the detrusor vesicae in the management of radiogenic LUTS. Our aim was to assess the effect of BTX A injections on these symptoms and related quality of life. Material and Methods: In total, 28 patients with BTX-A injections for radiogenic LUTS were assessed retrospectively. We analyzed symptoms recorded in bladder diaries, the results of quality-of-life questionnaires (ICIQ-LUTSqol), and urodynamic studies (UDS) before and after BTX-A injections. Results: A significant reduction in daily micturition frequency, nocturia, and pad consumption was demonstrated in the overall cohort and in gender-related subgroup analysis. There was a significant decrease in the ICIQ-LUTSqol independent of gender or BTX-A units. For UDS maximum cystometric bladder capacity (188.0 vs. 258.2 mL, p = 0.043), micturition volume (138.2 vs. 216.7 mL, p = 0.018), and first desire to void (98.2 vs. 171.2 mL, p = 0.042) was significantly improved. No side effects of the toxin injection or urinary retention were observed. Conclusions: Intradetrusor injection therapy with BTX-A could represent a safe and effective therapeutic option for radiogenic LUTS with increasing quality of life, reductions in symptoms, and the improvement of urodynamic parameters. Full article

Monitoring orthosis compliance using patient diaries is subjective, as patients can overestimate their levels of device use. An objective way to monitor compliance is required because if an orthotic prescription is not followed, the orthosis will not work as intended. This study aimed to develop and validate a device that monitors orthosis compliance objectively using pressure and acceleration. Fifteen participants were recruited to test the device’s ability to estimate wear time during the performance of several grip patterns and whilst completing selected activities of daily living. Sensor threshold values were used to discern whether users were wearing their orthosis or not. No differences between pressure sensor and accelerometer-based wear time estimations were found. The device’s pressure-based wear time estimations were found to have a specificity of 92.7 ± 16.4% and sensitivity of 74.0 ± 41.3%, whilst accelerometer-based wear time estimates had a specificity of 66.1 ± 34.7% and sensitivity of 86.2 ± 8.0%. This study successfully demonstrated the feasibility of monitoring hand orthosis compliance using pressure or acceleration. This device has the potential to provide insight into the effectiveness of both existing and novel orthotics, benefitting both clinical practice and research. Full article

Background/Objectives: Inadequate micronutrient intakes are common in individuals with overweight/obesityand can exacerbate cardiovascular and metabolic disease risk. Diet and exercise are primary strategies for managing overweight and may influence nutrient intakes. In this secondary analysis of dietary data collected in a randomized controlled trial (RCT, ClinicalTrials.gov (NCT04019860), 15 June 2019) of time-restricted eating (TRE), high-intensity interval training (HIIT), a combination (TREHIIT), or a control group (CON), we investigated intervention effects on energy and nutrient intakes in women with overweight/obesity. Methods: We randomized 131 women (body mass index (BMI) ≥ 27 kg/m²) to 7 weeks of TRE (≤10-h daily eating window with ad libitum energy intake), HIIT (3 sessions/week, performed at ≥90% maximal heart rate), TREHIIT, or CON. Participants recorded all energy intake in an online food diary during a baseline week (week 0) and at the end of the study (week 6 and week 7). We investigated between-group differences in changes in mean energy, macronutrient, and micronutrient intakes. Results: TRE had reduced intakes of potassium, magnesium, and phosphorus compared with CON (p < 0.01). TREHIIT had non-significant reduced intakes of potassium, thiamine, magnesium, copper, and phosphorus (0.01< p < 0.05). HIIT alone did not negatively impact micronutrient intakes. TRE and TREHIIT induced suboptimal intakes for a greater number of micronutrients compared with HIIT and CON. Conclusions: A ≤10-h TRE window might increase the risk of micronutrient inadequacy in women with overweight/obesity. Future research is needed to investigate the effects of integrating nutritional guidelines with TRE interventions to mitigate the risk of micronutrient inadequacy in individuals with overweight/obesity. Full article