Search

The current state of label conventions used to describe brain networks related to executive functions is highly inconsistent, leading to confusion among researchers regarding network labels. Visually similar networks are referred to by different labels, yet these same labels are used to distinguish networks within studies. We performed a literature review of fMRI studies and identified nine frequently-used labels that are used to describe topographically or functionally similar neural networks: central executive network (CEN), cognitive control network (CCN), dorsal attention network (DAN), executive control network (ECN), executive network (EN), frontoparietal network (FPN), working memory network (WMN), task positive network (TPN), and ventral attention network (VAN). Our aim was to meta-analytically determine consistency of network topography within and across these labels. We hypothesized finding considerable overlap in the spatial topography among the neural networks associated with these labels. An image-based meta-analysis was performed on 158 group-level statistical maps (SPMs) received from authors of 69 papers listed on PubMed. Our results indicated that there was very little consistency in the SPMs labeled with a given network name. We identified four clusters of SPMs representing four spatially distinct executive function networks. We provide recommendations regarding label nomenclature and propose that authors looking to assign labels to executive function networks adopt this template set for labeling networks., Funding Agencies|NSFNational Science Foundation (NSF) [1631325]; NIHUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [R01 DA041353]

Objective To examine the associations of physical fitness and physical activity with executive function in children with overweight and obesity. Study design A cross-sectional study involving 100 children with overweight and obesity (10.1 +/- 1.1 years old; 58.0% boys). We assessed physical fitness components (ie, muscular strength, speed-agility, and cardiorespiratory fitness) using the ALPHA battery, and physical activity and sedentary time by accelerometry. Cognitive flexibility was measured by the Design Fluency Test and Trail Making Test, inhibition by the Stroop test, and planning ability by the Zoo Map Test. Results Handgrip strength was positively associated with planning ability (P = .025). Speed-agility was positively related to cognitive flexibility and inhibition (P amp;lt; .05). Cardiorespiratory fitness and an overall fitness Z-score were positively associated with indicators of cognitive flexibility (P amp;lt; .05). No associations were found for physical activity and sedentary time with executive function (P amp;gt;= .05). Conclusions Muscular strength, speed agility, and cardiorespiratory fitness are associated with executive function in children with overweight and obesity. Cognitive flexibility seems to be more robustly associated with all fitness components, whereas planning ability and inhibition might depend on the component analyzed. The positive associations found in the present study in children with overweight and obesity call for more exercise-based randomized controlled trials in this population.

Bullying has been identified as the most common form of aggression and a major source of stress among children and adolescents. The main objective of this study was to analyze the association that school context in general and bullying in particular might have with hair cortisol concentration (HCC), examining the effect of executive function and sex on this association. The study included 659 11-year-old preadolescents from the cohorts of Gipuzkoa and Sabadell of the INMA (INfancia y Medio Ambiente-Children and Environment) project. We gathered information about school-related factors (bullying, school environment, problems with peers and academic performance) and executive function (risky decision-making). Hair samples were collected to measure cortisol concentrations and Structural Equation Modeling was used to examine associations between school-related factors, executive function and HCC. Results showed that being involved as a bully/victim was related to higher HCC and, higher HCC was associated with poorer executive function. This study may contribute to a better understanding of the consequences that chronic exposure to a stressful factors may have on preadolescents' health and developmental outcomes. Besides, our results are relevant for designing programs for prevention and intervention, which could modify individual physiological responses to stress and reduce the effects of stress on the health.

Exercise is often cited as a major factor contributing to improved cognitive functioning. As a result, the relationship between exercise and cognition has received much attention in scholarly literature. Systematic reviews and meta-analyses present varying and sometimes conflicting results about the extent to which exercise can influence cognition. The aim of this umbrella review was to summarize the effects of physical exercise on cognitive functions (global cognition, executive function, memory, attention, or processing speed) in healthy adults & GE; 55 years of age.Methods An umbrella review of systematic reviews with meta-analyses investigating the effect of exercise on cognition was performed. Databases (CINAHL, Cochrane Library, MEDLINE, PsycInfo, Scopus, and Web of Science) were searched from inception until June 2023 for reviews of randomized or non-randomised controlled trials. Full-text articles meeting the inclusion criteria were reviewed and methodological quality assessed. Overlap within included reviews was assessed using the corrected covered area method (CCA). A random effects model was used to calculate overall pooled effect size with sub-analyses for specific cognitive domains, exercise type and timing of exercise.Results Database searches identified 9227 reviews. A total of 20 met the inclusion criteria. They were based on 332 original primary studies. Overall quality of the reviews was considered moderate with most meeting 8 or more of the 16 AMSTAR 2 categories. Overall pooled effects indicated that exercise in general has a small positive effect on cognition (d = 0.22; SE = 0.04; p < 0.01). Mind-body exercise had the greatest effect with a pooled effect size of (d = 0.48; SE = 0.06; p < 0.001). Exercise had a moderate positive effect on global cognition (d = 0.43; SE = 0,11; p < 0,001) and a small positive effect on executive function, memory, attention, and processing speed. Chronic exercise was more effective than acu, Funding Agencies|Joenkoeping University

Exercise is often cited as a major factor contributing to improved cognitive functioning. As a result, the relationship between exercise and cognition has received much attention in scholarly literature. Systematic reviews and meta-analyses present varying and sometimes conflicting results about the extent to which exercise can influence cognition. The aim of this umbrella review was to summarize the effects of physical exercise on cognitive functions (global cognition, executive function, memory, attention, or processing speed) in healthy adults & GE; 55 years of age.Methods An umbrella review of systematic reviews with meta-analyses investigating the effect of exercise on cognition was performed. Databases (CINAHL, Cochrane Library, MEDLINE, PsycInfo, Scopus, and Web of Science) were searched from inception until June 2023 for reviews of randomized or non-randomised controlled trials. Full-text articles meeting the inclusion criteria were reviewed and methodological quality assessed. Overlap within included reviews was assessed using the corrected covered area method (CCA). A random effects model was used to calculate overall pooled effect size with sub-analyses for specific cognitive domains, exercise type and timing of exercise.Results Database searches identified 9227 reviews. A total of 20 met the inclusion criteria. They were based on 332 original primary studies. Overall quality of the reviews was considered moderate with most meeting 8 or more of the 16 AMSTAR 2 categories. Overall pooled effects indicated that exercise in general has a small positive effect on cognition (d = 0.22; SE = 0.04; p < 0.01). Mind-body exercise had the greatest effect with a pooled effect size of (d = 0.48; SE = 0.06; p < 0.001). Exercise had a moderate positive effect on global cognition (d = 0.43; SE = 0,11; p < 0,001) and a small positive effect on executive function, memory, attention, and processing speed. Chronic exercise was more effective than acu, Funding Agencies|Joenkoeping University

BackgroundThere is mixed evidence regarding the impact of interactive digital devices on child development. Tentatively some studies suggested that the use of digital devices may correlate negatively with language, executive function, and motor skills. However, attempts to amalgamate this evidence has been limited related to the available number of experimental and cohort studies that have evaluated the impact of digital technology use on child development. We conducted this review to determine the impact of interactive digital devices on child development among children aged 7 years or younger. Interactive technology has been defined as methods, tools, or devices that users interact with in order to achieve specific tasks. Data sourceTo carry out this systematic review, databases CINAHL, MEDLINE, Embase, PsychINFO, Scopus and Google Scholar were searched for relevant studies. Study selectionWe used the Joanna Briggs Institute methodology for systematic reviews. Data extractionData extraction and synthesis was carried out by two reviewers and checked by a third reviewer. Studies were stratified into tiers depending on the level of evidence provided and the domain of development assessed. ResultsFifty-three studies were eligible for inclusion in the review, 39 Tier 1 (randomized controlled trials and quasi-experimental studies) and 16 Tier 2 (descriptive studies). Childrens use of interactive digital technology was positively associated with receptive language and executive function and negatively associated or unrelated to motor proficiency. Other critical aspects informing the evidence, such as dose of exposure, intensity, or duration, were inconsistently reported, making estimates of exposure tentative and imprecise. ConclusionThe studies included in this review were predominantly correlational or comparative in nature and focuses on cognitive domains of learning rather than a specific developmental outcome. It is difficult to generalize our findings beyond the di

BackgroundThere is mixed evidence regarding the impact of interactive digital devices on child development. Tentatively some studies suggested that the use of digital devices may correlate negatively with language, executive function, and motor skills. However, attempts to amalgamate this evidence has been limited related to the available number of experimental and cohort studies that have evaluated the impact of digital technology use on child development. We conducted this review to determine the impact of interactive digital devices on child development among children aged 7 years or younger. Interactive technology has been defined as methods, tools, or devices that users interact with in order to achieve specific tasks. Data sourceTo carry out this systematic review, databases CINAHL, MEDLINE, Embase, PsychINFO, Scopus and Google Scholar were searched for relevant studies. Study selectionWe used the Joanna Briggs Institute methodology for systematic reviews. Data extractionData extraction and synthesis was carried out by two reviewers and checked by a third reviewer. Studies were stratified into tiers depending on the level of evidence provided and the domain of development assessed. ResultsFifty-three studies were eligible for inclusion in the review, 39 Tier 1 (randomized controlled trials and quasi-experimental studies) and 16 Tier 2 (descriptive studies). Childrens use of interactive digital technology was positively associated with receptive language and executive function and negatively associated or unrelated to motor proficiency. Other critical aspects informing the evidence, such as dose of exposure, intensity, or duration, were inconsistently reported, making estimates of exposure tentative and imprecise. ConclusionThe studies included in this review were predominantly correlational or comparative in nature and focuses on cognitive domains of learning rather than a specific developmental outcome. It is difficult to generalize our findings beyond the di

Exercise is often cited as a major factor contributing to improved cognitive functioning. As a result, the relationship between exercise and cognition has received much attention in scholarly literature. Systematic reviews and meta-analyses present varying and sometimes conflicting results about the extent to which exercise can influence cognition. The aim of this umbrella review was to summarize the effects of physical exercise on cognitive functions (global cognition, executive function, memory, attention, or processing speed) in healthy adults & GE; 55 years of age.Methods An umbrella review of systematic reviews with meta-analyses investigating the effect of exercise on cognition was performed. Databases (CINAHL, Cochrane Library, MEDLINE, PsycInfo, Scopus, and Web of Science) were searched from inception until June 2023 for reviews of randomized or non-randomised controlled trials. Full-text articles meeting the inclusion criteria were reviewed and methodological quality assessed. Overlap within included reviews was assessed using the corrected covered area method (CCA). A random effects model was used to calculate overall pooled effect size with sub-analyses for specific cognitive domains, exercise type and timing of exercise.Results Database searches identified 9227 reviews. A total of 20 met the inclusion criteria. They were based on 332 original primary studies. Overall quality of the reviews was considered moderate with most meeting 8 or more of the 16 AMSTAR 2 categories. Overall pooled effects indicated that exercise in general has a small positive effect on cognition (d = 0.22; SE = 0.04; p < 0.01). Mind-body exercise had the greatest effect with a pooled effect size of (d = 0.48; SE = 0.06; p < 0.001). Exercise had a moderate positive effect on global cognition (d = 0.43; SE = 0,11; p < 0,001) and a small positive effect on executive function, memory, attention, and processing speed. Chronic exercise was more effective than acu, Funding Agencies|Joenkoeping University

