OBJECTIVE: The objectives of this study are to assess reporting of evidence-based healthcare (EBHC) e-learning interventions using the Guideline for Reporting Evidence-based practice Educational interventions and Teaching (GREET) checklist and explore factors associated with compliant reporting.
METHODS: Methodological cross-sectional study.
METHODS: Based on the criteria used in an earlier systematic review, we included studies comparing EBHC e-learning and any other form of EBHC training or no EBHC training. We searched Medline, Embase, ERIC, CINAHL, CENTRAL, SCOPUS, Web of Knowledge, PsycInfo, ProQuest and Best Evidence Medical Education up to 4 January 2023. Screening of titles, abstracts, full-text articles and data extraction was done independently by two authors. For each study, we assessed adherence to each of the 17 GREET items and extracted information on possible predictors. Adequacy of reporting for each item of the GREET checklist was judged with yes (provided complete information), no (provided no information), unclear (when insufficient information was provided), or not applicable, when the item was clearly of no relevance to the intervention described (such as for item 8-details about the instructors-in the studies which used electronic, self-paced intervention, without any tutoring). Studies\' adherence to the GREET checklist was presented as percentages and absolute numbers. We performed univariate analysis to assess the association of potential adherence predictors with the GREET checklist. We summarised results descriptively.
RESULTS: We included 40 studies, the majority of which assessed e-learning or blended learning and mostly involved medical and other healthcare students. None of the studies fully reported all the GREET items. Overall, the median number of GREET items met (received yes) per study was 8 and third quartile (Q3) of GREET items met per study was 9 (min. 4 max. 14). When we used Q3 of the number of items met as cut-off point, adherence to the GREET reporting checklist was poor with 7 out of 40 studies (17.5%) reporting items of the checklist on acceptable level (adhered to at least 10 items out of 17). None of the studies reported on all 17 GREET items. For 3 items, 80% of included studies well reported information (received yes for these items): item 1 (brief description of intervention), item 4 (evidence-based practice content) and item 6 (educational strategies). Items for which 50% of included studies reported complete information (received yes for these items) included: item 9 (modes of delivery), item 11 (schedule) and 12 (time spent on learning). The items for which 70% or more of included studies did not provide information (received no for these items) included: item 7 (incentives) and item 13 (adaptations; for both items 70% of studies received no for them), item 14 (modifications of educational interventions-95% of studies received no for this item), item 16 (any processes to determine whether the materials and the educational strategies used in the educational intervention were delivered as originally planned-93% of studies received no for this item) and 17 (intervention delivery according to schedule-100% of studies received no for this item). Studies published after September 2016 showed slight improvements in nine reporting items. In the logistic regression models, using the cut-off point of Q3 (10 points or above) the odds of acceptable adherence to GREET guidelines were 7.5 times higher if adherence to other guideline (Consolidated Standards of Reporting Trials, Strengthening the Reporting of Observational Studies in Epidemiology, etc) was reported for a given study type (p=0.039), also higher number of study authors increased the odds of adherence to GREET guidance by 18% (p=0.037).
CONCLUSIONS: Studies assessing educational interventions on EBHC e-learning still poorly adhere to the GREET checklist. Using other reporting guidelines increased the odds of better GREET reporting. Journals should call for the use of appropriate use of reporting guidelines of future studies on teaching EBHC to increase transparency of reporting, decrease unnecessary research duplication and facilitate uptake of research evidence or result.
BACKGROUND: The Open Science Framework (https://doi.org/10.17605/OSF.IO/V86FR).

As interest in animal-assisted therapy (AAT) and canine-assisted psychotherapy (CAP) grows, there are increasing calls for the management of related health, safety, and welfare concerns for canines, providers, and clients. Existing health and safety guidelines lack empirical support and are, at times, contradictory. Welfare is increasingly prioritized; however, tools to monitor and manage welfare are underutilized and under-reported. The aim of this study was to provide expert consensus on the minimum health, safety, and welfare standards required to develop and deliver a CAP group program to adolescents experiencing common mental health disorders. Diverse AAT experts were recruited globally. Using Delphi methodology, over two rounds, 40 panelists reached a consensus agreement to include 32 items from a possible 49 into the minimum standards. Health and safety measures included risk assessment, veterinary screening, preventative medicine, training in infection control, and first aid. Welfare measures included training in welfare assessment, documentation of welfare, and flexible, individualized responses to promote wellbeing. Intestinal screening for parasites and the prohibition of raw food were not supported. Flexible and individualized assessment and management of canine welfare were supported over fixed and time-limited work schedules. Clinical practice implications are discussed, and recommendations are made.

