To assess the feasibility of using large language models (LLM) to develop research questions about changes to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food packages.

We conducted a controlled experiment using ChatGPT-4 and its plugin, MixerBox Scholarly, to generate research questions based on a section of the U.S. Department of Agriculture (USDA) summary of the final public comments on the WIC revision. Five questions weekly for 3 weeks were generated using LLM under two conditions: fed with or without relevant literature. The experiment generated ninety questions, which were evaluated using the Feasibility, Innovation, Novelty, Ethics and Relevance criteria. t tests and multivariate regression examined the difference by feeding status, artificial intelligence model, evaluator and criterion.

The United States.

Six WIC expert evaluators from academia, government, industry and non-profit sectors.

Five themes were identified: administrative barriers, nutrition outcomes, participant preferences, economics and other topics. Feeding and non-feeding groups had no significant differences (Coeff. = 0·03, P = 0·52). MixerBox-generated questions received significantly lower scores than ChatGPT (Coeff. = –0·11, P = 0·02). Ethics scores were significantly higher than feasibility scores (Coeff. = 0·65, P < 0·001). Significant differences were found between the evaluators (P < 0·001).

The LLM applications can assist in developing research questions with acceptable qualities related to the WIC food package revisions. Future research is needed to compare the development of research questions between LLM and human researchers.

In March 2019, flooding of the Missouri River and its tributaries destroyed infrastructure and farmland and affected communities, including those in the state of Nebraska. The objective of this study was to assess emergency preparedness and satisfaction with flood response, recovery, and relief efforts 5 years following the 2019 floods in rural eastern Nebraska.

Using stratified simple random sampling, this study surveyed 13 Nebraska communities to assess emergency preparedness and satisfaction with flood response, recovery, and relief efforts 5 years following the 2019 Missouri River Flood. Descriptive statistics are reported.

Households impacted by the 2019 Nebraska flood reported worsening physical and mental health symptoms and identified major gaps in communication, long-term mental health support, and infrastructure resilience. Self-reported preparedness improved post-flood. Inadequate early warnings and poor information dissemination eroded trust.

There are persistent mental and physical health impacts resulting from exposure to the 2019 Missouri River floods that can impact communities’ ability to respond and recover from subsequent hazards. Evaluating the impacts of previous disasters is a critical component of increasing community resiliency and local public health and emergency preparedness capacity to serve these populations.

To investigate the decision-making processes of nurse prescribers in general practice when managing acute episodes of illness in patients with multimorbidity.

Nurse independent prescribers in UK general practice are facing increasing complex clinical decision-making when assessing patients presenting acutely with undifferentiated and undiagnosed conditions as multimorbidity and polypharmacy becomes increasingly common. This qualitative study investigated the decision-making processes of nurse prescribers in general practice when managing acute episodes of illness in patients with multimorbidity.

Fourteen general practice nurse prescribers were recruited through purposive sampling. Think aloud in response to staged vignettes was used followed by semi-structured interviews. Thematic analysis was used to analyse think aloud and interview data.

Participants were experienced nurses with a range of clinical exposure and training who mostly made appropriate diagnostic and prescribing decisions. Pockets of expertise were revealed which reflected participants’ clinical experience, but there was a high rate of referral to the GP for some vignettes. Participants’ decision-making was underpinned by both analytical and intuitive processes, the quality of which was dependent on their individual knowledge and experience. A reliance on pattern recognition, aligned to intuitive decision-making, to determine the content of the consultations was identified as an area of risk and showed all participants to be inconsistent in their identification of complex factors. Omission of these factors could have important implications for prescribing decision-making. Organizational issues such as time-limited clinics also shaped the content of participants’ consultations, encouraged a limited, problem-focused approach, and reduced the opportunity for mentorship. Comprehensive knowledge, clinical experience, and mentorship are critical to ensure nurse prescribers make optimal decisions in the context of patients with multimorbidity. A team approach to the management of acute presentations in these patients is recommended to improve patient experience and maximize nurse prescribers’ contribution to the general practice workforce.

Existing evidence suggests a potential association between coffee consumption and non-alcoholic fatty liver disease (NAFLD, now known as MASLD), yet the nature of this relationship remains ambiguous. The primary objective of this study was to comprehensively investigate and clarify the association between coffee intake and the occurrence of NAFLD.

A cross-sectional study design was employed, analysing data from National Health and Nutrition Examination Survey (NHANES) spanning from 2013 to 2018. Weighted univariate and multivariate logistic regression models were utilised to assess the relationship between coffee consumption and NAFLD. Restricted cubic spline analysis was conducted to explore any potential nonlinear associations. Forest plots were generated to visualise the impact of coffee consumption on NAFLD across different subgroups, and threshold effect analysis was performed to evaluate the nonlinear relationship between coffee consumption and NAFLD prevalence specifically in women.

Data were from the US – representative NHANES.

8062 subjects aged ≥ 20 years were included.

The weighted prevalence of NAFLD among the participants was 44·18 %. After controlling for confounding variables, coffee consumption was found to be negatively associated with the risk of NAFLD (OR = 0·96, 95 % CI: 0·94, 0·99). The association between coffee consumption and NAFLD was observed to vary by gender and education level. For the prevention of NAFLD in women, the optimal coffee intake was determined to be two cups.

Increasing coffee intake emerges as a potentially effective non-pharmacological strategy for the prevention and management of NAFLD. Notably, for women, consuming two cups of coffee appears to represent the optimal threshold for maximising this beneficial effect.

