Proceedings of the 3rd Biennial Conference of the Society for Implementation Research Collaboration (SIRC) 2015: advancing efficient methodologies through community partnerships and team science

It is well documented that the majority of adults, children and families in need of evidence-based behavioral health interventionsi do not receive them [1, 2] and that few robust empirically supported methods for implementing evidence-based practices (EBPs) exist. The Society for Implementation Research Collaboration (SIRC) represents a burgeoning effort to advance the innovation and rigor of implementation research and is uniquely focused on bringing together researchers and stakeholders committed to evaluating the implementation of complex evidence-based behavioral health interventions. Through its diverse activities and membership, SIRC aims to foster the promise of implementation research to better serve the behavioral health needs of the population by identifying rigorous, relevant, and efficient strategies that successfully transfer scientific evidence to clinical knowledge for use in real world settings [3]. SIRC began as a National Institute of Mental Health (NIMH)-funded conference series in 2010 (previously titled the “Seattle Implementation Research Conference”; $150,000 USD for 3 conferences in 2011, 2013, and 2015) with the recognition that there were multiple researchers and stakeholdersi working in parallel on innovative implementation science projects in behavioral health, but that formal channels for communicating and collaborating with one another were relatively unavailable. There was a significant need for a forum within which implementation researchers and stakeholders could learn from one another, refine approaches to science and practice, and develop an implementation research agenda using common measures, methods, and research principles to improve both the frequency and quality with which behavioral health treatment implementation is evaluated. SIRC’s membership growth is a testament to this identified need with more than 1000 members from 2011 to the present.ii SIRC’s primary objectives are to: (1) foster communication and collaboration across diverse groups, including implementation researchers, intermediariesi, as well as community stakeholders (SIRC uses the term “EBP champions” for these groups) – and to do so across multiple career levels (e.g., students, early career faculty, established investigators); and (2) enhance and disseminate rigorous measures and methodologies for implementing EBPs and evaluating EBP implementation efforts. These objectives are well aligned with Glasgow and colleagues’ [4] five core tenets deemed critical for advancing implementation science: collaboration, efficiency and speed, rigor and relevance, improved capacity, and cumulative knowledge. SIRC advances these objectives and tenets through in-person conferences, which bring together multidisciplinary implementation researchers and those implementing evidence-based behavioral health interventions in the community to share their work and create professional connections and collaborations

Efficacy of cognitive-behavioral therapy and deep relaxation for children with attention-deficit hyperactivity disorder

Objective: This study made a preliminary exploration of the efficacy of physically-based cognitive-behavioral therapy and deep relaxation for children with attention-deficit hyperactivity disorder (ADHD). Methods: ADHD behavior and cognitive functions were assessed by test D2 and Conner’s scale before and after a one-year physically-based training program. The reliability of test scores was assessed by repeat testing of a control group (CG) of 10 students who did not have ADHD. Children (10 per group) with ADHD were assigned to physically-based cognitive-behavioral therapy and deep relaxation (E1) or physically-based cognitive-behavioral alone (E2). Results: After 52 weeks of treatment, an intra-group comparison showed that E1 and E2 had improved their scores on the test D2, whereas CG showed no significant change. In addition, most participants with ADHD showed a remarkable improvement in their attentional behavior, with group E1 responding better to treatment than group E2. Conclusions: Physically-based cognitive behavioral therapy appears to improve function and social competence in children with ADHD, and should be recommended as an alternative or supplement to pharmaceutical treatment

Acute Effects of an “Energy Drink” on Short-Term Maximal Performance, Reaction Times, Psychological and Physiological Parameters: Insights from a Randomized Double-Blind, Placebo-Controlled, Counterbalanced Crossover Trial