Relative Energy Deficiency in Sport (REDs) has various different risk factors, numerous signs and symptoms and is heavily influenced by one\'s environment. Accordingly, there is no singular validated diagnostic test. This 2023 International Olympic Committee\'s REDs Clinical Assessment Tool-V.2 (IOC REDs CAT2) implements a three-step process of: (1) initial screening; (2) severity/risk stratification based on any identified REDs signs/symptoms (primary and secondary indicators) and (3) a physician-led final diagnosis and treatment plan developed with the athlete, coach and their entire health and performance team. The CAT2 also introduces a more clinically nuanced four-level traffic-light (green, yellow, orange and red) severity/risk stratification with associated sport participation guidelines. Various REDs primary and secondary indicators have been identified and \'weighted\' in terms of scientific support, clinical severity/risk and methodological validity and usability, allowing for objective scoring of athletes based on the presence or absence of each indicator. Early draft versions of the CAT2 were developed with associated athlete-testing, feedback and refinement, followed by REDs expert validation via voting statements (ie, online questionnaire to assess agreement on each indicator). Physician and practitioner validity and usability assessments were also implemented. The aim of the IOC REDs CAT2 is to assist qualified clinical professionals in the early and accurate diagnosis of REDs, with an appropriate clinical severity and risk assessment, in order to protect athlete health and prevent prolonged and irreversible outcomes of REDs.

To develop and present consensus findings of the National Sleep Foundation sleep timing and variability panel regarding the impact of sleep timing variability on health and performance.
The National Sleep Foundation assembled a panel of sleep and circadian experts to evaluate the scientific evidence and conduct a formal consensus and voting procedure. A systematic literature review was conducted using the NIH National Library of Medicine PubMed database, and panelists voted on the appropriateness of 3 questions using a modified Delphi RAND/UCLA Appropriateness Method with 2 rounds of voting.
The literature search and panel review identified 63 full text publications to inform consensus voting. Panelists achieved consensus on each question: (1) is daily regularity in sleep timing important for (a) health or (b) performance? and (2) when sleep is of insufficient duration during the week (or work days), is catch-up sleep on weekends (or non-work days) important for health? Based on the evidence currently available, panelists agreed to an affirmative response to all 3 questions.
Consistency of sleep onset and offset timing is important for health, safety, and performance. Nonetheless, when insufficient sleep is obtained during the week/work days, weekend/non-work day catch-up sleep may be beneficial.

Eating behaviors and patterns are one of the key behavioral indicators of health, and as such these behaviors are a focus of interest across different areas of scholarship. Yet, to date, work in this area is impeded by the lack of a collective theoretical framework to conceptualize, assess, and intervene upon eating behaviors. The aim of this study was therefore to establish a consensus-based framework for health-promoting eating behaviors using a Delphi methodology. An initial systematic search identified constructs that yielded 150 items grouped into three topic areas: (1) the content, types of food and nutrition provided; (2) eating behaviors; and (3) thoughts and feelings related to eating and foods. Over the course of three iterative rounds of rating by a panel of n = 37 experts, a consensus was reached that included eight of the original items that represented the three topic areas. The findings from this study result in a novel consensus-based framework for health-promoting eating behaviors that can form the basis for collaborative work towards the integration of physical and mental health promotion.

The understanding of how physical activity and insufficient physical activity are associated with health outcomes has increased considerably over the past decades. Along with physical activity, the evidence on the associations between sedentary behavior and health has increased, which has resulted in the introduction of recommendations of sedentary behavior. In this article, we 1) present terminology for physical activity and sedentary behavior epidemiology, 2) show the relevant scientific evidence on associations of physical activity and sedentary behavior with selected health-related outcomes and 3) introduce the global guidelines for physical activity and sedentary behavior by the World Health Organization (WHO). Health-related outcomes include cardiovascular morbidity and mortality, total mortality, glucose regulation and type 2 diabetes, adiposity, overweight, obesity, cancer, musculoskeletal and bone health, brain health, and quality of life. These health-related outcomes are reflected across age groups and some population groups, such as pregnant and postpartum women. Furthermore, we discuss physical activity levels across Nordic countries and over time. For the Nordic Nutrition Recommendations, shared common physical activity guidelines were not developed. Instead, each country has created their own guidelines that are being referenced in the article, along with the global WHO guidelines.

