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CATS – Occupational Therapy Critically Appraised Topics Free to access, this is an OT Australia initiative. The site posts short summaries of evidence on a topic of interest, usually focused around a clinical question. Well worth a look but there haven’t been any new topics uploaded since 2014. Link:

OT Seeker – Occupational Therapy Systematic Evaluation of Evidence Free database of randomised trials, systematic reviews and clinical practice guidelines. Citation details and links where able provided. Link:

SpeechBite Free speech pathology database for the best interventions and treatment efficacy by providing methodological quality ratings of studies. Link:

PEDro – Physiotherapy Evidence Database Free database of randomised trials, systematic reviews and clinical practice guidelines. Citation details and links where able provided. Link:

PubMed Database of citations for biomedical literature. Some links to full text content available. Link:

Science Direct Free access to database of citations of science, technology and medicine literature. Link:

Research Gate Free to join, share and read research publications. Link:

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Australian Occupational Therapy Journal


Journal of Ageing & Health

  • Employment Dynamics Among Adult Children at the Onset of Parental Dementia: Variation by Sociodemographic Characteristics
    by Jeffrey E. Stokes on September 14, 2023 at 1:42 am

    Journal of Aging and Health, Ahead of Print. <br/>ObjectivesTo examine the influence of sociodemographic factors on employment changes among adult children following onset of parental Alzheimer’s disease and related dementia (ADRD).MethodsWe used Health and Retirement Study (2010–2018; N = 20,110) data to examine adult child (ages 50–70) changes in employment and work hours at onset of parental ADRD and potential variation by gender, age, race, ethnicity, and education.ResultsParental ADRD onset was not associated with changes in adult child employment overall, although associations differed substantially across subpopulations defined by education level. Sons with the lowest education were least likely to cease employment, while daughters with the lowest education were most likely to reduce work hours. Sons at older ages were increasingly likely to reduce work hours or end employment following parental ADRD onset.DiscussionThe potential impact of parental ADRD on adult child employment is complex and should be considered in the context of sociodemographic factors.

  • Alzheimer’s Centers in US Hospitals: Enough to Adequately Address Dementia Care Nationwide?
    by Ángela Gutiérrez on September 12, 2023 at 8:23 am

    Journal of Aging and Health, Ahead of Print. <br/>ObjectivesTo investigate the availability of Alzheimer’s Centers (ACs) in US hospitals.MethodsUtilizing the American Hospital Association Annual Survey, Area Health Resource File, and US Census (n = 3251), we employed multivariable logistic regression to examine hospital, county, and regional predictors of AC availability.ResultsLarge hospitals (>399 beds) had approximately 14 times higher odds of having an AC than small hospitals (<50 beds; OR = 14.0; 95% CI = 6.44 – 30.46). Counties with a higher proportion of Latino residents, relative to non-Latino Whites, had lower odds of having an AC (OR = .05; 95% CI = .01 – .41). Northeastern (OR = 1.92; 95% CI = 1.15 – 3.22) and Midwestern (OR = 2.12; 95% CI = 1.34 – 3.37) hospitals had higher odds of having an AC than Southern hospitals.DiscussionTo address dementia needs and disparities, investment in a national infrastructure is critical.

  • Retirement Pathways’ Effect on Physical and Mental Health: Evidence From Japan
    by Masaaki Mizuochi on September 12, 2023 at 3:41 am

    Journal of Aging and Health, Ahead of Print. <br/>ObjectivesFew studies have used rigorous causal analysis to examine the difference in health effects between abrupt and gradual transitions from full-time employment to full retirement.MethodsData were obtained from 10,253 individuals aged 50 years and older from the 2005–2019 Longitudinal Survey of Middle-aged and Older Adults conducted in Japan. An instrumental variable approach was used to determine the causal relationship between retirement pathways and health by exploiting the public pension eligibility age as the instrument.ResultsAbruptly retired individuals were more likely to have physical limitation and less likely to have depression than those not yet retired. In contrast, those who fully retired through a gradual transition were less likely to have physical limitation and more likely to have depression than those not yet retired.DiscussionRetirement pathways have different effects on physical and mental health, providing important implication for labor and health policies in aging societies.


