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Objectives: We aimed to describe the methods of smartphone-based cognitive ecological momentary assessment designs in clinical populations, with an intention to evaluate how the role of sex and/or gender has been considered in the design and analyses, particularly including female-specific physiology. Methods: This scoping review was conducted based on JBI scoping review methodology. On March 2nd, 2023, we searched for literature across four databases. Screening of the results and data extraction were conducted in duplicate according to the a priori methods in the pre-registered protocol. Results: 31 articles were included in this review. Participants ranged in age from 15-85 years old with various clinical disorders. Prompts were given between 1-7 times per day for 7-84 days. Executive function was the most frequently assessed cognitive domain. Over half the studies (n = 17, 55%) did not investigate the effects of sex and/or gender, and only one study considered the impact of hormonal therapy. Many studies (n = 14, 45%) used sex and gender interchangeably or incorrectly. Conclusions: Studies varied in design, with heterogeneity in the reporting of methodological information. The lack of attention to sex/gender on neuropsychological outcomes can lead to confusion and contradiction regarding its potential impact on cognition in clinical populations. This may hinder the identification of effective interventions for those assigned female at birth who have been overlooked or considered indistinguishable from their male counterparts. Given the well-documented impact of sex/gender on cognition, it is essential that future neuropsychological research, especially EMA-based studies, prioritize investigating sex/gender to ensure better outcomes for all. [ABSTRACT FROM AUTHOR]

Despite having a general understanding of concussions, many athletes choose not to report symptoms of a sports-related concussion (SRC) which leads to a larger burden on our healthcare system due to longer recoveries, more Emergency Department visits, and future medical appointments. Thus, there is a need to identify factors, such as competitiveness, that may help to better explain the nondisclosure of concussion symptoms. The current study aimed to investigate the role of athletes' concussion knowledge and competitiveness on concussion nondisclosure. Participants included 161 Canadian athletes (ages 14–32; 71% male) participating in collision sports (American football, rugby, hockey), soccer or rowing. Concussion knowledge, reporting and competitiveness were measured using the Rosenbaum Concussion Attitude and Knowledge Survey and Sports Orientation Questionnaire (SOQ). Two logistic regression models were performed to explain both history and future intention of playing despite experiencing concussion symptoms. Age, sex, and concussion knowledge were not significant for the regression models. The SOQ scores (measuring competitiveness) were significant for both regression models, such that higher competitiveness was associated with increased likelihood for past nondisclosure (b =.03, p =.03, OR = 1.03 (97.5% CI: 1.003,1.06)) and future nondisclosure intention (b =.05, p =.00, OR = 1.05 (97.5% CI: 1.03,1.08)). Regarding concussion knowledge, soccer players had significantly higher knowledge than those in collision sports and rugby, F(2, 158) = 140.5, p =.00; female athletes had significantly higher knowledge than males, t(66) = −4.26, p =.00; age was negatively associated with concussion knowledge (r = −0.35, p <.01). The results suggest that healthcare providers should be aware that athletes tend to have adequate concussion knowledge, but this knowledge does not explain past nondisclosure or future nondisclosure intention. Based on these findings, healthcare providers should focus on being able to identify highly competitive athletes who are most at risk of nondisclosure instead of exclusively aiming to increase concussion knowledge in athletes. [ABSTRACT FROM AUTHOR]

Objective: Factors such as physical activity and sports participation may have a positive effect on executive functioning. However, people involved in sports are at a higher risk of experiencing a concussion, which may have a detrimental effect. Previous research has yet to investigate those combined negative and positive effects while also utilizing a comprehensive assessment of executive function. This study aims precisely to examine the effects of physical activity, athletic status and concussion history on subjective (e.g., questionnaire) and objective measures (e.g., latent variables) of three well-established components of executive function (i.e., inhibiting, shifting, and updating) in young adults. Participants and Methods: 247 Canadian university students (ages 18 - 25; 83% female) completed a remote assessment of executive function involving nine computerized tasks and a behavioural self-report, in addition to demographic questionnaires and items assessing weekly physical activity, athletic status, and concussion history. A linear regression analysis was used to assess the effects of the predictor variables (age, sex, concussion history, physical activity and athletic status) on subjective reporting of executive functioning using the Executive Function Index. Furthermore, structural equation modelling (SEM) was used to predict objective executive function using a three-factor model (shifting, updating, inhibition). Results: The three-factor measurement model of executive function fit the data adequately: x2 = 26.10, df = 17, p = 0.07, CFI = 0.97, TLI = 0.95, RMSEA = 0.05 [90% CI: 0.00-0.09], SRMR = 0.04. Then, the three-factor SEM of executive function also fit the data adequately: X2 = 66.38, df = 51, p = 0.07, CFI = 0.95, TLI = 0.93, RMSEA = 0.04 [90% CI: 0.00-0.06], SRMR = 0.05. Using SEM, no direct relationship was found between the factors of executive function and the predictor variables (i.e., age, physical activity, concussion history, and athletic status). Sex was significantly related to inhibition (b = 0.52, p = 0.02), such that males had greater inhibition. For the regression, physical activity (b = 0.09, p <.01), concussion history (b = 3.29, p <.05) and athletic status (b = -4.01, p <.05) were found to be significant predictors for the Executive Function Index. Conclusions: Concussion history, physical activity, and athletic status were all predictive of subjective but not objective measures of executive function. Interestingly, these findings align with previous research that demonstrated performance-based executive function measures often do not align with self-report measures, which may suggest they are complementary but measure slightly different aspects of the underlying executive function construct. Mixed findings in the extant literature regarding sex differences and executive function require continued research to understand better the relationship and mechanisms behind the sex differences in inhibition. In summary, these findings offer support for the differentiation between subjective and objective measures of executive function when investigating their relationship with physical activity, sport participation, concussion history, age and sex. [ABSTRACT FROM AUTHOR]