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Baccalaureate nursing students are at increased risk for anxiety and related mood disorders. We conducted a cross-sectional study to explore the relationships among anxiety symptoms measured by the Generalized Anxiety Disorder (GAD-7) questionnaire and lifestyle behaviors including habitual diet, sleep quality (Pittsburg Sleep Quality Index [PSQI]), and physical activity. Descriptive statistics were obtained for sample characteristics, and Pearson correlations and backward stepwise linear regression explored relationships between the GAD-7 scores, the Multidimensional Assessment of Interoceptive Awareness, version 2 (MAIA-2) subscales, and other variables. Sixty-eight students completed the survey, with 38% having moderate-to-severe anxiety. On average, respondents had moderate diet quality (Healthy Eating Index median 60/100 [range 51–75]), had high sleep quality (PSQI median 7/21 [range 4–10]), and were highly active, with a median of 43 (range 24–78) weekly metabolic equivalent (MET) hours. Sixty-seven out of 68 respondents indicated a willingness to change lifestyle behaviors; the most prevalent time-related factors were school and social commitments, with stress and financial constraints being reported among half or more of respondents. Regression analysis determined that PSQI (β = 0.446) and the MAIA-2 Not-Worrying subscale (β = −0.366) were significant (p < 0.001 for both) predictors of anxiety severity. These results indicate that mindfulness and sleep hygiene may be the most actionable foci for interventions to reduce anxiety in baccalaureate nursing students. This study was not registered as a clinical trial.

Background/Objectives: Mood disorders include symptoms of depression, anxiety, and or stress, and have increased in prevalence. Green tea and its bioactive components (epigallocatechin gallate [EGCG] and L-theanine) have been investigated for their health benefits and neuroprotective properties. As adults seek integrative and alternative treatment modalities, it is relevant to determine the effects of natural and non-pharmacological treatments on humans. This study aimed to assess current evidence from published randomized controlled trials testing the effects of green tea, green tea extracts, or its bioactive compounds on mood disorder symptomology and brain-derived neurotrophic factor (BDNF). Methods: We searched PubMed, Cochrane Library, PsycINFO, Embase, Google Scholar, and ClinicalTrials.gov, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and utilizing predetermined inclusion and exclusion criteria. Results: A total of 445 studies were identified, 395 screened, and thirteen met inclusion criteria. Seven used one of the bioactive compounds found in green tea for intervention, while six used green tea extract, matcha, or traditional green tea. Mood disturbance was assessed with several tools, with studies reporting improvements in depressive (n = 4), anxiety (n = 6), stress (n = 5), and sleep (n = 1) symptoms. No studies found a statistically significant effect of green tea or its bioactive compounds on BDNF. Conclusions: Our findings suggest green tea, GTE, L-theanine, and EGCG may improve mood disorder symptomology, particularly symptoms of depression; no evidence to date reports effects on BDNF.

Background/Objectives: Hypertension (HTN) continues to be a leading cause of death and disability in older adults, especially in the southeastern United States. A cross-sectional study was conducted to evaluate the relationships among measured, diagnosed, and treated (HTN) in community-dwelling adults participating in student-led health screenings in eastern Alabama. Methods: Between 2017 and 2019, students from health-related disciplines facilitated screenings at 23 community and independent living sites to conduct health assessments, including measuring blood pressure (BP), obtaining medical history, and evaluating current prescriptions. Statistical analyses including chi-square tests, t-tests, and backward stepwise linear regression were performed. Results: The current sample includes data from 357 adults aged 60 to 99 years (mean age 74.6 ± 8.7), who were 70.9% females, 60.8% identifying as Black/African American (BA), and 36.8% residing in rural areas. The majority of clients had a prior HTN diagnosis (71.1%) and/or currently measured HTN (78.7%). Forty-three percent of adults screened had measured, diagnosed, and pharmaceutically treated HTN, while 31% had measured but untreated HTN. Black clients had higher measured systolic and diastolic BP and were more likely to also have been diagnosed with HTN (p < 0.05 for all). Linear regression indicated that lower systolic BP was predicted by not living alone (p = 0.003), White race (p = 0.004), and previous HTN diagnosis (p = 0.012), while female gender (p = 0.079) and decreasing body mass index (p = 0.053) had marginal predictive value. Conclusions: These results indicate that awareness and screening of HTN in this population are noteworthy, though management of the disease through ongoing screening and referrals is essential to reduce disparities.