The current study examined the relationships between the effects of consuming a caffeine-containing “energy drink” upon (i) short-term maximal performance, (ii) reaction times, and (iii) psychological factors (i.e., mood state, ratings of perceived exertion (RPE), and affective load) and on physiological parameters (i.e., blood pressure and blood glucose). A randomized, double-blind, placebo-controlled, counterbalanced crossover design was implemented in this study. Nineteen male physical-education students (age: 21.2 ± 1.2 years; height: 1.76 ± 0.08 m; body-mass: 76.6 ± 12.6 kg) performed two test sessions: after drinking the “Red Bull’ beverage (RB) and after drinking a placebo (PL). One hour after ingestion of each drink, resting blood glucose and blood pressure were measured and the participants completed the Profile of Mood States questionnaire. Then, after a 5-min warm-up, simple visual reaction time and handgrip force were measured, and the 30-s Wingate test was performed. Immediately after these tests, the RPE, blood glucose, and blood pressure were measured, and the affective load was calculated. Differences between treatments were assessed using two-way repeated measures analyses of variance and paired t-tests, as appropriate. Relationships between the test variables were assessed using Bland−Altman correlations. Significant (i) improvements in peak and mean power output, handgrip force, pre- and post-exercise blood glucose, blood pressure, and vigor and (ii) reductions in reaction times, depression, confusion, fatigue, anger, anxiety, RPE, and affective load scores were observed after RB compared to PL. There were significant correlations of (i) physical performances and reaction times with (ii) RPE, affective load, and pre- and post-exercise blood glucose levels. Gains in peak and mean power were significantly correlated with reductions in fatigue, anxiety (peak power only), and anger (mean power only). The reduction of reaction times was significantly correlated with decreases in confusion and anger and with increases in vigor. Handgrip force and reaction times were significantly correlated with pre- and post-exercise blood pressures. We conclude that RB ingestion has a positive effect on physical performance and reaction times. This effect is related to ergogenic responses in both psychological (i.e., RPE, affective load, and mood state) and physiological (i.e., blood glucose and blood pressure) domains

Effects of three different types of exercise on blood leukocyte count during and following exercise

CONTEXT: High-intensity exercise causes tissue damage, production of stress hormones, and alterations in the function and quantity of various immune cells. Many clinical-physical stressors such as surgery, trauma, burns and sepsis induce a pattern of hormonal and immunological response similar to that of exercise. It has thus been suggested that heavy exercise might be used to cause graded and well-defined amounts of muscle trauma, thereby serving as an experimental model for inflammation and sepsis. OBJECTIVE: In order to explore whether some form of strenuous exercise might provide an useful model for the inflammatory process, we studied the effects of three different exercise protocols on blood leukocyte count during and following exercise. DESIGN: Four different experimental conditions, using a randomized-block design. SETTING: Defence and Civil Institute of Environmental Medicine, North York, Ontario, Canada. PARTICIPANTS: Eight healthy and moderately fit males. PROCEDURES: Participants were each assigned to four experimental conditions. Subjects performed 5 minutes of cycle-ergometry exercise at 90%, 2 hours of cycle-ergometry exercise at 60%, a standard circuit of resistance exercises with 3 sets of 10 repetitions at 60 to 70% of one-repetition maximum (1-RM) force at each of 5 different stations; or they remained seated for 5 hours. DIAGNOSTIC TEST USED: Flow cytometric analysis. MAIN MEASUREMENTS: Blood samples were analyzed for total leukocyte counts, total T cells, T helper/inducer cells, T suppressor/cytotoxic cells, B cells, cytolytic T cells, and natural killer cells. RESULTS: The peak aerobic and prolonged submaximal exercise induced similar alterations in cell counts. These changes were generally larger than those produced by the resistance exercise, although both resistance and peak aerobic exercise resulted in a significantly longer-lasting decrease in the CD4+/CD8+ ratio than the submaximal exercise bout did. CONCLUSION: The data suggest that, of the three exercise patterns tested, prolonged aerobic exercise induced the largest and most readily measured patterns of immune response. Nevertheless, the changes provided only a partial model for the clinical inflammatory process

Dental Trauma First-Aid Knowledge and Attitudes of Physical Education Teachers: A Systematic Review and Meta-Analysis of the Literature with Meta-Regressions