Extensive evidence links air pollution exposure to cognitive decline; however, it remains unclear whether cognitive reserve and brain reserve modify this association. We examined the moderating roles of cognitive reserve contributors and brain reserve in the association between air pollution and cognitive function in dementia-free adults.

Cross-sectional data were obtained from 650 participants who underwent 3T brain magnetic resonance imaging and completed the Montreal Cognitive Assessment (MoCA). Cognitive reserve contributors were assessed based on education, occupation, and social engagement. Brain reserve was quantified using the ventricle-to-brain ratio derived from brain scans. Five-year average concentrations of particulate matter with diameters ≤10 and ≤2.5 μm and nitrogen dioxide were estimated based on residential addresses. Partial least squares structural equation modeling was applied to construct latent variables representing the air pollution mixture and composite cognitive reserve (contributors). Analyses examined whether cognitive reserve contributors and brain reserve modified associations of air pollution with MoCA scores and suspected mild cognitive impairment.

In individuals with an average level of cognitive reserve, a 1–standard deviation increase in air pollution mixture was associated with a 0.24-point decrease in MoCA scores (95% confidence interval [CI]: −0.31 to −0.16). This association was attenuated in individuals with higher cognitive reserve (β = −0.12; 95% CI: −0.25 to 0.02) and intensified in those with lower cognitive reserve (β = −0.36; 95% CI: −0.37 to −0.35). The moderating effect of brain reserve was not significant.

Higher cognitive reserve may mitigate the effects of air pollution on cognitive function.

Within resource-limited health care, it is important to demonstrate the value and impact of neuropsychological assessment (NPA) services. However, the most suitable methods for capturing these outcomes are yet to be established. We aimed to identify key potential outcomes of NPA, existing measures of these outcomes, and issues and challenges associated with outcome measurement.

Focus groups of experienced Australian neuropsychologists discussed possible NPA outcomes, existing measures, and challenges of outcome measurement, analyzed using thematic analysis. The Delphi method of expert consensus was then used to identify the most important set of NPA outcomes, using iterative survey rounds with expert panelists. Panelists also rated the top three outcomes most likely to demonstrate the impact of NPA in trials.

There were 50 potential NPA outcomes generated by the focus groups, spanning proximal and distal patient, caregiver, health service, and societal domains. Numerous issues and challenges were identified associated with meaningfully measuring NPA outcomes. After three Delphi survey rounds (n = 46), a total of 16 outcomes achieved consensus agreement. Few existing validated measures were identified. The top three rated outcomes were 1) better patient and/or caregiver understanding of presenting problems, 2) better patient and/or caregiver understanding of how to manage and cope with cognitive symptoms, and 3) diagnostic clarification.

Psychoeducational benefits of NPA were considered by Australian experts as key outcomes relevant across contexts; however, there are no existing measures of these outcomes. Future research should develop valid outcome measures to be used in clinical trials evaluating NPA impacts.

This study aimed: 1) to characterize the use and prevalence of nutrition and health claims (NHC), and 2) to examine the association between NHC and the potential presence of Health Canada’s front-of-pack (FOP) nutrition symbol indicating high saturated fats, sugars and/or sodium on a sample of Canadian prepackaged food products.

A cross-sectional analysis was conducted on five categories of prepackaged food products. Label components were classified using the INFORMAS labelling taxonomy. Products’ nutritional profile was evaluated using Health Canada’s FOP symbol nutrient thresholds for saturated fats, sugars and sodium.

Data were obtained from the Food Quality Observatory database, collected between 2018 and 2022 from food retailers in Québec City and the Greater Montreal Area or online.

A total of 2,937 food products were evaluated from five food categories: Breakfast cereals (n=392), Cookies and granola bars (n=983), Flavoured milks and plant-based alternative beverages (n=202), Salty snacks and crackers (n=1063) and Yogurts and plant-based yogurt alternatives (n=297).

Overall, 74.2% of food products had a NHC and 28.9% had a NHC and would require to display the FOP symbol. Food products that would require the FOP symbol were less likely to carry a NHC.

The results demonstrate substantial use of marketing techniques highlighting positive product attributes. Given the potential for inconsistent messaging on food products carrying NHC and the FOP symbol, these results highlight an opportunity to improve Canadian labelling regulations by restricting the use of NHC on products high in saturated fats, sugars and/or sodium.

Understanding service users’ knowledge of and attitudes towards the rapidly progressing field of mental health technology (MHT) is an important endeavour in clinical psychiatry.

To evaluate the current use of and attitudes towards MHT (mobile apps, online therapy and counselling, telehealth, web-based programmes, chatbots, social media), a 5-point Likert-scale survey was designed based on previous studies and distributed to attendees of an adult community mental health service in Ireland. Chi-square tests were used and corrected for multiple comparisons.

107 mental health service users completed the survey (58% female, aged 18–80). 86% of respondents owned a smartphone. 27.1% reported using a mental health application, while 33.6% expressed interest in using one in the future. 61.7% reported they had not used and were not interested in using AI for their mental health, and 51.4% indicated they would not feel comfortable using it. 46.8% were not comfortable with psychiatrists utilising AI in their care. The majority (86.9%) preferred face-to-face appointments, while 52.6% would consider using MHT while on a waiting list. Younger participants reported significantly greater comfort using mental health apps and higher self-rated knowledge of AI.

There were low levels of knowledge about and comfort using MHT, accompanied by concerns about confidentiality and privacy. Younger service users tended to be more comfortable with and knowledgeable about MHT. Despite the growing interest in digital approaches, there remains a clear preference for face-to-face appointments, underscoring the importance of addressing privacy and safety concerns, together with training and education.