Background/Objectives: Mood disorders like depression, anxiety, and stress have increased steadily among adults, with growing interest in non-pharmaceutical treatments to improve symptomology. Epigallocatechin-3-gallate (EGCG) and curcumin are polyphenols with evidence to support their positive impacts on mood disorder symptomology and potential mood-associated biomarkers like brain-derived neurotrophic factor (BDNF). This study examined the effects of combined EGCG and curcumin supplementation on mood disturbance symptomology and serum brain-derived neurotrophic factor in adults. Methods: An 8-week randomized double-blinded placebo-controlled trial was conducted in adults (n = 64, 18–50 years old). Participants were randomized to a supplement group (n = 32; 350 mg EGCG and 1330 mg curcumin daily) or a matched placebo group (n = 32). Mood disturbance (DASS-21, GAD-7), sleep disturbance (GSAQ), and physical activity (IPAQ) were assessed at baseline, Week 4, and Week 8. Anthropometric measures, 24 h diet recalls, and fasted blood samples for serum BDNF were collected at baseline and Week 8. A multivariate ANOVA evaluated primary outcomes (DASS-21 composite score and BDNF), followed by repeated measures ANOVA for secondary outcomes (p < 0.05). Results: Significant improvements were observed across all participants for mood (DASS-21 composite and subscales, GAD-7, p < 0.001 for all), sleep (p < 0.001), and physical activity (p < 0.01), with no significant difference between supplement and placebo groups. Mean serum BDNF increased in both groups, but neither were statistically significant with no group-by-time interactions. Sugar intake (g/kg body weight) was positively correlated with mood symptoms at Week 8 in the supplement group. Baseline fruit and vegetable intake was associated with mood symptom severity at select time points; however, dietary changes during the intervention were not significantly related to changes in mood outcomes. Conclusions: Combined EGCG and curcumin supplementation did not show additional benefits beyond placebo for mood disturbance or serum BDNF over eight weeks. Observed improvements across both groups suggest that behavioral or lifestyle factors may play a larger role in short-term mood improvements than supplementation alone.

Background: Previous research indicates that gastrointestinal discomfort from milk consumption may be attributable to A1 β-casein, rather than lactose intolerance alone. A2 milk (free of A1 β-casein) consumption may result in fewer symptoms compared to conventional milk containing both A1/A2 β-casein. Objective: In this five-week, double-blind, double-crossover study, we assessed the physiological responses to doses escalating in volume of lactose-free conventional milk (Lactaid), A2 milk, and lactose-free A2 milk in fluid milk-avoiding participants. Methods: Each milk type was consumed over three separate weeks with three increasing doses across five days per week, >one week washout. Gastrointestinal symptoms, blood glucose, and breath gases were monitored for twenty-four, two-, and three-hours post-consumption, respectively. Sensory evaluation was completed for each sample. Results: Fifty-three participants consented and were randomized, with forty-eight participants completing the study. Overall, symptoms were minimal. On Days 1 and 3, lower ratings of bloating and flatulence were observed in A2 compared to lactose-free A2. Breath hydrogen responses reflected lactose content, but were higher in lactose-free A2 than Lactaid on Day 5. Thirty-three participants were deemed lactose-intolerant and had higher fasting and average breath hydrogen for all samples. The only symptom corresponding to the increase in breath hydrogen among these participants was flatulence after A2 consumption. Surprisingly, flatulence was apparently higher for lactose-tolerant individuals when consuming Lactaid compared to A2. Conclusions: These findings suggest that adults who avoid conventional fluid milk consumption may experience minimal GI discomfort from lactose-free and/or A1-free milks.

Background: Circadian rhythm disruption caused by shift work alters metabolic and hormonal pathways, which accelerates chronic disease onset, leading to decreased quality and quantity of life. This study aimed to determine whether a practical lifestyle intervention emphasizing nutrition timing and recovery habits could mitigate the metabolic and psychological effects of night-shift work. We conducted a randomized, open-label, crossover trial with two 8-week periods. Methods: Female healthcare workers (n = 13) aged 18–50 years with a body mass index (BMI) between 27 and 40 kg/m2 and working predominantly night shifts (≥30 h/week for ≥6 months) were randomized. During the 8-week intervention phase, participants received daily text messages with guidance on food, sleep/rest, and physical activity and were provided with whey protein isolate powder and grain-based snack bars to consume during work shifts. The program targeted improved nutrient timing, adequate protein intake, and structured rest without formal exercise training, allowing evaluation of dietary and behavioral effects feasible for this population. Total caloric (~30 kcal/kg lean mass) and protein (2 g/kg lean mass) needs were measured, along with sleep/rest goals of 6–8 h/24 h. Primary outcome measures were change in visceral fat percentage (VF%) by DXA and mental/physical quality of life (RAND SF-12). Secondary outcomes included fasting triglycerides, ALT, blood glucose, LDL, actigraphy, and fecal microbiome. Mixed-design two-way ANOVA was conducted to assess the effects of group (immediate [IG] and delayed [DG]), time (baseline, 8-week crossover, and week 16), and Group × Time (GxT) interactions, and Bonferroni correction was applied to post hoc t-tests. Results: Eleven participants completed the study. Both groups increased dietary protein intake (p < 0.001), and a GxT interaction for VF% (p = 0.039) indicated DG reduced VF% to a greater extent (−0.335 ± 0.114% (p = 0.003) vs. 0.279 ± 0.543% (p = 0.158)). Mental and physical QOL, objectively measured physical activity and sleep, serum lipids and inflammatory markers, and fecal microbiota remained unchanged (p > 0.05 for all GxT). Conclusions: The findings suggest that targeted nutrition and recovery strategies can modestly improve dietary intake and visceral fat; however, consistent with prior work, interventions without structured exercise may be insufficient to reverse broader metabolic effects of circadian disruption. This trial was registered at ClinicalTrials.gov, identifier: NCT06158204, first registered: 28 November 2023.