  • Retrospective Evaluation of Neuropathologic Proxies of the Minimal Atrophy Subtype Compared With Corticolimbic Alzheimer Disease Subtypes
    by Boon, B. D. C., Labuzan, S. A., Peng, Z., Matchett, B. J., Kouri, N., Hinkle, K. M., Lachner, C., Ross, O. A., Ertekin-Taner, N., Carter, R. E., Ferman, T. J., Duara, R., Dickson, D. W., Graff-Radford, N. R., Murray, M. E. on October 2, 2023 at 7:45 pm

    Background and Objectives Alzheimer disease (AD) is neuropathologically classified into 3 corticolimbic subtypes based on the neurofibrillary tangle distribution throughout the hippocampus and association cortices: limbic predominant, typical, and hippocampal sparing. In vivo, a fourth subtype, dubbed “minimal atrophy,” was identified using structural MRI. The objective of this study was to identify a neuropathologic proxy for the neuroimaging-defined minimal atrophy subtype. Methods We applied 2 strategies in the Florida Autopsied Multi-Ethnic (FLAME) cohort to evaluate a neuropathologic proxy for the minimal atrophy subtype. In the first strategy, we selected AD cases with a Braak tangle stage IV (Braak IV) because of the relative paucity of neocortical tangle involvement compared with Braak >IV. Braak IV cases were compared with the 3 AD subtypes. In the alternative strategy, typical AD was stratified by brain weight and cases having a relatively high brain weight (>75th percentile) were defined as minimal atrophy. Results Braak IV cases (n = 37) differed from AD subtypes (limbic predominant [n = 174], typical [n = 986], and hippocampal sparing [n = 187] AD) in having the least years of education (median 12 years, group-wise p < 0.001) and the highest brain weight (median 1,140 g, p = 0.002). Braak IV cases most resembled the limbic predominant cases owing to their high proportion of APOE 4 carriers (75%, p < 0.001), an amnestic syndrome (100%, p < 0.001), as well as older age of cognitive symptom onset and death (median 79 and 85 years, respectively, p < 0.001). Only 5% of Braak IV cases had amygdala-predominant Lewy bodies (the lowest frequency observed, p = 0.017), whereas 32% had coexisting pathology of Lewy body disease, which was greater than the other subtypes (p = 0.005). Nearly half (47%) of the Braak IV samples had coexisting limbic predominant age-related TAR DNA-binding protein 43 encephalopathy neuropathologic change. Cases with a high brain weight (n = 201) were less likely to have amygdala-predominant Lewy bodies (14%, p = 0.006) and most likely to have Lewy body disease (31%, p = 0.042) compared with those with middle (n = 455) and low (n = 203) brain weight. Discussion The frequency of Lewy body disease was increased in both neuropathologic proxies of the minimal atrophy subtype. We hypothesize that Lewy body disease may underlie cognitive decline observed in minimal atrophy cases.

  • Randomized Phase II Study of the Safety and Efficacy of Semorinemab in Participants With Mild-to-Moderate Alzheimer Disease: Lauriet
    by Monteiro, C., Toth, B., Brunstein, F., Bobbala, A., Datta, S., Ceniceros, R., Sanabria Bohorquez, S. M., Anania, V. G., Wildsmith, K. R., Schauer, S. P., Lee, J., Dolton, M. J., Ramakrishnan, V., Abramzon, D., Teng, E., for the Lauriet investigators on October 2, 2023 at 7:45 pm