The IOC made recommendations for recording and reporting epidemiological data on injuries and illness in sports in 2020, but with little, if any, focus on female athletes. Therefore, the aims of this supplement to the IOC consensus statement are to (i) propose a taxonomy for categorisation of female athlete health problems across the lifespan; (ii) make recommendations for data capture to inform consistent recording and reporting of symptoms, injuries, illnesses and other health outcomes in sports injury epidemiology and (iii) make recommendations for specifications when applying the Strengthening the Reporting of Observational Studies in Epidemiology-Sport Injury and Illness Surveillance (STROBE-SIIS) to female athlete health data.In May 2021, five researchers and clinicians with expertise in sports medicine, epidemiology and female athlete health convened to form a consensus working group, which identified key themes. Twenty additional experts were invited and an iterative process involving all authors was then used to extend the IOC consensus statement, to include issues which affect female athletes.Ten domains of female health for categorising health problems according to biological, life stage or environmental factors that affect females in sport were identified: menstrual and gynaecological health; preconception and assisted reproduction; pregnancy; postpartum; menopause; breast health; pelvic floor health; breast feeding, parenting and caregiving; mental health and sport environments.This paper extends the IOC consensus statement to include 10 domains of female health, which may affect female athletes across the lifespan, from adolescence through young adulthood, to mid-age and older age. Our recommendations for data capture relating to female athlete population characteristics, and injuries, illnesses and other health consequences, will improve the quality of epidemiological studies, to inform better injury and illness prevention strategies.

National adherence to the recess recommendations of the Centers for Disease Control and Prevention (CDC) has not been comprehensively studied in the United States.
Data from 6 nationally representative data sets over the last decade (Classification of Laws Associated with School Students, Early Childhood Longitudinal Study, National Health and Nutrition Examination Survey, National Youth Fitness Survey, School Health Policies and Practices Survey, and the School Nutrition and Meal Cost Study) provided estimates for adherence to CDC recess guidelines.
While approximately 65-80% of elementary school-children receive the recommended 20+ minutes of daily recess according to parent-, principal-, and school-report, adherence declines by sixth grade, and little information is available for middle/high school students. Adherence to playground safety was high (90%), but adherence to recommendations about recess before lunch (<50%), withholding recess as punishment (∼50%), and training recess staff (<50%) were lower.
School policy and practice should align with CDC recommendations, with the aim of providing sufficient quality recess to all youth, K-12th grade. Comprehensive, on-going national surveillance of multiple recess domains is needed to inform policy and ensure equitable provision of recess.

The federal Child and Adult Care Food Program (CACFP) sets minimum nutrition and portion size standards for meals served in participating childcare programs. CACFP has been associated with more nutritious meals served. It is unclear, however, whether CACFP results in children\'s dietary intake being aligned with national recommendations. We assess whether children\'s dietary intake in CACFP-participating childcare centres meets benchmarks set by the Dietary Guidelines for Americans (DGA).
This is a cross-sectional study. We used direct observation to estimate quantities of foods/beverages served and consumed per child. Mean amounts served per child per day were compared with CACFP portion size requirements for each component (fruits, vegetables, milk and meat/meat alternate). Mean amounts of foods/beverages consumed were compared with DGA recommendations (energy content, fruits, vegetables, whole/refined grains, dairy, protein and added sugars). One sample t-tests evaluated if quantities served and consumed were different from CACFP and DGA standards, respectively.
Six CACFP-participating childcare centres.
2-5 year-old children attending childcare.
We observed forty-six children across 166 child meals. Most meals served met CACFP nutrition standards. Compared with CACFP portion size standards, children were served more grains at breakfast and lunch; more fruits/vegetables at lunch but less at breakfast and snack and less dairy at all eating occasions. Compared with DGA recommendations, children under-consumed every food/beverage category except grains during at least one eating occasion.
Children were served quantities of foods/beverages mostly consistent with CACFP portion size requirements, but had sub-optimal intake relative to DGA. More research is needed to help children consume healthy diets in childcare.

Due to a growing challenge to feed the world\'s population and an increased awareness to minimize the impact of our food choices on climate change, a more plant-based diet has gained popularity with a growing number of plant-based products on the market. To stimulate a plant-based diet that also improves long-term health, data are needed to monitor whether these products are healthy alternatives to animal-based foods. Therefore, this study inventoried 916 plant-based meat, fish, and dairy alternatives from eight Dutch supermarkets. The nutritional quality of each product was assessed by (1) the Dutch food-based dietary guidelines and (2) the Nutri-Score. The results show that over 70% of meat, fish, and dairy alternatives have an A/B Nutri-Score (indicating high nutritional quality), but do not comply with the Dutch dietary guidelines. This is mainly due to high salt and low vitamin B12 and iron content (meat and fish alternatives) or low protein and calcium levels (dairy alternatives). In conclusion, the majority of plant-based products are nutritionally not full alternatives of the animal-based equivalents; however, there are still opportunities for reformulation. To aid the consumer in making healthy plant-based food choices, a better alignment between the Nutri-Score and the recommended dietary guidelines is needed.