IntroductionMilitary veterans are at greater risk for chronic medical conditions, many of which are associated with greater body mass index (BMI). Detrimental changes to diet and physical activity (PA) levels after separation from military service contribute to this disparity which may be mitigated by nutrition education (NE) during service.MethodsWe conducted a survey in student veterans attending two southeastern US universities to determine current nutrition knowledge and hypothesised that NE received during time of service would be associated with better current diet quality (DQ), PA and BMI. Food group knowledge (FGK), and nutrient knowledge, DQ measured by Healthy Eating Index (HEI), and PA reported in metabolic equivalent minutes per week (MET-min/week) were assessed using previously validated questionnaires. Height and weight were also self-reported to calculate BMI. Differences in these variables between NE groups were assessed using Mann-Whitney U tests. Change in DQ, PA and BMI were assessed with Wilcoxon signed rank tests. Stepwise backward regression analysis was used to identify significant predictors related to HEI and BMI status.ResultsSixty-three out of 83 total responses were valid. Respondents were 60% male, 81% white, 43% and 27% served in the Army and Navy, respectively and 30% reported receiving NE while in the military. Veterans who received NE while serving did not have higher FGK, nutrition knowledge, current DQ, MET-min/week or BMI than their counterparts. Overall, respondents reported decreased MET-min/week (p<0.001), increased BMI (p=0.01) and no change in DQ. PA (p=0.014) and FGK (p<0.001) were significant predictors of current DQ, while no variables significantly predicted current BMI.ConclusionsInverse relationships between BMI and PA were observed after separation from duty. These results warrant the development and implementation of effective lifestyle interventions in veterans to prevent chronic disease and improve quality of life.

Chronic pain management is a growing concern in the medical community with one out of three people in America suffering from chronic pain. This educational practice-focused project identified the value of educating a group of primary care providers (PCP) on pharmacogenetic (PGx) testing offering genetic-based prescribing choices and reducing trial and failure in treating chronic pain patients. The practice-focused question explored if there would be support regarding learning gained by the providers following an evidence-based education process on PGx testing, as shown from pretest to posttest results. The educational model was guided by the analysis, design, development, implementation, and evaluation (ADDIE) model. Due to the COVID-19 pandemic precautions, distant learning via Zoom offered a safe learning platform. This evidence-based education project consisted of 19 PCPs who were invited to participate. The purpose of the project and their role in the project was explained, and they were provided with an access QR code for the Survey Monkey® platform. The data gathering consisted of demographics (n = 18), pretest (n = 19), and posttest (n = 12). The data were analyzed using a descriptive measurement of pretest to posttest questions The PCPs' test results revealed increased comprehension of PGx testing from pretest to posttest, reporting a mean increase of 21.20% of total correct answers. The positive social change gained in this educational practice-focused project improved providers’ knowledge and understanding of PGx testing, offering a safe, individualized, patient-centered approach to chronic pain management.

This work-in-progress seeks to benchmark the visual literacy skills of undergraduate mechanical engineering students at a small technical university, as well as the faculty’s current efforts to develop students’ visual literacy skills. Visual literacy is accepted as a crucial 21st century for students, professionals, and citizens, yet its definition varies greatly across the literature. In addition, existing assessment tools are too general and are insufficient for measuring visual literacy as it applies to engineering design. Our work seeks to establish a simplified method for assessing the visual literacy skills of graduating seniors in a mechanical engineering program. This work will inform the practical next steps in improving visual literacy pedagogy within the program in ways that are sustainable and effective for both faculty and students. We report on the methods of reviewing student visual literacy skills through an examination of a sample of capstone reports completed by the undergraduate mechanical engineering students in the class of 2017 in order to provide a baseline assessment of visual literacy skills. In addition, we report on survey results from faculty respondents regarding the importance they place on visual literacy within their instruction and in assessing students, what tools and methodologies faculty are currently employing, and explore what resources faculty would be most likely to utilize for enhancing instruction within this area. It is expected that strategies and tools will be identified that could be adapted for use at other institutions and programs for assessing visual literacy in STEM fields. Future expansion of this work will include assessment of a larger sample of mechanical engineering student work, as well as other STEM programs in order to measure student growth in visual literacy skills over the duration of their undergraduate experiences. Pilot studies involving faculty training in enhanced pedagogical strategies will also be developed based on the outcomes of our research.