The main objective of the present review is to evaluate the knowledge and attitudes of physical education (PE) teachers concerning dental trauma first-aid through a systematic appraisal of the literature, meta-analysis and meta-regressions. The entire content of PubMed and ISI/Web of Science was mined. Eligibility criteria for selecting studies were studies evaluating dental trauma first-aid knowledge and/or attitudes and/or the effectiveness of mouthguards use by PE teachers. Articles written in any language and published or accepted by peer-reviewed journals were considered. Methodological quality was assessed using an adapted version of the Downs and Black instrument. Of 15 selected articles, three were of strong quality, three were moderate, and the remaining nine were rated as weak. The majority of studies showed that PE teachers had an inadequate knowledge of the initial management of dental trauma. Specifically, there was a lack of knowledge concerning an appropriate washing and transporting medium and the extra-alveolar period of an avulsed tooth. Due to the inadequate knowledge of PE teachers regarding dental trauma management, specific education should be added to PE classes to improve the emergency treatment of dental injuries

Sleep Patterns, Alertness, Dietary Intake, Muscle Soreness, Fatigue, and Mental Stress Recorded before, during and after Ramadan Observance

Ramadan is one of the pillars of the Islamic creed. Its observance commonly causes chrono-biological changes. The present study examined sleep and alertness during Ramadan observance relative to data collected before and after Ramadan in a sample of young, physically active men. Information was also collected on dietary intake, muscle soreness, fatigue, and mental stress over the three periods. Fourteen physically active men (age: 21.6 ± 3.3 years, height: 1.77 ± 0.06 m, body-mass: 73.1 ± 9.0 kg) completed the Hooper questionnaire and the Pittsburgh Sleep Quality Index (PSQI) and responded to the digit cancellation test (DCT) fifteen days before Ramadan, during the last ten days of Ramadan and 20 days after Ramadan. The PSQI results indicated that sleep duration was significantly longer before Ramadan (p = 0.003) and after Ramadan (p = 0.04) compared to during Ramadan and was longer before Ramadan than after Ramadan (p = 0.04). In addition, the sleep efficiency was lower during Ramadan in comparison to before Ramadan (p = 0.02) and after Ramadan (p = 0.04). The daytime dysfunction score increased during Ramadan in comparison with before Ramadan (p = 0.01) and after Ramadan (p = 0.04), and the sleep quality score was higher during (p = 0.003) and after Ramadan (p = 0.04) as compared to before Ramadan. The sleep disturbance score increased during Ramadan relative to before Ramadan (p = 0.04). However, Ramadan observance had no significant effect on sleep latency. Mental alertness also decreased at the end of Ramadan compared to before (p = 0.003) or after Ramadan (p = 0.01). Dietary intake, muscle soreness, fatigue, and mental stress as estimated by the Hooper questionnaire remained unchanged over the three periods of the investigation (p > 0.05). In conclusion, Ramadan observance had an adverse effect on sleep quantity and on mental alertness, but not on sleep quality. However, dietary intake, muscle soreness, fatigue, and mental stress remained unaffected

Effects of 25-Min Nap Opportunity during Ramadan Observance on the 5-m Shuttle Run Performance and the Perception of Fatigue in Physically Active Men

We aimed to investigate the effects of a 25-min nap opportunity on physical performance during the 5-m shuttle run test (5mSRT), feelings (i.e., evaluated by the feeling scale), attention (i.e., evaluated by the digit cancellation test) and the perception of fatigue (i.e., recorded by the rating of perceived exertion (RPE)) during Ramadan observance. Twelve physically active men (age: 21.1 ± 3.2 yrs, height: 1.76 ± 0.05 m, body-mass: 71.2 ± 9.3 kg) voluntarily participated in five test sessions: 15 days before Ramadan (BR), the first 10 days of Ramadan (FR), the last 10 days of Ramadan (ER), 10 days after Ramadan (10AR) and 20 days after Ramadan (20AR). During each test session, participants performed the digit cancellation test, a 5-min standard warm-up, the 5mSRT (6 × 30-s with 35-s intervals-between) and the rating of perceived exertion (RPE) after no-nap (N0) and 25-min nap opportunity (N25) conditions. Participants also completed the Pittsburgh Sleep Quality Index (PSQI) during each period. The total distance covered during the 5mSRT did not differ significantly before, during or after Ramadan, but was significantly greater after N25 compared to N0 at 10AR (687.5 ± 23.0 m vs. 725.6 ± 41.1 m; p = 0.018) and 20AR (698.3 ± 19.8 m vs. 742.6 ± 58.3 m; p = 0.003). The attention scores were higher after N25 in comparison with N0 at 10AR (p = 0.04) and 20AR (p = 0.02). RPE scores were not significantly different between N25 and N0 conditions. Feelings scores were higher after N25 compared to N0 during both FR (p = 0.007) and 20AR (p = 0.04). A significant deterioration of sleep quality was recorded during Ramadan (i.e., PSQI scores were significantly higher during and after compared to BR (p < 0.0005)). A 25-min nap opportunity was beneficial for physical and cognitive performance after Ramadan observance; however, any effect is insufficient to show significant beneficial impacts during Ramadan