Exercise is often cited as a major factor contributing to improved cognitive functioning. As a result, the relationship between exercise and cognition has received much attention in scholarly literature. Systematic reviews and meta-analyses present varying and sometimes conflicting results about the extent to which exercise can influence cognition. The aim of this umbrella review was to summarize the effects of physical exercise on cognitive functions (global cognition, executive function, memory, attention, or processing speed) in healthy adults & GE; 55 years of age.Methods An umbrella review of systematic reviews with meta-analyses investigating the effect of exercise on cognition was performed. Databases (CINAHL, Cochrane Library, MEDLINE, PsycInfo, Scopus, and Web of Science) were searched from inception until June 2023 for reviews of randomized or non-randomised controlled trials. Full-text articles meeting the inclusion criteria were reviewed and methodological quality assessed. Overlap within included reviews was assessed using the corrected covered area method (CCA). A random effects model was used to calculate overall pooled effect size with sub-analyses for specific cognitive domains, exercise type and timing of exercise.Results Database searches identified 9227 reviews. A total of 20 met the inclusion criteria. They were based on 332 original primary studies. Overall quality of the reviews was considered moderate with most meeting 8 or more of the 16 AMSTAR 2 categories. Overall pooled effects indicated that exercise in general has a small positive effect on cognition (d = 0.22; SE = 0.04; p < 0.01). Mind-body exercise had the greatest effect with a pooled effect size of (d = 0.48; SE = 0.06; p < 0.001). Exercise had a moderate positive effect on global cognition (d = 0.43; SE = 0,11; p < 0,001) and a small positive effect on executive function, memory, attention, and processing speed. Chronic exercise was more effective than acu, Funding Agencies|Joenkoeping University

BackgroundThere is mixed evidence regarding the impact of interactive digital devices on child development. Tentatively some studies suggested that the use of digital devices may correlate negatively with language, executive function, and motor skills. However, attempts to amalgamate this evidence has been limited related to the available number of experimental and cohort studies that have evaluated the impact of digital technology use on child development. We conducted this review to determine the impact of interactive digital devices on child development among children aged 7 years or younger. Interactive technology has been defined as methods, tools, or devices that users interact with in order to achieve specific tasks. Data sourceTo carry out this systematic review, databases CINAHL, MEDLINE, Embase, PsychINFO, Scopus and Google Scholar were searched for relevant studies. Study selectionWe used the Joanna Briggs Institute methodology for systematic reviews. Data extractionData extraction and synthesis was carried out by two reviewers and checked by a third reviewer. Studies were stratified into tiers depending on the level of evidence provided and the domain of development assessed. ResultsFifty-three studies were eligible for inclusion in the review, 39 Tier 1 (randomized controlled trials and quasi-experimental studies) and 16 Tier 2 (descriptive studies). Childrens use of interactive digital technology was positively associated with receptive language and executive function and negatively associated or unrelated to motor proficiency. Other critical aspects informing the evidence, such as dose of exposure, intensity, or duration, were inconsistently reported, making estimates of exposure tentative and imprecise. ConclusionThe studies included in this review were predominantly correlational or comparative in nature and focuses on cognitive domains of learning rather than a specific developmental outcome. It is difficult to generalize our findings beyond the di

BackgroundThere is mixed evidence regarding the impact of interactive digital devices on child development. Tentatively some studies suggested that the use of digital devices may correlate negatively with language, executive function, and motor skills. However, attempts to amalgamate this evidence has been limited related to the available number of experimental and cohort studies that have evaluated the impact of digital technology use on child development. We conducted this review to determine the impact of interactive digital devices on child development among children aged 7 years or younger. Interactive technology has been defined as methods, tools, or devices that users interact with in order to achieve specific tasks. Data sourceTo carry out this systematic review, databases CINAHL, MEDLINE, Embase, PsychINFO, Scopus and Google Scholar were searched for relevant studies. Study selectionWe used the Joanna Briggs Institute methodology for systematic reviews. Data extractionData extraction and synthesis was carried out by two reviewers and checked by a third reviewer. Studies were stratified into tiers depending on the level of evidence provided and the domain of development assessed. ResultsFifty-three studies were eligible for inclusion in the review, 39 Tier 1 (randomized controlled trials and quasi-experimental studies) and 16 Tier 2 (descriptive studies). Childrens use of interactive digital technology was positively associated with receptive language and executive function and negatively associated or unrelated to motor proficiency. Other critical aspects informing the evidence, such as dose of exposure, intensity, or duration, were inconsistently reported, making estimates of exposure tentative and imprecise. ConclusionThe studies included in this review were predominantly correlational or comparative in nature and focuses on cognitive domains of learning rather than a specific developmental outcome. It is difficult to generalize our findings beyond the di

BackgroundThere is mixed evidence regarding the impact of interactive digital devices on child development. Tentatively some studies suggested that the use of digital devices may correlate negatively with language, executive function, and motor skills. However, attempts to amalgamate this evidence has been limited related to the available number of experimental and cohort studies that have evaluated the impact of digital technology use on child development. We conducted this review to determine the impact of interactive digital devices on child development among children aged 7 years or younger. Interactive technology has been defined as methods, tools, or devices that users interact with in order to achieve specific tasks. Data sourceTo carry out this systematic review, databases CINAHL, MEDLINE, Embase, PsychINFO, Scopus and Google Scholar were searched for relevant studies. Study selectionWe used the Joanna Briggs Institute methodology for systematic reviews. Data extractionData extraction and synthesis was carried out by two reviewers and checked by a third reviewer. Studies were stratified into tiers depending on the level of evidence provided and the domain of development assessed. ResultsFifty-three studies were eligible for inclusion in the review, 39 Tier 1 (randomized controlled trials and quasi-experimental studies) and 16 Tier 2 (descriptive studies). Childrens use of interactive digital technology was positively associated with receptive language and executive function and negatively associated or unrelated to motor proficiency. Other critical aspects informing the evidence, such as dose of exposure, intensity, or duration, were inconsistently reported, making estimates of exposure tentative and imprecise. ConclusionThe studies included in this review were predominantly correlational or comparative in nature and focuses on cognitive domains of learning rather than a specific developmental outcome. It is difficult to generalize our findings beyond the di

Exercise is often cited as a major factor contributing to improved cognitive functioning. As a result, the relationship between exercise and cognition has received much attention in scholarly literature. Systematic reviews and meta-analyses present varying and sometimes conflicting results about the extent to which exercise can influence cognition. The aim of this umbrella review was to summarize the effects of physical exercise on cognitive functions (global cognition, executive function, memory, attention, or processing speed) in healthy adults & GE; 55 years of age.Methods An umbrella review of systematic reviews with meta-analyses investigating the effect of exercise on cognition was performed. Databases (CINAHL, Cochrane Library, MEDLINE, PsycInfo, Scopus, and Web of Science) were searched from inception until June 2023 for reviews of randomized or non-randomised controlled trials. Full-text articles meeting the inclusion criteria were reviewed and methodological quality assessed. Overlap within included reviews was assessed using the corrected covered area method (CCA). A random effects model was used to calculate overall pooled effect size with sub-analyses for specific cognitive domains, exercise type and timing of exercise.Results Database searches identified 9227 reviews. A total of 20 met the inclusion criteria. They were based on 332 original primary studies. Overall quality of the reviews was considered moderate with most meeting 8 or more of the 16 AMSTAR 2 categories. Overall pooled effects indicated that exercise in general has a small positive effect on cognition (d = 0.22; SE = 0.04; p < 0.01). Mind-body exercise had the greatest effect with a pooled effect size of (d = 0.48; SE = 0.06; p < 0.001). Exercise had a moderate positive effect on global cognition (d = 0.43; SE = 0,11; p < 0,001) and a small positive effect on executive function, memory, attention, and processing speed. Chronic exercise was more effective than acu, Funding Agencies|Joenkoeping University

IMPORTANCE Pediatric overweight and obesity are highly prevalent across the world, with implications for poorer cognitive and brain health. Exercise might potentially attenuate these adverse consequences. OBJECTIVES To investigate the effects of an exercise program on brain health indicators, including intelligence, executive function, academic performance, and brain outcomes, among children with overweight or obesity and to explore potential mediators and moderators of the main effects of exercise. DESIGN, SETTING, AND PARTICIPANTS All preexercise and postexercise data for this 20-week randomized clinical trial of 109 children aged 8 to 11 years with overweight or obesity were collected from November 21, 2014, to June 30, 2016, with neuroimaging data processing and analyses conducted between June 1, 2017, and December 20, 2021. All 109 children were included in the intention-to-treat analyses; 90 children (82.6%) completed the postexercise evaluation and attended 70% or more of the recommended exercise sessions and were included in per-protocol analyses. INTERVENTIONS All participants received lifestyle recommendations. The control group continued their usual routines, whereas the exercise group attended a minimum of 3 supervised 90-minute sessions per week in an out-of-school setting. MAIN OUTCOMES AND MEASURES Intelligence, executive function (cognitive flexibility, inhibition, and working memory), and academic performance were assessed with standardized tests, and hippocampal volume was measured with magnetic resonance imaging. RESULTS The 109 participants included 45 girls (41.3%); participants had a mean (SD) body mass index of 26.8 (3.6) and a mean (SD) age of 10.0 (1.1) years at baseline. In per-protocol analyses, the exercise intervention improved crystallized intelligence, with the exercise group improving from before exercise to after exercise (mean z score, 0.62 [95% CI, 0.44-0.80]) compared with the control group (mean z score, -0.10 [95% CI, -0.28 to 0, Funding Agencies|Spanish Ministry of Economy and Competitiveness [DEP2013-47540, DEP2016-79512-R, DEP2017-91544-EXP]; European Regional Development Fund (ERDF); European Commission [667302]; Alicia Koplowitz Foundation; ERDF (FEDER in Spanish) [B-CTS-355-UGR18]; University of Granada, Plan Propio de Investigacion, Visiting Scholar grants; Junta de Andalucia, Consejeria de Conocimiento, Investigacion y Universidades; Unit of Excellence on Exercise, Nutrition and Health (UCEENS); ERDF [SOMM17/6107/UGR]; EXERNET Research Network on Exercise and Health [DEP2005-00046/ACTI]; High Council of Sports [09/UPB/19]; Spanish Ministry of Science and Innovation [FPU 14/06837, FPI-BES-2014-068829, FJC2018-037925-I, FJCI-2014-19563, IJCI-2017-33642, RYC2019-027287-I, FPU15/02645, FJCI-2017-33396, IJC2019-041916-I]; Junta de Andalucia; National Agency for Research and Development (ANID)/BECAS Chile [72180543]; Ramon Areces Foundation