    Background and Objectives Accumulation of tau pathology in Alzheimer disease (AD) correlates with cognitive decline. Anti-tau immunotherapies were proposed as potential interventions in AD. While antibodies targeting N-terminal tau failed to demonstrate clinical efficacy in prodromal-to-mild AD, their utility at other disease stages was not evaluated in prior studies. Lauriet is a phase 2 study of an anti-tau monoclonal antibody, semorinemab, in patients with mild-to-moderate AD. Methods The phase 2 Lauriet study included a randomized, placebo-controlled, double-blind period, during which participants with mild-to-moderate AD received 4,500 mg of IV semorinemab or placebo every 4 weeks for 48 or 60 weeks. Participants who chose to continue in the subsequent optional open-label extension received 4,500 mg of semorinemab every 4 weeks for up to 96 weeks. Coprimary efficacy endpoints were change from baseline to week 49 or 61 on the 11-item version of the Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog11) and the Alzheimer’s Disease Cooperative Study-Activities of Daily Living (ADCS-ADL) scale. Secondary efficacy endpoints included change from baseline on the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating-Sum of Boxes (CDR-SB). Safety, pharmacokinetics, and pharmacodynamic effects were also evaluated. Results Between December 3, 2018, and February 27, 2020, 624 individuals were screened, 272 participants were randomized, and 238 were included in the modified intent-to-treat population (received ≥1 dose(s) of study medication and underwent baseline and ≥1 postbaseline assessment(s)). Baseline characteristics were well balanced. At week 49, the semorinemab arm demonstrated a 42.2% reduction (–2.89 points, 95% CI –4.56 to –1.21, p = 0.0008) in decline on the ADAS-Cog11 (coprimary endpoint) relative to the placebo arm. However, no treatment effects were observed on the ADCS-ADL scale (coprimary endpoint; absolute difference between the 2 treatment arms in the ADCS-ADL score change from baseline of –0.83 points, 95% CI –3.39 to 1.72, p = 0.52) or on the MMSE or CDR-SB (secondary endpoints). Semorinemab was safe and well tolerated. Discussion Based on the results of the prespecified coprimary endpoints, this study was negative. While semorinemab had a significant effect on cognition measured by the ADAS-Cog11, this effect did not extend to improved functional or global outcomes. These results may warrant further exploration of semorinemab or other anti-tau therapies in mild-to-moderate AD. Classification of Evidence This study provides Class I evidence that semorinemab does not slow functional decline in patients with mild-to-moderate AD. Trial Registration Information The Lauriet study is registered on, NCT03828747, and EudraCT 2018-003398-87.

  • Association of Plasma Biomarkers of Alzheimer Disease With Cognition and Medical Comorbidities in a Biracial Cohort
    by Ramanan, V. K., Graff-Radford, J., Syrjanen, J., Shir, D., Algeciras-Schimnich, A., Lucas, J., Martens, Y. A., Carrasquillo, M. M., Day, G. S., Ertekin-Taner, N., Lachner, C., Willis, F. B., Knopman, D. S., Jack, C. R., Petersen, R. C., Vemuri, P., Graff-Radford, N., Mielke, M. M. on October 2, 2023 at 7:45 pm

    Background and Objectives Recent advances in blood-based biomarkers offer the potential to revolutionize the diagnosis and management of Alzheimer disease (AD), but additional research in diverse populations is critical. We assessed the profiles of blood-based AD biomarkers and their relationships to cognition and common medical comorbidities in a biracial cohort. Methods Participants were evaluated through the Mayo Clinic Jacksonville Alzheimer Disease Research Center and matched on age, sex, and cognitive status. Plasma AD biomarkers (β-amyloid peptide 1–42 [Aβ42/40], plasma tau phosphorylated at position 181 [p-tau181], glial fibrillary acidic protein [GFAP], and neurofilament light) were measured using the Quanterix SiMoA HD-X analyzer. Cognition was assessed with the Mini-Mental State Examination. Wilcoxon rank sum tests were used to assess for differences in plasma biomarker levels by sex. Linear models tested for associations of self-reported race, chronic kidney disease (CKD), and vascular risk factors with plasma AD biomarker levels. Additional models assessed for interactions between race and plasma biomarkers in predicting cognition. Results The sample comprised African American (AA; N = 267) and non-Hispanic White (NHW; N = 268) participants, including 69% female participants and age range 43–100 (median 80.2) years. Education was higher in NHW participants (median 16 vs 12 years, p < 0.001) while APOE 4 positivity was higher in AA participants (43% vs 34%; p = 0.04). We observed no differences in plasma AD biomarker levels between AA and NHW participants. These results were unchanged after stratifying by cognitive status (unimpaired vs impaired). Although the p-tau181-cognition association seemed stronger in NHW participants while the Aβ42/40-cognition association seemed stronger in AA participants, these findings did not survive after excluding individuals with CKD. Female participants displayed higher GFAP (177.5 pg/mL vs 157.73 pg/mL; p = 0.002) and lower p-tau181 (2.62 pg/mL vs 3.28 pg/mL; p = 0.001) levels than male participants. Diabetes was inversely associated with GFAP levels (β = –0.01; p < 0.001). Discussion In a biracial community-based sample of adults, we observed that sex differences, CKD, and vascular risk factors, but not self-reported race, contributed to variation in plasma AD biomarkers. Although some prior studies have reported primary effects of race/ethnicity, our results reinforce the need to account for broad-based medical and social determinants of health (including sex, systemic comorbidities, and other factors) in effectively and equitably deploying plasma AD biomarkers in the general population.