4D-Var Inversion of European NH Emissions Using CrIS NH Measurements and GEOS-Chem Adjoint With Bi-Directional and Uni-Directional Flux Schemes.

We conduct the first 4D-Var inversion of NH3 accounting for NH3 bi-directional flux, using CrIS satellite NH3 observations over Europe in 2016. We find posterior NH3 emissions peak more in springtime than prior emissions at continental to national scales, and annually they are generally smaller than the prior emissions over central Europe, but larger over most of the rest of Europe. Annual posterior anthropogenic NH3 emissions for 25 European Union members (EU25) are 25% higher than the prior emissions and very close (<2% difference) to other inventories. Our posterior annual anthropogenic emissions for EU25, the UK, the Netherlands, and Switzerland are generally 10%-20% smaller than when treating NH3 fluxes as uni-directional emissions, while the monthly regional difference can be up to 34% (Switzerland in July). Compared to monthly mean in-situ observations, our posterior NH3 emissions from both schemes generally improve the magnitude and seasonality of simulated surface NH3 and bulk NH x wet deposition throughout most of Europe, whereas evaluation against hourly measurements at a background site shows the bi-directional scheme better captures observed diurnal variability of surface NH3. This contrast highlights the need for accurately simulating diurnal variability of NH3 in assimilation of sun-synchronous observations and also the potential value of future geostationary satellite observations. Overall, our top-down ammonia emissions can help to examine the effectiveness of air pollution control policies to facilitate future air pollution management, as well as helping us understand the uncertainty in top-down NH3 emissions estimates associated with treatment of NH3 surface exchange

4D-Var Inversion of European NH Emissions Using CrIS NH Measurements and GEOS-Chem Adjoint With Bi-Directional and Uni-Directional Flux Schemes.

We conduct the first 4D-Var inversion of NH3 accounting for NH3 bi-directional flux, using CrIS satellite NH3 observations over Europe in 2016. We find posterior NH3 emissions peak more in springtime than prior emissions at continental to national scales, and annually they are generally smaller than the prior emissions over central Europe, but larger over most of the rest of Europe. Annual posterior anthropogenic NH3 emissions for 25 European Union members (EU25) are 25% higher than the prior emissions and very close (<2% difference) to other inventories. Our posterior annual anthropogenic emissions for EU25, the UK, the Netherlands, and Switzerland are generally 10%-20% smaller than when treating NH3 fluxes as uni-directional emissions, while the monthly regional difference can be up to 34% (Switzerland in July). Compared to monthly mean in-situ observations, our posterior NH3 emissions from both schemes generally improve the magnitude and seasonality of simulated surface NH3 and bulk NH x wet deposition throughout most of Europe, whereas evaluation against hourly measurements at a background site shows the bi-directional scheme better captures observed diurnal variability of surface NH3. This contrast highlights the need for accurately simulating diurnal variability of NH3 in assimilation of sun-synchronous observations and also the potential value of future geostationary satellite observations. Overall, our top-down ammonia emissions can help to examine the effectiveness of air pollution control policies to facilitate future air pollution management, as well as helping us understand the uncertainty in top-down NH3 emissions estimates associated with treatment of NH3 surface exchange