Objectives: Sub-optimal replacement of glucocorticoids (GC) in autoimmune Addisons disease (AAD) may affect cognitive functioning. The present study therefore sought to investigate cognitive performance and self-reported problems with executive functions in a cohort of young adult patients with AAD. Design and methods: 67 patients with AAD (39 females), mean age 32 yrs. (range 19-41), and 80 control participants (43 females), mean age 29 yrs. (range 19-43), completed neuropsychological tests estimating verbal and non-verbal intellectual ability, learning, memory and executive functioning, in addition to self-report scales assessing problems with executive functions, fatigue and symptoms of anxiety and depression. Results: Patients performed within the average range on all cognitive tests compared to population norms. However, female AAD patients reported more problems than controls with both hot (emotion regulation) and cold (cognitive regulation) executive functions in daily life. Moreover, experienced problems with executive functions in both male and female patients were associated with increased mental fatigue and lower GC replacement doses. Conclusions: Despite average performance in neuropsychological tests by both sexes, young adult female patients with AAD experience problems with executive functions in daily life. Coping with mental fatigue and optimization of pharmacotherapy may be important factors to be addressed in order to provide timely support for patients. Future research is needed to further determine other risk factors for experiencing executive function impairments in AAD., Funding Agencies|Marianne and Marcus Wallenberg Foundation; Knut and Alice Wallenberg Foundation; International Fund raising for Congenital Adrenal Hyperplasia (IFCAH)/European Society for Pediatric Endocrinology (ESPE); Stockholm County Council (ALF-SLL); Swedish Research Council [DNR 2021-02440, DNR 2016-02849]; Region Stockholm [DNR RS 20191140]; Foundation of Johan Gronberg; Stiftelsen Frimurare Barnhuset i Stockholm; Samariten; Jerringfonden; Sallskapet Barnavard; Wera Ekstroms stiftelse for Pediatrikforskning; Foundation for Research and Education in Pediatric Endocrinology; Novo Nordisk Foundation; Torsten and Ragnar Soderbergs Foundations; Foundation of Lisa

IMPORTANCE Pediatric overweight and obesity are highly prevalent across the world, with implications for poorer cognitive and brain health. Exercise might potentially attenuate these adverse consequences. OBJECTIVES To investigate the effects of an exercise program on brain health indicators, including intelligence, executive function, academic performance, and brain outcomes, among children with overweight or obesity and to explore potential mediators and moderators of the main effects of exercise. DESIGN, SETTING, AND PARTICIPANTS All preexercise and postexercise data for this 20-week randomized clinical trial of 109 children aged 8 to 11 years with overweight or obesity were collected from November 21, 2014, to June 30, 2016, with neuroimaging data processing and analyses conducted between June 1, 2017, and December 20, 2021. All 109 children were included in the intention-to-treat analyses; 90 children (82.6%) completed the postexercise evaluation and attended 70% or more of the recommended exercise sessions and were included in per-protocol analyses. INTERVENTIONS All participants received lifestyle recommendations. The control group continued their usual routines, whereas the exercise group attended a minimum of 3 supervised 90-minute sessions per week in an out-of-school setting. MAIN OUTCOMES AND MEASURES Intelligence, executive function (cognitive flexibility, inhibition, and working memory), and academic performance were assessed with standardized tests, and hippocampal volume was measured with magnetic resonance imaging. RESULTS The 109 participants included 45 girls (41.3%); participants had a mean (SD) body mass index of 26.8 (3.6) and a mean (SD) age of 10.0 (1.1) years at baseline. In per-protocol analyses, the exercise intervention improved crystallized intelligence, with the exercise group improving from before exercise to after exercise (mean z score, 0.62 [95% CI, 0.44-0.80]) compared with the control group (mean z score, -0.10 [95% CI, -0.28 to 0, Funding Agencies|Spanish Ministry of Economy and Competitiveness [DEP2013-47540, DEP2016-79512-R, DEP2017-91544-EXP]; European Regional Development Fund (ERDF); European Commission [667302]; Alicia Koplowitz Foundation; ERDF (FEDER in Spanish) [B-CTS-355-UGR18]; University of Granada, Plan Propio de Investigacion, Visiting Scholar grants; Junta de Andalucia, Consejeria de Conocimiento, Investigacion y Universidades; Unit of Excellence on Exercise, Nutrition and Health (UCEENS); ERDF [SOMM17/6107/UGR]; EXERNET Research Network on Exercise and Health [DEP2005-00046/ACTI]; High Council of Sports [09/UPB/19]; Spanish Ministry of Science and Innovation [FPU 14/06837, FPI-BES-2014-068829, FJC2018-037925-I, FJCI-2014-19563, IJCI-2017-33642, RYC2019-027287-I, FPU15/02645, FJCI-2017-33396, IJC2019-041916-I]; Junta de Andalucia; National Agency for Research and Development (ANID)/BECAS Chile [72180543]; Ramon Areces Foundation

Objectives: Sub-optimal replacement of glucocorticoids (GC) in autoimmune Addisons disease (AAD) may affect cognitive functioning. The present study therefore sought to investigate cognitive performance and self-reported problems with executive functions in a cohort of young adult patients with AAD. Design and methods: 67 patients with AAD (39 females), mean age 32 yrs. (range 19-41), and 80 control participants (43 females), mean age 29 yrs. (range 19-43), completed neuropsychological tests estimating verbal and non-verbal intellectual ability, learning, memory and executive functioning, in addition to self-report scales assessing problems with executive functions, fatigue and symptoms of anxiety and depression. Results: Patients performed within the average range on all cognitive tests compared to population norms. However, female AAD patients reported more problems than controls with both hot (emotion regulation) and cold (cognitive regulation) executive functions in daily life. Moreover, experienced problems with executive functions in both male and female patients were associated with increased mental fatigue and lower GC replacement doses. Conclusions: Despite average performance in neuropsychological tests by both sexes, young adult female patients with AAD experience problems with executive functions in daily life. Coping with mental fatigue and optimization of pharmacotherapy may be important factors to be addressed in order to provide timely support for patients. Future research is needed to further determine other risk factors for experiencing executive function impairments in AAD., Funding Agencies|Marianne and Marcus Wallenberg Foundation; Knut and Alice Wallenberg Foundation; International Fund raising for Congenital Adrenal Hyperplasia (IFCAH)/European Society for Pediatric Endocrinology (ESPE); Stockholm County Council (ALF-SLL); Swedish Research Council [DNR 2021-02440, DNR 2016-02849]; Region Stockholm [DNR RS 20191140]; Foundation of Johan Gronberg; Stiftelsen Frimurare Barnhuset i Stockholm; Samariten; Jerringfonden; Sallskapet Barnavard; Wera Ekstroms stiftelse for Pediatrikforskning; Foundation for Research and Education in Pediatric Endocrinology; Novo Nordisk Foundation; Torsten and Ragnar Soderbergs Foundations; Foundation of Lisa

IMPORTANCE Pediatric overweight and obesity are highly prevalent across the world, with implications for poorer cognitive and brain health. Exercise might potentially attenuate these adverse consequences. OBJECTIVES To investigate the effects of an exercise program on brain health indicators, including intelligence, executive function, academic performance, and brain outcomes, among children with overweight or obesity and to explore potential mediators and moderators of the main effects of exercise. DESIGN, SETTING, AND PARTICIPANTS All preexercise and postexercise data for this 20-week randomized clinical trial of 109 children aged 8 to 11 years with overweight or obesity were collected from November 21, 2014, to June 30, 2016, with neuroimaging data processing and analyses conducted between June 1, 2017, and December 20, 2021. All 109 children were included in the intention-to-treat analyses; 90 children (82.6%) completed the postexercise evaluation and attended 70% or more of the recommended exercise sessions and were included in per-protocol analyses. INTERVENTIONS All participants received lifestyle recommendations. The control group continued their usual routines, whereas the exercise group attended a minimum of 3 supervised 90-minute sessions per week in an out-of-school setting. MAIN OUTCOMES AND MEASURES Intelligence, executive function (cognitive flexibility, inhibition, and working memory), and academic performance were assessed with standardized tests, and hippocampal volume was measured with magnetic resonance imaging. RESULTS The 109 participants included 45 girls (41.3%); participants had a mean (SD) body mass index of 26.8 (3.6) and a mean (SD) age of 10.0 (1.1) years at baseline. In per-protocol analyses, the exercise intervention improved crystallized intelligence, with the exercise group improving from before exercise to after exercise (mean z score, 0.62 [95% CI, 0.44-0.80]) compared with the control group (mean z score, -0.10 [95% CI, -0.28 to 0, Funding Agencies|Spanish Ministry of Economy and Competitiveness [DEP2013-47540, DEP2016-79512-R, DEP2017-91544-EXP]; European Regional Development Fund (ERDF); European Commission [667302]; Alicia Koplowitz Foundation; ERDF (FEDER in Spanish) [B-CTS-355-UGR18]; University of Granada, Plan Propio de Investigacion, Visiting Scholar grants; Junta de Andalucia, Consejeria de Conocimiento, Investigacion y Universidades; Unit of Excellence on Exercise, Nutrition and Health (UCEENS); ERDF [SOMM17/6107/UGR]; EXERNET Research Network on Exercise and Health [DEP2005-00046/ACTI]; High Council of Sports [09/UPB/19]; Spanish Ministry of Science and Innovation [FPU 14/06837, FPI-BES-2014-068829, FJC2018-037925-I, FJCI-2014-19563, IJCI-2017-33642, RYC2019-027287-I, FPU15/02645, FJCI-2017-33396, IJC2019-041916-I]; Junta de Andalucia; National Agency for Research and Development (ANID)/BECAS Chile [72180543]; Ramon Areces Foundation

Objectives: Sub-optimal replacement of glucocorticoids (GC) in autoimmune Addisons disease (AAD) may affect cognitive functioning. The present study therefore sought to investigate cognitive performance and self-reported problems with executive functions in a cohort of young adult patients with AAD. Design and methods: 67 patients with AAD (39 females), mean age 32 yrs. (range 19-41), and 80 control participants (43 females), mean age 29 yrs. (range 19-43), completed neuropsychological tests estimating verbal and non-verbal intellectual ability, learning, memory and executive functioning, in addition to self-report scales assessing problems with executive functions, fatigue and symptoms of anxiety and depression. Results: Patients performed within the average range on all cognitive tests compared to population norms. However, female AAD patients reported more problems than controls with both hot (emotion regulation) and cold (cognitive regulation) executive functions in daily life. Moreover, experienced problems with executive functions in both male and female patients were associated with increased mental fatigue and lower GC replacement doses. Conclusions: Despite average performance in neuropsychological tests by both sexes, young adult female patients with AAD experience problems with executive functions in daily life. Coping with mental fatigue and optimization of pharmacotherapy may be important factors to be addressed in order to provide timely support for patients. Future research is needed to further determine other risk factors for experiencing executive function impairments in AAD., Funding Agencies|Marianne and Marcus Wallenberg Foundation; Knut and Alice Wallenberg Foundation; International Fund raising for Congenital Adrenal Hyperplasia (IFCAH)/European Society for Pediatric Endocrinology (ESPE); Stockholm County Council (ALF-SLL); Swedish Research Council [DNR 2021-02440, DNR 2016-02849]; Region Stockholm [DNR RS 20191140]; Foundation of Johan Gronberg; Stiftelsen Frimurare Barnhuset i Stockholm; Samariten; Jerringfonden; Sallskapet Barnavard; Wera Ekstroms stiftelse for Pediatrikforskning; Foundation for Research and Education in Pediatric Endocrinology; Novo Nordisk Foundation; Torsten and Ragnar Soderbergs Foundations; Foundation of Lisa