BMJ Paediatrics

  • Initial dosage optimisation of cyclosporine in Chinese paediatric patients undergoing allogeneic haematopoietic stem cell transplantation based on population pharmacokinetics: a retrospective study
    by Feng, H., Wang, X., Zheng, W., Liu, S., Jiang, H., Lin, Y., Qiu, H., Chan, T. F., Huang, M., Li, Y., Mo, X., Li, J. on August 29, 2023 at 3:32 pm

    Objective Improved understanding of cyclosporine A (CsA) pharmacokinetics in children undergoing allogeneic haematopoietic stem cell transplantation (allo-HSCT) is crucial for effective prevention of acute graft-versus-host disease and medication safety. The aim of this study was to establish a population pharmacokinetic (Pop-PK) model that could be used for individualised therapy to paediatric patients undergoing allo-HSCT in China. Design, setting and participants A retrospective analysis of 251 paediatric HSCT patients who received CsA intravenously in the early post transplantation period at Women and Children’s Medical Center in Guangzhou was conducted. Analysis measures The model building dataset from 176 children was used to develop and analyse the CsA Pop-Pk model by using the nonlinear mixed effect model method. The basic information was collected by the electronic medical record system. Genotype was analysed by matrix-assisted time-of-flight mass spectrometry. The stability and predictability of the final model were verified internally, and a validation dataset of 75 children was used for external validation. Monte Carlo simulation is used to adjust and optimise the initial dose of CsA in paediatric allo-HSCT patients. Results The typical values for clearance (CL) and volume of distribution () were 14.47 L/hour and 2033.53 L, respectively. The body weight and haematocrit were identified as significant variables for V, while only body weight had an impact on CL. The simulation based on the final model suggests that paediatrics with HSCT required an appropriate intravenous dose of 5 mg/kg/day to reach the therapeutic trough concentration. Conclusions The CsA Pop-PK model established in this study can quantitatively describe the factors influencing pharmacokinetic parameters and precisely predict the intrinsic exposure to CsA in children. In addition, our dosage simulation results can provide evidence for the personalised medications Trial registration number ChiCTR2000040561

  • Assessing household financial burdens for preprimary education and associated socioeconomic inequalities: a case study in China
    by Wei, Y., Liu, K., Kang, L., Behrman, J. R., Richter, L. M., Stein, A., Song, Y., Lu, C. on August 10, 2023 at 3:52 pm

    Background Providing young children with universal access to preprimary education (PPE) is considered a powerful tool for human capital development and eliminating the intergenerational transmission of poverty. To remove household financial barrier for achieving universal PPE, this study proposed a measure to identify households incurring ‘heavy financial burdens from paying for PPE’ (HBPPE) and conducted a case study in China. Methods Using nationally representative data in 2019, we estimated the percentage of households with HBPPE (spent 7% or more of their total annual expenditure) and associated socioeconomic inequalities. We also applied a three-level logit regression model to investigate the factors associated with the probabilities of households incurring HBPPE. Results Half of the sampled households spent 7% or more of their expenditures on PPE. Households in the lowest wealth quintile (54%) or households with children attending private PPE (55%) had higher percentages of HBPPE than households in other wealth quintiles (eg, 51% in the highest wealth quintile) or households with children attending public kindergartens (41%). Logit regression analysis shows that the poorest households and households with children attending private kindergarten were more likely to incur HBPPE than their counterparts. Conclusion To ensuring universal access to PPE in China, future policy should consider increasing the enrolment of children from low-income families in public kindergartens and increasing governmental investments in low-income households by subsidising children attending PPE.