IMPORTANCE Pediatric overweight and obesity are highly prevalent across the world, with implications for poorer cognitive and brain health. Exercise might potentially attenuate these adverse consequences. OBJECTIVES To investigate the effects of an exercise program on brain health indicators, including intelligence, executive function, academic performance, and brain outcomes, among children with overweight or obesity and to explore potential mediators and moderators of the main effects of exercise. DESIGN, SETTING, AND PARTICIPANTS All preexercise and postexercise data for this 20-week randomized clinical trial of 109 children aged 8 to 11 years with overweight or obesity were collected from November 21, 2014, to June 30, 2016, with neuroimaging data processing and analyses conducted between June 1, 2017, and December 20, 2021. All 109 children were included in the intention-to-treat analyses; 90 children (82.6%) completed the postexercise evaluation and attended 70% or more of the recommended exercise sessions and were included in per-protocol analyses. INTERVENTIONS All participants received lifestyle recommendations. The control group continued their usual routines, whereas the exercise group attended a minimum of 3 supervised 90-minute sessions per week in an out-of-school setting. MAIN OUTCOMES AND MEASURES Intelligence, executive function (cognitive flexibility, inhibition, and working memory), and academic performance were assessed with standardized tests, and hippocampal volume was measured with magnetic resonance imaging. RESULTS The 109 participants included 45 girls (41.3%); participants had a mean (SD) body mass index of 26.8 (3.6) and a mean (SD) age of 10.0 (1.1) years at baseline. In per-protocol analyses, the exercise intervention improved crystallized intelligence, with the exercise group improving from before exercise to after exercise (mean z score, 0.62 [95% CI, 0.44-0.80]) compared with the control group (mean z score, -0.10 [95% CI, -0.28 to 0, Funding Agencies|Spanish Ministry of Economy and Competitiveness [DEP2013-47540, DEP2016-79512-R, DEP2017-91544-EXP]; European Regional Development Fund (ERDF); European Commission [667302]; Alicia Koplowitz Foundation; ERDF (FEDER in Spanish) [B-CTS-355-UGR18]; University of Granada, Plan Propio de Investigacion, Visiting Scholar grants; Junta de Andalucia, Consejeria de Conocimiento, Investigacion y Universidades; Unit of Excellence on Exercise, Nutrition and Health (UCEENS); ERDF [SOMM17/6107/UGR]; EXERNET Research Network on Exercise and Health [DEP2005-00046/ACTI]; High Council of Sports [09/UPB/19]; Spanish Ministry of Science and Innovation [FPU 14/06837, FPI-BES-2014-068829, FJC2018-037925-I, FJCI-2014-19563, IJCI-2017-33642, RYC2019-027287-I, FPU15/02645, FJCI-2017-33396, IJC2019-041916-I]; Junta de Andalucia; National Agency for Research and Development (ANID)/BECAS Chile [72180543]; Ramon Areces Foundation

IMPORTANCE Pediatric overweight and obesity are highly prevalent across the world, with implications for poorer cognitive and brain health. Exercise might potentially attenuate these adverse consequences. OBJECTIVES To investigate the effects of an exercise program on brain health indicators, including intelligence, executive function, academic performance, and brain outcomes, among children with overweight or obesity and to explore potential mediators and moderators of the main effects of exercise. DESIGN, SETTING, AND PARTICIPANTS All preexercise and postexercise data for this 20-week randomized clinical trial of 109 children aged 8 to 11 years with overweight or obesity were collected from November 21, 2014, to June 30, 2016, with neuroimaging data processing and analyses conducted between June 1, 2017, and December 20, 2021. All 109 children were included in the intention-to-treat analyses; 90 children (82.6%) completed the postexercise evaluation and attended 70% or more of the recommended exercise sessions and were included in per-protocol analyses. INTERVENTIONS All participants received lifestyle recommendations. The control group continued their usual routines, whereas the exercise group attended a minimum of 3 supervised 90-minute sessions per week in an out-of-school setting. MAIN OUTCOMES AND MEASURES Intelligence, executive function (cognitive flexibility, inhibition, and working memory), and academic performance were assessed with standardized tests, and hippocampal volume was measured with magnetic resonance imaging. RESULTS The 109 participants included 45 girls (41.3%); participants had a mean (SD) body mass index of 26.8 (3.6) and a mean (SD) age of 10.0 (1.1) years at baseline. In per-protocol analyses, the exercise intervention improved crystallized intelligence, with the exercise group improving from before exercise to after exercise (mean z score, 0.62 [95% CI, 0.44-0.80]) compared with the control group (mean z score, -0.10 [95% CI, -0.28 to 0, Funding Agencies|Spanish Ministry of Economy and Competitiveness [DEP2013-47540, DEP2016-79512-R, DEP2017-91544-EXP]; European Regional Development Fund (ERDF); European Commission [667302]; Alicia Koplowitz Foundation; ERDF (FEDER in Spanish) [B-CTS-355-UGR18]; University of Granada, Plan Propio de Investigacion, Visiting Scholar grants; Junta de Andalucia, Consejeria de Conocimiento, Investigacion y Universidades; Unit of Excellence on Exercise, Nutrition and Health (UCEENS); ERDF [SOMM17/6107/UGR]; EXERNET Research Network on Exercise and Health [DEP2005-00046/ACTI]; High Council of Sports [09/UPB/19]; Spanish Ministry of Science and Innovation [FPU 14/06837, FPI-BES-2014-068829, FJC2018-037925-I, FJCI-2014-19563, IJCI-2017-33642, RYC2019-027287-I, FPU15/02645, FJCI-2017-33396, IJC2019-041916-I]; Junta de Andalucia; National Agency for Research and Development (ANID)/BECAS Chile [72180543]; Ramon Areces Foundation

Objectives: Sub-optimal replacement of glucocorticoids (GC) in autoimmune Addisons disease (AAD) may affect cognitive functioning. The present study therefore sought to investigate cognitive performance and self-reported problems with executive functions in a cohort of young adult patients with AAD. Design and methods: 67 patients with AAD (39 females), mean age 32 yrs. (range 19-41), and 80 control participants (43 females), mean age 29 yrs. (range 19-43), completed neuropsychological tests estimating verbal and non-verbal intellectual ability, learning, memory and executive functioning, in addition to self-report scales assessing problems with executive functions, fatigue and symptoms of anxiety and depression. Results: Patients performed within the average range on all cognitive tests compared to population norms. However, female AAD patients reported more problems than controls with both hot (emotion regulation) and cold (cognitive regulation) executive functions in daily life. Moreover, experienced problems with executive functions in both male and female patients were associated with increased mental fatigue and lower GC replacement doses. Conclusions: Despite average performance in neuropsychological tests by both sexes, young adult female patients with AAD experience problems with executive functions in daily life. Coping with mental fatigue and optimization of pharmacotherapy may be important factors to be addressed in order to provide timely support for patients. Future research is needed to further determine other risk factors for experiencing executive function impairments in AAD., Funding Agencies|Marianne and Marcus Wallenberg Foundation; Knut and Alice Wallenberg Foundation; International Fund raising for Congenital Adrenal Hyperplasia (IFCAH)/European Society for Pediatric Endocrinology (ESPE); Stockholm County Council (ALF-SLL); Swedish Research Council [DNR 2021-02440, DNR 2016-02849]; Region Stockholm [DNR RS 20191140]; Foundation of Johan Gronberg; Stiftelsen Frimurare Barnhuset i Stockholm; Samariten; Jerringfonden; Sallskapet Barnavard; Wera Ekstroms stiftelse for Pediatrikforskning; Foundation for Research and Education in Pediatric Endocrinology; Novo Nordisk Foundation; Torsten and Ragnar Soderbergs Foundations; Foundation of Lisa

Objectives: Sub-optimal replacement of glucocorticoids (GC) in autoimmune Addisons disease (AAD) may affect cognitive functioning. The present study therefore sought to investigate cognitive performance and self-reported problems with executive functions in a cohort of young adult patients with AAD. Design and methods: 67 patients with AAD (39 females), mean age 32 yrs. (range 19-41), and 80 control participants (43 females), mean age 29 yrs. (range 19-43), completed neuropsychological tests estimating verbal and non-verbal intellectual ability, learning, memory and executive functioning, in addition to self-report scales assessing problems with executive functions, fatigue and symptoms of anxiety and depression. Results: Patients performed within the average range on all cognitive tests compared to population norms. However, female AAD patients reported more problems than controls with both hot (emotion regulation) and cold (cognitive regulation) executive functions in daily life. Moreover, experienced problems with executive functions in both male and female patients were associated with increased mental fatigue and lower GC replacement doses. Conclusions: Despite average performance in neuropsychological tests by both sexes, young adult female patients with AAD experience problems with executive functions in daily life. Coping with mental fatigue and optimization of pharmacotherapy may be important factors to be addressed in order to provide timely support for patients. Future research is needed to further determine other risk factors for experiencing executive function impairments in AAD., Funding Agencies|Marianne and Marcus Wallenberg Foundation; Knut and Alice Wallenberg Foundation; International Fund raising for Congenital Adrenal Hyperplasia (IFCAH)/European Society for Pediatric Endocrinology (ESPE); Stockholm County Council (ALF-SLL); Swedish Research Council [DNR 2021-02440, DNR 2016-02849]; Region Stockholm [DNR RS 20191140]; Foundation of Johan Gronberg; Stiftelsen Frimurare Barnhuset i Stockholm; Samariten; Jerringfonden; Sallskapet Barnavard; Wera Ekstroms stiftelse for Pediatrikforskning; Foundation for Research and Education in Pediatric Endocrinology; Novo Nordisk Foundation; Torsten and Ragnar Soderbergs Foundations; Foundation of Lisa

This observational cohort study explored objective neurocognitive deficits in COVID-19 patients five months after discharge, and any associations with demographic factors and disease severity indicators. Medical notes of all COVID-19 patients admitted to hospital in Region ostergotland, Sweden, March-May 2020, were reviewed. After applying exclusion criteria, 433 patients were screened by telephone. Of these, 185 patients reported persistent and concerning post-COVID-19 problems, including but not restricted to cognitive functions, and were invited to a clinical evaluation. The Repeatable Battery for Assessment of Neuropsychological Status (RBANS) and Colour-Word Interference Test (CWIT) were used to assess immediate memory, visuo-spatial function, language, attention, delayed memory, and executive function. A total of 133 patients had valid test performances. Mean RBANS Global Cognition Score was 83.4, with 37% scoring below cut-off (1.5 SD). Deficits in Attention and Memory indices were most common, each affecting approximately 30% of the patients. After adjustment for sex, language, level of education and premorbid function, neurocognitive performance was positively associated with length of hospital stay, but not with the disease severity indicators WHO CPS and CRP. Findings support that comprehensive neuropsychological assessment should be performed when patients report post-COVID-19 symptoms that affect daily life., Funding Agencies|ALF grant; Region Ostergotland

This observational cohort study explored objective neurocognitive deficits in COVID-19 patients five months after discharge, and any associations with demographic factors and disease severity indicators. Medical notes of all COVID-19 patients admitted to hospital in Region ostergotland, Sweden, March-May 2020, were reviewed. After applying exclusion criteria, 433 patients were screened by telephone. Of these, 185 patients reported persistent and concerning post-COVID-19 problems, including but not restricted to cognitive functions, and were invited to a clinical evaluation. The Repeatable Battery for Assessment of Neuropsychological Status (RBANS) and Colour-Word Interference Test (CWIT) were used to assess immediate memory, visuo-spatial function, language, attention, delayed memory, and executive function. A total of 133 patients had valid test performances. Mean RBANS Global Cognition Score was 83.4, with 37% scoring below cut-off (1.5 SD). Deficits in Attention and Memory indices were most common, each affecting approximately 30% of the patients. After adjustment for sex, language, level of education and premorbid function, neurocognitive performance was positively associated with length of hospital stay, but not with the disease severity indicators WHO CPS and CRP. Findings support that comprehensive neuropsychological assessment should be performed when patients report post-COVID-19 symptoms that affect daily life., Funding Agencies|ALF grant; Region Ostergotland

This observational cohort study explored objective neurocognitive deficits in COVID-19 patients five months after discharge, and any associations with demographic factors and disease severity indicators. Medical notes of all COVID-19 patients admitted to hospital in Region ostergotland, Sweden, March-May 2020, were reviewed. After applying exclusion criteria, 433 patients were screened by telephone. Of these, 185 patients reported persistent and concerning post-COVID-19 problems, including but not restricted to cognitive functions, and were invited to a clinical evaluation. The Repeatable Battery for Assessment of Neuropsychological Status (RBANS) and Colour-Word Interference Test (CWIT) were used to assess immediate memory, visuo-spatial function, language, attention, delayed memory, and executive function. A total of 133 patients had valid test performances. Mean RBANS Global Cognition Score was 83.4, with 37% scoring below cut-off (1.5 SD). Deficits in Attention and Memory indices were most common, each affecting approximately 30% of the patients. After adjustment for sex, language, level of education and premorbid function, neurocognitive performance was positively associated with length of hospital stay, but not with the disease severity indicators WHO CPS and CRP. Findings support that comprehensive neuropsychological assessment should be performed when patients report post-COVID-19 symptoms that affect daily life., Funding Agencies|ALF grant; Region Ostergotland

This observational cohort study explored objective neurocognitive deficits in COVID-19 patients five months after discharge, and any associations with demographic factors and disease severity indicators. Medical notes of all COVID-19 patients admitted to hospital in Region ostergotland, Sweden, March-May 2020, were reviewed. After applying exclusion criteria, 433 patients were screened by telephone. Of these, 185 patients reported persistent and concerning post-COVID-19 problems, including but not restricted to cognitive functions, and were invited to a clinical evaluation. The Repeatable Battery for Assessment of Neuropsychological Status (RBANS) and Colour-Word Interference Test (CWIT) were used to assess immediate memory, visuo-spatial function, language, attention, delayed memory, and executive function. A total of 133 patients had valid test performances. Mean RBANS Global Cognition Score was 83.4, with 37% scoring below cut-off (1.5 SD). Deficits in Attention and Memory indices were most common, each affecting approximately 30% of the patients. After adjustment for sex, language, level of education and premorbid function, neurocognitive performance was positively associated with length of hospital stay, but not with the disease severity indicators WHO CPS and CRP. Findings support that comprehensive neuropsychological assessment should be performed when patients report post-COVID-19 symptoms that affect daily life., Funding Agencies|ALF grant; Region Ostergotland

This observational cohort study explored objective neurocognitive deficits in COVID-19 patients five months after discharge, and any associations with demographic factors and disease severity indicators. Medical notes of all COVID-19 patients admitted to hospital in Region ostergotland, Sweden, March-May 2020, were reviewed. After applying exclusion criteria, 433 patients were screened by telephone. Of these, 185 patients reported persistent and concerning post-COVID-19 problems, including but not restricted to cognitive functions, and were invited to a clinical evaluation. The Repeatable Battery for Assessment of Neuropsychological Status (RBANS) and Colour-Word Interference Test (CWIT) were used to assess immediate memory, visuo-spatial function, language, attention, delayed memory, and executive function. A total of 133 patients had valid test performances. Mean RBANS Global Cognition Score was 83.4, with 37% scoring below cut-off (1.5 SD). Deficits in Attention and Memory indices were most common, each affecting approximately 30% of the patients. After adjustment for sex, language, level of education and premorbid function, neurocognitive performance was positively associated with length of hospital stay, but not with the disease severity indicators WHO CPS and CRP. Findings support that comprehensive neuropsychological assessment should be performed when patients report post-COVID-19 symptoms that affect daily life., Funding Agencies|ALF grant; Region Ostergotland

Background: Safe driving is a complex activity that requires calibration. This means the driver can accurately assess the level of task demand required for task completion and can accurately evaluate their driving capability. There is much debate on the calibration ability of post-stroke drivers. Objectives: The aim of this study was to assess the cognition, self-rated performance, and estimation of task demand in a driving simulator with post-stroke drivers and controls. Methods: A between-groups study design was employed, which included a post-stroke driver group and a group of similarly aged older control drivers. Both groups were observed driving in two simulator-based driving scenarios and asked to complete the NASA Task Load Index (TLX) to assess their perceived task demand and self-rate their driving performance. Participants also completed a battery of psychometric tasks to assess attention and executive function, which was used to determine whether post-stroke cognitive impairment impacted on calibration. Results: There was no difference in the amount of perceived task demand required to complete the driving task. Despite impairments in cognition, the post-stroke drivers were not more likely to over-estimate their driving abilities than controls. On average, the post-stroke drivers self-rated themselves more poorly than the controls and this rating was related to cognitive ability. Conclusion: This study suggests that post-stroke drivers may be aware of their deficits and adjust their driving behavior. Furthermore, using self-performance measures alongside a driving simulator and cognitive assessments may provide complementary fitness-to-drive assessments, as well as rehabilitation tools during post-stroke recovery., Funding Agencies|Curtin University CSIRS scholarship

Background: Bullying is a type of aggressive behavior that occurs repeatedly and intentionally in school environments and where there is a power imbalance. The main objective of this study was to analyze the association that hormones and the psychosocial context jointly have with bullying behavior. Method: Participants were 302 11-year-old preadolescents from the Gipuzkoan cohort of the INMA Project. Bullying was assessed using the Olweus Bully/victim Questionnaire. Prenatal sexual hormones were assessed by calculating 2D:4D ratio and in order to measure prepubertal testosterone and cortisol levels saliva samples were collected within a week of each other. Additionally, various psychosocial factors were evaluated: executive function, family context, school environment and social context. To analyze our complex hypothesis, six metamodels were tested using structural equation modeling. Results: In relation to victims, results showed that victimization was related to worse school environment perception in boys, and higher stress and conflict in the family in girls. In the case of their involvement in bullying as a bully, lower salivary cortisol levels, worse school environment perception and lower peers and social support was related to being more frequently involved as a bully in boys, while having more family stress and conflict was related with being a bully in girls. Conclusions: This approach makes it possible not only to explore the different biological and psychosocial factors affect bullying behavior, but also to explore associations between the predictor variables., Funding Agencies|Instituto de Salud Carlos III [FIS-PI06/0867, FIS-PI09/00090, FIS-PI13/02187, FIS-PI18/01142, FIS-PI18/01237]; Department of Health of the Basque Government [2005111093, 2009111069, 2013111089, 2015111065, 2018111086]; Provincial Government of Gipuzkoa [DFG06/002, DFG08/001, DFG15/221, DFG 89/17]; Department of Education, Language Policy and Culture of the Government of the Basque Country; FEDER funds

Background: Bullying is a type of aggressive behavior that occurs repeatedly and intentionally in school environments and where there is a power imbalance. The main objective of this study was to analyze the association that hormones and the psychosocial context jointly have with bullying behavior. Method: Participants were 302 11-year-old preadolescents from the Gipuzkoan cohort of the INMA Project. Bullying was assessed using the Olweus Bully/victim Questionnaire. Prenatal sexual hormones were assessed by calculating 2D:4D ratio and in order to measure prepubertal testosterone and cortisol levels saliva samples were collected within a week of each other. Additionally, various psychosocial factors were evaluated: executive function, family context, school environment and social context. To analyze our complex hypothesis, six metamodels were tested using structural equation modeling. Results: In relation to victims, results showed that victimization was related to worse school environment perception in boys, and higher stress and conflict in the family in girls. In the case of their involvement in bullying as a bully, lower salivary cortisol levels, worse school environment perception and lower peers and social support was related to being more frequently involved as a bully in boys, while having more family stress and conflict was related with being a bully in girls. Conclusions: This approach makes it possible not only to explore the different biological and psychosocial factors affect bullying behavior, but also to explore associations between the predictor variables., Funding Agencies|Instituto de Salud Carlos III [FIS-PI06/0867, FIS-PI09/00090, FIS-PI13/02187, FIS-PI18/01142, FIS-PI18/01237]; Department of Health of the Basque Government [2005111093, 2009111069, 2013111089, 2015111065, 2018111086]; Provincial Government of Gipuzkoa [DFG06/002, DFG08/001, DFG15/221, DFG 89/17]; Department of Education, Language Policy and Culture of the Government of the Basque Country; FEDER funds

Background: Bullying is a type of aggressive behavior that occurs repeatedly and intentionally in school environments and where there is a power imbalance. The main objective of this study was to analyze the association that hormones and the psychosocial context jointly have with bullying behavior. Method: Participants were 302 11-year-old preadolescents from the Gipuzkoan cohort of the INMA Project. Bullying was assessed using the Olweus Bully/victim Questionnaire. Prenatal sexual hormones were assessed by calculating 2D:4D ratio and in order to measure prepubertal testosterone and cortisol levels saliva samples were collected within a week of each other. Additionally, various psychosocial factors were evaluated: executive function, family context, school environment and social context. To analyze our complex hypothesis, six metamodels were tested using structural equation modeling. Results: In relation to victims, results showed that victimization was related to worse school environment perception in boys, and higher stress and conflict in the family in girls. In the case of their involvement in bullying as a bully, lower salivary cortisol levels, worse school environment perception and lower peers and social support was related to being more frequently involved as a bully in boys, while having more family stress and conflict was related with being a bully in girls. Conclusions: This approach makes it possible not only to explore the different biological and psychosocial factors affect bullying behavior, but also to explore associations between the predictor variables., Funding Agencies|Instituto de Salud Carlos III [FIS-PI06/0867, FIS-PI09/00090, FIS-PI13/02187, FIS-PI18/01142, FIS-PI18/01237]; Department of Health of the Basque Government [2005111093, 2009111069, 2013111089, 2015111065, 2018111086]; Provincial Government of Gipuzkoa [DFG06/002, DFG08/001, DFG15/221, DFG 89/17]; Department of Education, Language Policy and Culture of the Government of the Basque Country; FEDER funds

Background: Bullying is a type of aggressive behavior that occurs repeatedly and intentionally in school environments and where there is a power imbalance. The main objective of this study was to analyze the association that hormones and the psychosocial context jointly have with bullying behavior. Method: Participants were 302 11-year-old preadolescents from the Gipuzkoan cohort of the INMA Project. Bullying was assessed using the Olweus Bully/victim Questionnaire. Prenatal sexual hormones were assessed by calculating 2D:4D ratio and in order to measure prepubertal testosterone and cortisol levels saliva samples were collected within a week of each other. Additionally, various psychosocial factors were evaluated: executive function, family context, school environment and social context. To analyze our complex hypothesis, six metamodels were tested using structural equation modeling. Results: In relation to victims, results showed that victimization was related to worse school environment perception in boys, and higher stress and conflict in the family in girls. In the case of their involvement in bullying as a bully, lower salivary cortisol levels, worse school environment perception and lower peers and social support was related to being more frequently involved as a bully in boys, while having more family stress and conflict was related with being a bully in girls. Conclusions: This approach makes it possible not only to explore the different biological and psychosocial factors affect bullying behavior, but also to explore associations between the predictor variables., Funding Agencies|Instituto de Salud Carlos III [FIS-PI06/0867, FIS-PI09/00090, FIS-PI13/02187, FIS-PI18/01142, FIS-PI18/01237]; Department of Health of the Basque Government [2005111093, 2009111069, 2013111089, 2015111065, 2018111086]; Provincial Government of Gipuzkoa [DFG06/002, DFG08/001, DFG15/221, DFG 89/17]; Department of Education, Language Policy and Culture of the Government of the Basque Country; FEDER funds