  • Development and internal validation of a Neonatal Healthcare-associated infectiOn Prediction score (NeoHoP score) for very low birthweight infants in low-resource settings: a retrospective case-control study
    by Lloyd, L. G., van Weissenbruch, M. M., Dramowski, A., Gleeson, B., Ferreyra, C., Bekker, A. on August 8, 2023 at 12:44 am

    Background and objectives Early diagnosis of neonatal infection is essential to prevent serious complications and to avoid unnecessary use of antibiotics. The prevalence of healthcare-associated infections (HAIs) among very low birthweight (VLBW; <1500 g) infants is 20%; and the mortality in low-resource settings can be as high as 70%. This study aimed to develop an Infection Prediction Score to diagnose bacterial HAIs. Methods A retrospective cohort of VLBW infants investigated for HAI was randomised into two unmatched cohorts. The first cohort was used for development of the score, and the second cohort was used for the internal validation thereof. Potential predictors included risk factors, clinical features, interventions, and laboratory data. The model was developed based on logistic regression analysis. Results The study population of 655 VLBW infants with 1116 episodes of clinically suspected HAIs was used to develop the model. The model had five significant variables: capillary refill time >3 s, lethargy, abdominal distention, presence of a central venous catheter in the previous 48 hours and a C reactive protein ≥10 mg/L. The area below the receiver operating characteristic curve was 0.868. A score of ≥2 had a sensitivity of 54.2% and a specificity of 96.4%. Conclusion A novel Infection Prediction Score for HAIs among VLBW infants may be an important tool for healthcare providers working in low-resource settings but external validation needs to be performed before widespread use can be recommended.

Journal of Paediatrics

Paediatric Physical Therapy

Speech Language & Hearing

International Journal of Speech-Language Pathology

Journal of Speech, Language & Hearing Research

Journal of Orthopaedic amp; Sports Physical Therapy

Australian Journal of Psychology

BMJ Evidence-Based Mental Health Journal

  • Trichotillomania: a perspective synthesised from neuroscience and lived experience
    by Mackay, C. E. on September 21, 2023 at 1:50 am

    Trichotillomania, or hair-pulling disorder, is one of a family of disorders called body-focused repetitive behaviours (BFRBs), which also include disordered skin-picking (dermotillomania) and nail-biting (onychophagia). The disorders affect 1%–2% of the population, cause high levels of distress and have high levels of comorbidity with other psychiatric diagnoses. The key facts and figures are briefly reviewed and some important points are further explored: (1) BFRBs are associated with psychological distress, but are distinct from other diagnoses, (2) The pathological behaviours mirror excessive self-grooming behaviours in other species, and may relate to immune-system mediated feedback loops, and (3) The resulting behaviours are stigmatised and cause intense shame and isolation for those who suffer, which might in itself maintain the feedback loop. These observations lead to the hypothesis that the core disorder is one of pathological grooming, which may have a basis in an immune response, with shame being both a consequence and a maintainer of the disorder. The major barrier to testing the hypotheses and potential interventions remains the stigma that keeps these disorders, and those who suffer from them, in the shadows.

  • Impact of the COVID-19 pandemic on antipsychotic prescribing in individuals with autism, dementia, learning disability, serious mental illness or living in a care home: a federated analysis of 59 million patients primary care records in situ using OpenSAFELY
    by Macdonald, O., Green, A., Walker, A., Curtis, H., Croker, R., Brown, A., Butler-Cole, B., Andrews, C., Massey, J., Inglesby, P., Morton, C., Fisher, L., Morley, J., Mehrkar, A., Bacon, S., Davy, S., Evans, D., Dillingham, I., Ward, T., Hulme, W., Bates, C., Cockburn, J., Parry, J., Hester, F., Harper, S., O’Hanlon, S., Eavis, A., Jarvis, R., Avramov, D., Parkes, N., Wood, I., Goldacre, B., Mackenna, B. on September 15, 2023 at 2:58 pm