Background: Bullying is a type of aggressive behavior that occurs repeatedly and intentionally in school environments and where there is a power imbalance. The main objective of this study was to analyze the association that hormones and the psychosocial context jointly have with bullying behavior. Method: Participants were 302 11-year-old preadolescents from the Gipuzkoan cohort of the INMA Project. Bullying was assessed using the Olweus Bully/victim Questionnaire. Prenatal sexual hormones were assessed by calculating 2D:4D ratio and in order to measure prepubertal testosterone and cortisol levels saliva samples were collected within a week of each other. Additionally, various psychosocial factors were evaluated: executive function, family context, school environment and social context. To analyze our complex hypothesis, six metamodels were tested using structural equation modeling. Results: In relation to victims, results showed that victimization was related to worse school environment perception in boys, and higher stress and conflict in the family in girls. In the case of their involvement in bullying as a bully, lower salivary cortisol levels, worse school environment perception and lower peers and social support was related to being more frequently involved as a bully in boys, while having more family stress and conflict was related with being a bully in girls. Conclusions: This approach makes it possible not only to explore the different biological and psychosocial factors affect bullying behavior, but also to explore associations between the predictor variables., Funding Agencies|Instituto de Salud Carlos III [FIS-PI06/0867, FIS-PI09/00090, FIS-PI13/02187, FIS-PI18/01142, FIS-PI18/01237]; Department of Health of the Basque Government [2005111093, 2009111069, 2013111089, 2015111065, 2018111086]; Provincial Government of Gipuzkoa [DFG06/002, DFG08/001, DFG15/221, DFG 89/17]; Department of Education, Language Policy and Culture of the Government of the Basque Country; FEDER funds

Social drinking is common, but it is unclear how moderate levels of alcohol influence decision making. Most prior studies have focused on adverse long-term effects on cognitive and executive function in people with alcohol use disorders (AUD). Some studies have investigated the acute effects of alcohol on decision making in healthy people, but have predominantly used small samples and focused on a narrow selection of tasks related to personal decision making, e.g., delay or probability discounting. Here, we conducted a large (n = 264), preregistered randomized placebo-controlled study (RCT) using a parallel group design, to systematically assess the acute effects of alcohol on measures of decision making in both personal and social domains. We found a robust effect of a 0.6 g/kg dose of alcohol on both moral judgment and altruistic behavior, but no effects on several measures of risk taking or waiting impulsivity. These findings suggest that alcohol at low to moderate doses selectively moderates decision making in the social domain, and promotes utilitarian decisions over those dictated by rule-based ethical principles (deontological). This is consistent with existing theory that emphasizes the dual roles of shortsighted information processing and salient social cues in shaping decisions made under the influence of alcohol. A better understanding of these effects is important to understand altered social functioning during alcohol intoxication., Funding Agencies|Swedish Research CouncilSwedish Research CouncilEuropean Commission [MH: 2013-07434, GT: 2018-01755]; Swedish Research Council for Health, Working Life and WelfareSwedish Research CouncilSwedish Research Council for Health Working Life & Welfare (Forte) [EP: 2020-00864]

Introduction Driving is a complex activity involving a high level of cognitive abilities and thus might be affected after a brain injury/disease. The aim of this research was to evaluate the feasibility and construct validity of a driving simulator tool as a complement to existing driving assessments of patients with cognitive dysfunctions after a brain injury/disease. Method A descriptive and prospective research design was achieved. For construct validation, decisions were based on results from the Useful Field of View, Nordic Stroke Driver Screening Assessment, Trail Making Test and, when necessary for the decision, an on-road observation. Results from the simulator tool were not included in the clinical decision process. Results A total of 129 patients from four different rehabilitation services were included. The results showed a significant difference in test results between those who were considered medically fit versus unfit to drive. A factor analysis revealed four components, all including attention in combination with processing speed, visuospatial function, simultaneous capacity and executive function; these are all represented in the simulator tool. A correlation analysis showed that simulator subtest 3 (response/divergent response to stimuli) had the strongest correlation with most of the other tests included. Conclusions The simulator was found to be feasible and valid and found to include components other than those measured in the other tests., Funding Agencies|County Council of Ostergotland, Sweden [LIO-582071, SC-2017-00091-26]; Medical Research Council of Southeast Sweden [FORSS -605951, 654091, 755541, 850271]

Introduction Driving is a complex activity involving a high level of cognitive abilities and thus might be affected after a brain injury/disease. The aim of this research was to evaluate the feasibility and construct validity of a driving simulator tool as a complement to existing driving assessments of patients with cognitive dysfunctions after a brain injury/disease. Method A descriptive and prospective research design was achieved. For construct validation, decisions were based on results from the Useful Field of View, Nordic Stroke Driver Screening Assessment, Trail Making Test and, when necessary for the decision, an on-road observation. Results from the simulator tool were not included in the clinical decision process. Results A total of 129 patients from four different rehabilitation services were included. The results showed a significant difference in test results between those who were considered medically fit versus unfit to drive. A factor analysis revealed four components, all including attention in combination with processing speed, visuospatial function, simultaneous capacity and executive function; these are all represented in the simulator tool. A correlation analysis showed that simulator subtest 3 (response/divergent response to stimuli) had the strongest correlation with most of the other tests included. Conclusions The simulator was found to be feasible and valid and found to include components other than those measured in the other tests., Funding Agencies|County Council of Ostergotland, Sweden [LIO-582071, SC-2017-00091-26]; Medical Research Council of Southeast Sweden [FORSS -605951, 654091, 755541, 850271]

Introduction 24-hour movement behaviours (physical activity, sedentary behaviour and sleep) during the early years are associated with health and developmental outcomes, prompting the WHO to develop Global guidelines for physical activity, sedentary behaviour and sleep for children under 5 years of age. Prevalence data on 24-hour movement behaviours is lacking, particularly in low-income and middle-income countries (LMICs). This paper describes the development of the SUNRISE International Study of Movement Behaviours in the Early Years protocol, designed to address this gap. Methods and analysis SUNRISE is the first international cross-sectional study that aims to determine the proportion of 3- and 4-year-old children who meet the WHO Global guidelines. The study will assess if proportions differ by gender, urban/rural location and/or socioeconomic status. Executive function, motor skills and adiposity will be assessed and potential correlates of 24-hour movement behaviours examined. Pilot research from 24 countries (14 LMICs) informed the study design and protocol. Data are collected locally by research staff from partnering institutions who are trained throughout the research process. Piloting of all measures to determine protocol acceptability and feasibility was interrupted by COVID-19 but is nearing completion. At the time of publication 41 countries are participating in the SUNRISE study. Ethics and dissemination The SUNRISE protocol has received ethics approved from the University of Wollongong, Australia, and in each country by the applicable ethics committees. Approval is also sought from any relevant government departments or organisations. The results will inform global efforts to prevent childhood obesity and ensure young children reach their health and developmental potential. Findings on the correlates of movement behaviours can guide future interventions to improve the movement behaviours in culturally specific ways. Study findings will be disseminate, Funding Agencies|American Council on Exercise, USA; Beijing Health System High Level Talents Training Project, China [2015-3-88]; Biomedical Research Foundation, Dhaka, Bangladesh [BRF-19-01]; Canadian Institutes of Health Research Frederick Banting and Charles Best Canada Graduate Scholarship (CGS-M)Canadian Institutes of Health Research (CIHR); Canadian Institutes of Health Research Planning and Dissemination GrantCanadian Institutes of Health Research (CIHR) [155265]; Civilian Research Development Foundation (CRDF) Global [OISE-20-66864-1]; Department of National Planning and Monitoring, PNG Government [02704]; Early Start, University of Wollongong, Australia; Faculty of Health Sciences at the University of the Witwatersrand, Johannesburg, South Africa; Fogarty International Center (FIC) of the National Institutes of Health [D43 TW010137]; Geran Universiti Penyelidikan (GUP), Universiti Kebangsaan Malaysia [GUP-2018-142]; Global Challenges Program, University of Wollongong, Australia [888/006/497]; Harry Crossley Foundation, South Africa; National Institute of Education-Ministry of Education, Singapore [OER 04/19 TWP]; Pham Ngoc Thach University of Medicine, Vietnam [1319/QD-TDHYKPNT]; Sasakawa Sports Research Grant, Sasakawa Sports Foundation, Japan [190A2-004]; Stella de Silva Research grant from Sri Lanka College of Paediatricians, Sri Lanka; The DST-NRF Centre for Excellence in Human Development at the University of Witwatersrand, Johannesburg, South Africa; International Society of Behavioral Nutrition and Physical Activity, Pioneers Program (ISBNPA-2021); The University Research Coordination Office of the De La Salle University, Philippines [29 IR S 3TAY192021]; Universidad de La Frontera Research Directorate, Chile [DI20-0093, DFP19-0012, DI20-1002]; WHO European Office for Prevention and Control of Noncommunicable Diseases

Stroke can adversely affect the coordination and judgement of drivers due to executive dysfunction, which is relatively common in the post-stroke population but often undetected. Quantitatively examining vehicle control performance in post-stroke driving becomes essential to inspect whether and where post-stroke older drivers are risky. To date, it is unclear as to which indicators, such as lane keeping or speed control, can differentiate the driving performance of post-stroke older drivers from that of normal (neurotypical) older drivers. By employing a case-control design using advanced vehicle movement tracking and analysis technology, this pilot study aimed to compare the variations in driving trajectory, lane keeping and speed control between the two groups of older drivers using spatial and statistical techniques. The results showed that the mean standard deviation of lane deviation (SDLD) in post-stroke participants was higher than that of normal participants in complex driving tasks (U-turn and left turn) but almost the same in simple driving tasks (straight line sections). No statistically significant differences were found in the speed control performance. The findings indicate that, although older drivers can still drive as they need to after a stroke, the decline in cognitive abilities still imposes a higher cognitive workload and more effort for post-stroke older drivers. Future studies can investigate post-stroke adults driving behaviour at more challenging driving scenarios or design driving intervention programs to improve their executive function in driving.

Introduction 24-hour movement behaviours (physical activity, sedentary behaviour and sleep) during the early years are associated with health and developmental outcomes, prompting the WHO to develop Global guidelines for physical activity, sedentary behaviour and sleep for children under 5 years of age. Prevalence data on 24-hour movement behaviours is lacking, particularly in low-income and middle-income countries (LMICs). This paper describes the development of the SUNRISE International Study of Movement Behaviours in the Early Years protocol, designed to address this gap. Methods and analysis SUNRISE is the first international cross-sectional study that aims to determine the proportion of 3- and 4-year-old children who meet the WHO Global guidelines. The study will assess if proportions differ by gender, urban/rural location and/or socioeconomic status. Executive function, motor skills and adiposity will be assessed and potential correlates of 24-hour movement behaviours examined. Pilot research from 24 countries (14 LMICs) informed the study design and protocol. Data are collected locally by research staff from partnering institutions who are trained throughout the research process. Piloting of all measures to determine protocol acceptability and feasibility was interrupted by COVID-19 but is nearing completion. At the time of publication 41 countries are participating in the SUNRISE study. Ethics and dissemination The SUNRISE protocol has received ethics approved from the University of Wollongong, Australia, and in each country by the applicable ethics committees. Approval is also sought from any relevant government departments or organisations. The results will inform global efforts to prevent childhood obesity and ensure young children reach their health and developmental potential. Findings on the correlates of movement behaviours can guide future interventions to improve the movement behaviours in culturally specific ways. Study findings will be disseminate, Funding Agencies|American Council on Exercise, USA; Beijing Health System High Level Talents Training Project, China [2015-3-88]; Biomedical Research Foundation, Dhaka, Bangladesh [BRF-19-01]; Canadian Institutes of Health Research Frederick Banting and Charles Best Canada Graduate Scholarship (CGS-M)Canadian Institutes of Health Research (CIHR); Canadian Institutes of Health Research Planning and Dissemination GrantCanadian Institutes of Health Research (CIHR) [155265]; Civilian Research Development Foundation (CRDF) Global [OISE-20-66864-1]; Department of National Planning and Monitoring, PNG Government [02704]; Early Start, University of Wollongong, Australia; Faculty of Health Sciences at the University of the Witwatersrand, Johannesburg, South Africa; Fogarty International Center (FIC) of the National Institutes of Health [D43 TW010137]; Geran Universiti Penyelidikan (GUP), Universiti Kebangsaan Malaysia [GUP-2018-142]; Global Challenges Program, University of Wollongong, Australia [888/006/497]; Harry Crossley Foundation, South Africa; National Institute of Education-Ministry of Education, Singapore [OER 04/19 TWP]; Pham Ngoc Thach University of Medicine, Vietnam [1319/QD-TDHYKPNT]; Sasakawa Sports Research Grant, Sasakawa Sports Foundation, Japan [190A2-004]; Stella de Silva Research grant from Sri Lanka College of Paediatricians, Sri Lanka; The DST-NRF Centre for Excellence in Human Development at the University of Witwatersrand, Johannesburg, South Africa; International Society of Behavioral Nutrition and Physical Activity, Pioneers Program (ISBNPA-2021); The University Research Coordination Office of the De La Salle University, Philippines [29 IR S 3TAY192021]; Universidad de La Frontera Research Directorate, Chile [DI20-0093, DFP19-0012, DI20-1002]; WHO European Office for Prevention and Control of Noncommunicable Diseases

Introduction 24-hour movement behaviours (physical activity, sedentary behaviour and sleep) during the early years are associated with health and developmental outcomes, prompting the WHO to develop Global guidelines for physical activity, sedentary behaviour and sleep for children under 5 years of age. Prevalence data on 24-hour movement behaviours is lacking, particularly in low-income and middle-income countries (LMICs). This paper describes the development of the SUNRISE International Study of Movement Behaviours in the Early Years protocol, designed to address this gap. Methods and analysis SUNRISE is the first international cross-sectional study that aims to determine the proportion of 3- and 4-year-old children who meet the WHO Global guidelines. The study will assess if proportions differ by gender, urban/rural location and/or socioeconomic status. Executive function, motor skills and adiposity will be assessed and potential correlates of 24-hour movement behaviours examined. Pilot research from 24 countries (14 LMICs) informed the study design and protocol. Data are collected locally by research staff from partnering institutions who are trained throughout the research process. Piloting of all measures to determine protocol acceptability and feasibility was interrupted by COVID-19 but is nearing completion. At the time of publication 41 countries are participating in the SUNRISE study. Ethics and dissemination The SUNRISE protocol has received ethics approved from the University of Wollongong, Australia, and in each country by the applicable ethics committees. Approval is also sought from any relevant government departments or organisations. The results will inform global efforts to prevent childhood obesity and ensure young children reach their health and developmental potential. Findings on the correlates of movement behaviours can guide future interventions to improve the movement behaviours in culturally specific ways. Study findings will be disseminate, Funding Agencies|American Council on Exercise, USA; Beijing Health System High Level Talents Training Project, China [2015-3-88]; Biomedical Research Foundation, Dhaka, Bangladesh [BRF-19-01]; Canadian Institutes of Health Research Frederick Banting and Charles Best Canada Graduate Scholarship (CGS-M)Canadian Institutes of Health Research (CIHR); Canadian Institutes of Health Research Planning and Dissemination GrantCanadian Institutes of Health Research (CIHR) [155265]; Civilian Research Development Foundation (CRDF) Global [OISE-20-66864-1]; Department of National Planning and Monitoring, PNG Government [02704]; Early Start, University of Wollongong, Australia; Faculty of Health Sciences at the University of the Witwatersrand, Johannesburg, South Africa; Fogarty International Center (FIC) of the National Institutes of Health [D43 TW010137]; Geran Universiti Penyelidikan (GUP), Universiti Kebangsaan Malaysia [GUP-2018-142]; Global Challenges Program, University of Wollongong, Australia [888/006/497]; Harry Crossley Foundation, South Africa; National Institute of Education-Ministry of Education, Singapore [OER 04/19 TWP]; Pham Ngoc Thach University of Medicine, Vietnam [1319/QD-TDHYKPNT]; Sasakawa Sports Research Grant, Sasakawa Sports Foundation, Japan [190A2-004]; Stella de Silva Research grant from Sri Lanka College of Paediatricians, Sri Lanka; The DST-NRF Centre for Excellence in Human Development at the University of Witwatersrand, Johannesburg, South Africa; International Society of Behavioral Nutrition and Physical Activity, Pioneers Program (ISBNPA-2021); The University Research Coordination Office of the De La Salle University, Philippines [29 IR S 3TAY192021]; Universidad de La Frontera Research Directorate, Chile [DI20-0093, DFP19-0012, DI20-1002]; WHO European Office for Prevention and Control of Noncommunicable Diseases

Stroke can adversely affect the coordination and judgement of drivers due to executive dysfunction, which is relatively common in the post-stroke population but often undetected. Quantitatively examining vehicle control performance in post-stroke driving becomes essential to inspect whether and where post-stroke older drivers are risky. To date, it is unclear as to which indicators, such as lane keeping or speed control, can differentiate the driving performance of post-stroke older drivers from that of normal (neurotypical) older drivers. By employing a case-control design using advanced vehicle movement tracking and analysis technology, this pilot study aimed to compare the variations in driving trajectory, lane keeping and speed control between the two groups of older drivers using spatial and statistical techniques. The results showed that the mean standard deviation of lane deviation (SDLD) in post-stroke participants was higher than that of normal participants in complex driving tasks (U-turn and left turn) but almost the same in simple driving tasks (straight line sections). No statistically significant differences were found in the speed control performance. The findings indicate that, although older drivers can still drive as they need to after a stroke, the decline in cognitive abilities still imposes a higher cognitive workload and more effort for post-stroke older drivers. Future studies can investigate post-stroke adults driving behaviour at more challenging driving scenarios or design driving intervention programs to improve their executive function in driving.

Stroke can adversely affect the coordination and judgement of drivers due to executive dysfunction, which is relatively common in the post-stroke population but often undetected. Quantitatively examining vehicle control performance in post-stroke driving becomes essential to inspect whether and where post-stroke older drivers are risky. To date, it is unclear as to which indicators, such as lane keeping or speed control, can differentiate the driving performance of post-stroke older drivers from that of normal (neurotypical) older drivers. By employing a case-control design using advanced vehicle movement tracking and analysis technology, this pilot study aimed to compare the variations in driving trajectory, lane keeping and speed control between the two groups of older drivers using spatial and statistical techniques. The results showed that the mean standard deviation of lane deviation (SDLD) in post-stroke participants was higher than that of normal participants in complex driving tasks (U-turn and left turn) but almost the same in simple driving tasks (straight line sections). No statistically significant differences were found in the speed control performance. The findings indicate that, although older drivers can still drive as they need to after a stroke, the decline in cognitive abilities still imposes a higher cognitive workload and more effort for post-stroke older drivers. Future studies can investigate post-stroke adults driving behaviour at more challenging driving scenarios or design driving intervention programs to improve their executive function in driving.

Introduction 24-hour movement behaviours (physical activity, sedentary behaviour and sleep) during the early years are associated with health and developmental outcomes, prompting the WHO to develop Global guidelines for physical activity, sedentary behaviour and sleep for children under 5 years of age. Prevalence data on 24-hour movement behaviours is lacking, particularly in low-income and middle-income countries (LMICs). This paper describes the development of the SUNRISE International Study of Movement Behaviours in the Early Years protocol, designed to address this gap. Methods and analysis SUNRISE is the first international cross-sectional study that aims to determine the proportion of 3- and 4-year-old children who meet the WHO Global guidelines. The study will assess if proportions differ by gender, urban/rural location and/or socioeconomic status. Executive function, motor skills and adiposity will be assessed and potential correlates of 24-hour movement behaviours examined. Pilot research from 24 countries (14 LMICs) informed the study design and protocol. Data are collected locally by research staff from partnering institutions who are trained throughout the research process. Piloting of all measures to determine protocol acceptability and feasibility was interrupted by COVID-19 but is nearing completion. At the time of publication 41 countries are participating in the SUNRISE study. Ethics and dissemination The SUNRISE protocol has received ethics approved from the University of Wollongong, Australia, and in each country by the applicable ethics committees. Approval is also sought from any relevant government departments or organisations. The results will inform global efforts to prevent childhood obesity and ensure young children reach their health and developmental potential. Findings on the correlates of movement behaviours can guide future interventions to improve the movement behaviours in culturally specific ways. Study findings will be disseminate, Funding Agencies|American Council on Exercise, USA; Beijing Health System High Level Talents Training Project, China [2015-3-88]; Biomedical Research Foundation, Dhaka, Bangladesh [BRF-19-01]; Canadian Institutes of Health Research Frederick Banting and Charles Best Canada Graduate Scholarship (CGS-M)Canadian Institutes of Health Research (CIHR); Canadian Institutes of Health Research Planning and Dissemination GrantCanadian Institutes of Health Research (CIHR) [155265]; Civilian Research Development Foundation (CRDF) Global [OISE-20-66864-1]; Department of National Planning and Monitoring, PNG Government [02704]; Early Start, University of Wollongong, Australia; Faculty of Health Sciences at the University of the Witwatersrand, Johannesburg, South Africa; Fogarty International Center (FIC) of the National Institutes of Health [D43 TW010137]; Geran Universiti Penyelidikan (GUP), Universiti Kebangsaan Malaysia [GUP-2018-142]; Global Challenges Program, University of Wollongong, Australia [888/006/497]; Harry Crossley Foundation, South Africa; National Institute of Education-Ministry of Education, Singapore [OER 04/19 TWP]; Pham Ngoc Thach University of Medicine, Vietnam [1319/QD-TDHYKPNT]; Sasakawa Sports Research Grant, Sasakawa Sports Foundation, Japan [190A2-004]; Stella de Silva Research grant from Sri Lanka College of Paediatricians, Sri Lanka; The DST-NRF Centre for Excellence in Human Development at the University of Witwatersrand, Johannesburg, South Africa; International Society of Behavioral Nutrition and Physical Activity, Pioneers Program (ISBNPA-2021); The University Research Coordination Office of the De La Salle University, Philippines [29 IR S 3TAY192021]; Universidad de La Frontera Research Directorate, Chile [DI20-0093, DFP19-0012, DI20-1002]; WHO European Office for Prevention and Control of Noncommunicable Diseases

Stroke can adversely affect the coordination and judgement of drivers due to executive dysfunction, which is relatively common in the post-stroke population but often undetected. Quantitatively examining vehicle control performance in post-stroke driving becomes essential to inspect whether and where post-stroke older drivers are risky. To date, it is unclear as to which indicators, such as lane keeping or speed control, can differentiate the driving performance of post-stroke older drivers from that of normal (neurotypical) older drivers. By employing a case-control design using advanced vehicle movement tracking and analysis technology, this pilot study aimed to compare the variations in driving trajectory, lane keeping and speed control between the two groups of older drivers using spatial and statistical techniques. The results showed that the mean standard deviation of lane deviation (SDLD) in post-stroke participants was higher than that of normal participants in complex driving tasks (U-turn and left turn) but almost the same in simple driving tasks (straight line sections). No statistically significant differences were found in the speed control performance. The findings indicate that, although older drivers can still drive as they need to after a stroke, the decline in cognitive abilities still imposes a higher cognitive workload and more effort for post-stroke older drivers. Future studies can investigate post-stroke adults driving behaviour at more challenging driving scenarios or design driving intervention programs to improve their executive function in driving.