    Background The COVID-19 pandemic affected how care was delivered to vulnerable patients, such as those with dementia or learning disability. Objective To explore whether this affected antipsychotic prescribing in at-risk populations. Methods With the approval of NHS England, we completed a retrospective cohort study, using the OpenSAFELY platform to explore primary care data of 59 million patients. We identified patients in five at-risk groups: autism, dementia, learning disability, serious mental illness and care home residents. We calculated the monthly prevalence of antipsychotic prescribing in these groups, as well as the incidence of new prescriptions in each month. Findings The average monthly rate of antipsychotic prescribing increased in dementia from 82.75 patients prescribed an antipsychotic per 1000 patients (95% CI 82.30 to 83.19) in January–March 2019 to 90.1 (95% CI 89.68 to 90.60) in October–December 2021 and from 154.61 (95% CI 153.79 to 155.43) to 166.95 (95% CI 166.23 to 167.67) in care homes. There were notable spikes in the rate of new prescriptions issued to patients with dementia and in care homes. In learning disability and autism groups, the rate of prescribing per 1000 decreased from 122.97 (95% CI 122.29 to 123.66) to 119.29 (95% CI 118.68 to 119.91) and from 54.91 (95% CI 54.52 to 55.29) to 51.04 (95% CI 50.74 to 51.35), respectively. Conclusion and implications We observed a spike in antipsychotic prescribing in the dementia and care home groups, which correlated with lockdowns and was likely due to prescribing of antipsychotics for palliative care. We observed gradual increases in antipsychotic use in dementia and care home patients and decreases in their use in patients with learning disability or autism.

  • Understanding the causal relationships of attention-deficit/hyperactivity disorder with mental disorders and suicide attempt: a network Mendelian randomisation study
    by Meisinger, C., Freuer, D. on September 5, 2023 at 10:30 pm

    Background Attention-deficit/hyperactivity disorder (ADHD) is a lifespan neurodevelopmental condition resulting from complex interactions between genetic and environmental risk factors. There is evidence that ADHD is associated with other mental disorders, but it remains unclear whether and in what way a causal relationship exists. Objective To investigate the direct and indirect causal paths between ADHD and seven common mental disorders. Methods Two-sample network Mendelian randomisation analysis was performed to identify psychiatric disorders causally related to ADHD. Total and direct effects were estimated in an univariable and multivariable setting, respectively. Robustness of results was ensured in three ways: a range of pleiotropy-robust methods, an iterative approach identifying and excluding outliers, and use of up to two genome-wide association studies per outcome to replicate results and calculate subsequently pooled meta-estimates. Results Genetic liability to ADHD was independently associated with the risk of anorexia nervosa (OR 1.28 (95% CI 1.11 to 1.47); p=0.001). A bidirectional association was found with major depressive disorder (OR 1.09 (95% CI 1.03 to 1.15); p=0.003 in the forward direction and OR 1.76 (95% CI 1.50 to 2.06); p=4×10–12 in the reverse direction). Moreover, after adjustment for major depression disorder, a direct association with both suicide attempt (OR 1.30 (95% CI 1.16 to 1.547); p=2×10–5) and post-traumatic stress disorder (OR 1.18 (95% CI 1.05 to 1.33); p=0.007) was observed. There was no evidence of a relationship with anxiety, bipolar disorder or schizophrenia. Conclusions This study suggests that ADHD is an independent risk factor for a number of common psychiatric disorders. Clinical implications The risk of comorbid psychiatric disorders in individuals with ADHD needs to be considered both in diagnosis and treatment.

Journal of the Academy of Nutrition and Dietetics

Nutrition & Dietetics

British Journal of Sports Medicine

  • Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews
    by Singh, B., Olds, T., Curtis, R., Dumuid, D., Virgara, R., Watson, A., Szeto, K., O’Connor, E., Ferguson, T., Eglitis, E., Miatke, A., Simpson, C. E., Maher, C. on September 29, 2023 at 8:16 am

    Objective To synthesise the evidence on the effects of physical activity on symptoms of depression, anxiety and psychological distress in adult populations. Design Umbrella review. Data sources Twelve electronic databases were searched for eligible studies published from inception to 1 January 2022. Eligibility criteria for selecting studies Systematic reviews with meta-analyses of randomised controlled trials designed to increase physical activity in an adult population and that assessed depression, anxiety or psychological distress were eligible. Study selection was undertaken in duplicate by two independent reviewers. Results Ninety-seven reviews (1039 trials and 128 119 participants) were included. Populations included healthy adults, people with mental health disorders and people with various chronic diseases. Most reviews (n=77) had a critically low A MeaSurement Tool to Assess systematic Reviews score. Physical activity had medium effects on depression (median effect size=–0.43, IQR=–0.66 to –0.27), anxiety (median effect size=–0.42, IQR=–0.66 to –0.26) and psychological distress (effect size=–0.60, 95% CI –0.78 to –0.42), compared with usual care across all populations. The largest benefits were seen in people with depression, HIV and kidney disease, in pregnant and postpartum women, and in healthy individuals. Higher intensity physical activity was associated with greater improvements in symptoms. Effectiveness of physical activity interventions diminished with longer duration interventions. Conclusion and relevance Physical activity is highly beneficial for improving symptoms of depression, anxiety and distress across a wide range of adult populations, including the general population, people with diagnosed mental health disorders and people with chronic disease. Physical activity should be a mainstay approach in the management of depression, anxiety and psychological distress. PROSPERO registration number CRD42021292710.

  • Resistance training prescription for muscle strength and hypertrophy in healthy adults: a systematic review and Bayesian network meta-analysis
    by Currier, B. S., Mcleod, J. C., Banfield, L., Beyene, J., Welton, N. J., D’Souza, A. C., Keogh, J. A. J., Lin, L., Coletta, G., Yang, A., Colenso-Semple, L., Lau, K. J., Verboom, A., Phillips, S. M. on September 29, 2023 at 8:16 am

    Objective To determine how distinct combinations of resistance training prescription (RTx) variables (load, sets and frequency) affect muscle strength and hypertrophy. Data sources MEDLINE, Embase, Emcare, SPORTDiscus, CINAHL, and Web of Science were searched until February 2022. Eligibility criteria Randomised trials that included healthy adults, compared at least 2 predefined conditions (non-exercise control (CTRL) and 12 RTx, differentiated by load, sets and/or weekly frequency), and reported muscle strength and/or hypertrophy were included. Analyses Systematic review and Bayesian network meta-analysis methodology was used to compare RTxs and CTRL. Surface under the cumulative ranking curve values were used to rank conditions. Confidence was assessed with threshold analysis. Results The strength network included 178 studies (n=5097; women=45%). The hypertrophy network included 119 studies (n=3364; women=47%). All RTxs were superior to CTRL for muscle strength and hypertrophy. Higher-load (>80% of single repetition maximum) prescriptions maximised strength gains, and all prescriptions comparably promoted muscle hypertrophy. While the calculated effects of many prescriptions were similar, higher-load, multiset, thrice-weekly training (standardised mean difference (95% credible interval); 1.60 (1.38 to 1.82) vs CTRL) was the highest-ranked RTx for strength, and higher-load, multiset, twice-weekly training (0.66 (0.47 to 0.85) vs CTRL) was the highest-ranked RTx for hypertrophy. Threshold analysis demonstrated these results were extremely robust. Conclusion All RTx promoted strength and hypertrophy compared with no exercise. The highest-ranked prescriptions for strength involved higher loads, whereas the highest-ranked prescriptions for hypertrophy included multiple sets. PROSPERO registration number CRD42021259663 and CRD42021258902.

  • Analysis of the Sport Mental Health Assessment Tool 1 (SMHAT-1) in Team USA athletes
    by Anderson, T., Adams, W. M., Bartley, J. D., Brutus, A. L., Donaldson, A. T., Finnoff, J. T. on September 29, 2023 at 8:16 am

    Objective The Sport Mental Health Assessment Tool 1 (SMHAT-1) was introduced as a critical component to the athlete health evaluation. However, the effectiveness of the initial triage step questionnaire (Athlete Psychological Strain Questionnaire (APSQ)) has yet to be analysed within a National Olympic and Paralympic Committee delegation. This study evaluated the ability of the APSQ to identify athletes at risk for mental health concerns. Methods Athletes completed the APSQ and all subsequent screening questionnaires of the SMHAT-1 as part of their Tokyo and Beijing Olympic and Paralympic Games health history screening. Each questionnaire was scored according to published guidelines, and the false-negative rate (FNR) for the APSQ identifying athletes that were positively screened on the subsequent questionnaires was computed. Results 1066 athletes from 51 different Olympic and Paralympic and Summer and Winter sports completed the SMHAT-1. The FNRs for all athletes who were positively screened on a subsequent questionnaire with an APSQ score of <17 ranged from 4.8% to 66.7%. The global FNR for being positively screened on any questionnaire was 67.5%. Female, Paralympic and Winter athletes scored higher on one or more questionnaires compared with male, Olympic and Summer athletes, respectively (p<0.05). Conclusion Due to the high FNR of the APSQ detecting a potential mental health concern, we recommend athletes complete the APSQ and all subsequent questionnaires of the SMHAT-1 rather than using only the APSQ as an initial screening test.