Introduction Driving is a complex activity involving a high level of cognitive abilities and thus might be affected after a brain injury/disease. The aim of this research was to evaluate the feasibility and construct validity of a driving simulator tool as a complement to existing driving assessments of patients with cognitive dysfunctions after a brain injury/disease. Method A descriptive and prospective research design was achieved. For construct validation, decisions were based on results from the Useful Field of View, Nordic Stroke Driver Screening Assessment, Trail Making Test and, when necessary for the decision, an on-road observation. Results from the simulator tool were not included in the clinical decision process. Results A total of 129 patients from four different rehabilitation services were included. The results showed a significant difference in test results between those who were considered medically fit versus unfit to drive. A factor analysis revealed four components, all including attention in combination with processing speed, visuospatial function, simultaneous capacity and executive function; these are all represented in the simulator tool. A correlation analysis showed that simulator subtest 3 (response/divergent response to stimuli) had the strongest correlation with most of the other tests included. Conclusions The simulator was found to be feasible and valid and found to include components other than those measured in the other tests., Funding Agencies|County Council of Ostergotland, Sweden [LIO-582071, SC-2017-00091-26]; Medical Research Council of Southeast Sweden [FORSS -605951, 654091, 755541, 850271]

Introduction 24-hour movement behaviours (physical activity, sedentary behaviour and sleep) during the early years are associated with health and developmental outcomes, prompting the WHO to develop Global guidelines for physical activity, sedentary behaviour and sleep for children under 5 years of age. Prevalence data on 24-hour movement behaviours is lacking, particularly in low-income and middle-income countries (LMICs). This paper describes the development of the SUNRISE International Study of Movement Behaviours in the Early Years protocol, designed to address this gap. Methods and analysis SUNRISE is the first international cross-sectional study that aims to determine the proportion of 3- and 4-year-old children who meet the WHO Global guidelines. The study will assess if proportions differ by gender, urban/rural location and/or socioeconomic status. Executive function, motor skills and adiposity will be assessed and potential correlates of 24-hour movement behaviours examined. Pilot research from 24 countries (14 LMICs) informed the study design and protocol. Data are collected locally by research staff from partnering institutions who are trained throughout the research process. Piloting of all measures to determine protocol acceptability and feasibility was interrupted by COVID-19 but is nearing completion. At the time of publication 41 countries are participating in the SUNRISE study. Ethics and dissemination The SUNRISE protocol has received ethics approved from the University of Wollongong, Australia, and in each country by the applicable ethics committees. Approval is also sought from any relevant government departments or organisations. The results will inform global efforts to prevent childhood obesity and ensure young children reach their health and developmental potential. Findings on the correlates of movement behaviours can guide future interventions to improve the movement behaviours in culturally specific ways. Study findings will be disseminate, Funding Agencies|American Council on Exercise, USA; Beijing Health System High Level Talents Training Project, China [2015-3-88]; Biomedical Research Foundation, Dhaka, Bangladesh [BRF-19-01]; Canadian Institutes of Health Research Frederick Banting and Charles Best Canada Graduate Scholarship (CGS-M)Canadian Institutes of Health Research (CIHR); Canadian Institutes of Health Research Planning and Dissemination GrantCanadian Institutes of Health Research (CIHR) [155265]; Civilian Research Development Foundation (CRDF) Global [OISE-20-66864-1]; Department of National Planning and Monitoring, PNG Government [02704]; Early Start, University of Wollongong, Australia; Faculty of Health Sciences at the University of the Witwatersrand, Johannesburg, South Africa; Fogarty International Center (FIC) of the National Institutes of Health [D43 TW010137]; Geran Universiti Penyelidikan (GUP), Universiti Kebangsaan Malaysia [GUP-2018-142]; Global Challenges Program, University of Wollongong, Australia [888/006/497]; Harry Crossley Foundation, South Africa; National Institute of Education-Ministry of Education, Singapore [OER 04/19 TWP]; Pham Ngoc Thach University of Medicine, Vietnam [1319/QD-TDHYKPNT]; Sasakawa Sports Research Grant, Sasakawa Sports Foundation, Japan [190A2-004]; Stella de Silva Research grant from Sri Lanka College of Paediatricians, Sri Lanka; The DST-NRF Centre for Excellence in Human Development at the University of Witwatersrand, Johannesburg, South Africa; International Society of Behavioral Nutrition and Physical Activity, Pioneers Program (ISBNPA-2021); The University Research Coordination Office of the De La Salle University, Philippines [29 IR S 3TAY192021]; Universidad de La Frontera Research Directorate, Chile [DI20-0093, DFP19-0012, DI20-1002]; WHO European Office for Prevention and Control of Noncommunicable Diseases

Stroke can adversely affect the coordination and judgement of drivers due to executive dysfunction, which is relatively common in the post-stroke population but often undetected. Quantitatively examining vehicle control performance in post-stroke driving becomes essential to inspect whether and where post-stroke older drivers are risky. To date, it is unclear as to which indicators, such as lane keeping or speed control, can differentiate the driving performance of post-stroke older drivers from that of normal (neurotypical) older drivers. By employing a case-control design using advanced vehicle movement tracking and analysis technology, this pilot study aimed to compare the variations in driving trajectory, lane keeping and speed control between the two groups of older drivers using spatial and statistical techniques. The results showed that the mean standard deviation of lane deviation (SDLD) in post-stroke participants was higher than that of normal participants in complex driving tasks (U-turn and left turn) but almost the same in simple driving tasks (straight line sections). No statistically significant differences were found in the speed control performance. The findings indicate that, although older drivers can still drive as they need to after a stroke, the decline in cognitive abilities still imposes a higher cognitive workload and more effort for post-stroke older drivers. Future studies can investigate post-stroke adults driving behaviour at more challenging driving scenarios or design driving intervention programs to improve their executive function in driving.

Introduction Driving is a complex activity involving a high level of cognitive abilities and thus might be affected after a brain injury/disease. The aim of this research was to evaluate the feasibility and construct validity of a driving simulator tool as a complement to existing driving assessments of patients with cognitive dysfunctions after a brain injury/disease. Method A descriptive and prospective research design was achieved. For construct validation, decisions were based on results from the Useful Field of View, Nordic Stroke Driver Screening Assessment, Trail Making Test and, when necessary for the decision, an on-road observation. Results from the simulator tool were not included in the clinical decision process. Results A total of 129 patients from four different rehabilitation services were included. The results showed a significant difference in test results between those who were considered medically fit versus unfit to drive. A factor analysis revealed four components, all including attention in combination with processing speed, visuospatial function, simultaneous capacity and executive function; these are all represented in the simulator tool. A correlation analysis showed that simulator subtest 3 (response/divergent response to stimuli) had the strongest correlation with most of the other tests included. Conclusions The simulator was found to be feasible and valid and found to include components other than those measured in the other tests., Funding Agencies|County Council of Ostergotland, Sweden [LIO-582071, SC-2017-00091-26]; Medical Research Council of Southeast Sweden [FORSS -605951, 654091, 755541, 850271]

Introduction 24-hour movement behaviours (physical activity, sedentary behaviour and sleep) during the early years are associated with health and developmental outcomes, prompting the WHO to develop Global guidelines for physical activity, sedentary behaviour and sleep for children under 5 years of age. Prevalence data on 24-hour movement behaviours is lacking, particularly in low-income and middle-income countries (LMICs). This paper describes the development of the SUNRISE International Study of Movement Behaviours in the Early Years protocol, designed to address this gap. Methods and analysis SUNRISE is the first international cross-sectional study that aims to determine the proportion of 3- and 4-year-old children who meet the WHO Global guidelines. The study will assess if proportions differ by gender, urban/rural location and/or socioeconomic status. Executive function, motor skills and adiposity will be assessed and potential correlates of 24-hour movement behaviours examined. Pilot research from 24 countries (14 LMICs) informed the study design and protocol. Data are collected locally by research staff from partnering institutions who are trained throughout the research process. Piloting of all measures to determine protocol acceptability and feasibility was interrupted by COVID-19 but is nearing completion. At the time of publication 41 countries are participating in the SUNRISE study. Ethics and dissemination The SUNRISE protocol has received ethics approved from the University of Wollongong, Australia, and in each country by the applicable ethics committees. Approval is also sought from any relevant government departments or organisations. The results will inform global efforts to prevent childhood obesity and ensure young children reach their health and developmental potential. Findings on the correlates of movement behaviours can guide future interventions to improve the movement behaviours in culturally specific ways. Study findings will be disseminate, Funding Agencies|American Council on Exercise, USA; Beijing Health System High Level Talents Training Project, China [2015-3-88]; Biomedical Research Foundation, Dhaka, Bangladesh [BRF-19-01]; Canadian Institutes of Health Research Frederick Banting and Charles Best Canada Graduate Scholarship (CGS-M)Canadian Institutes of Health Research (CIHR); Canadian Institutes of Health Research Planning and Dissemination GrantCanadian Institutes of Health Research (CIHR) [155265]; Civilian Research Development Foundation (CRDF) Global [OISE-20-66864-1]; Department of National Planning and Monitoring, PNG Government [02704]; Early Start, University of Wollongong, Australia; Faculty of Health Sciences at the University of the Witwatersrand, Johannesburg, South Africa; Fogarty International Center (FIC) of the National Institutes of Health [D43 TW010137]; Geran Universiti Penyelidikan (GUP), Universiti Kebangsaan Malaysia [GUP-2018-142]; Global Challenges Program, University of Wollongong, Australia [888/006/497]; Harry Crossley Foundation, South Africa; National Institute of Education-Ministry of Education, Singapore [OER 04/19 TWP]; Pham Ngoc Thach University of Medicine, Vietnam [1319/QD-TDHYKPNT]; Sasakawa Sports Research Grant, Sasakawa Sports Foundation, Japan [190A2-004]; Stella de Silva Research grant from Sri Lanka College of Paediatricians, Sri Lanka; The DST-NRF Centre for Excellence in Human Development at the University of Witwatersrand, Johannesburg, South Africa; International Society of Behavioral Nutrition and Physical Activity, Pioneers Program (ISBNPA-2021); The University Research Coordination Office of the De La Salle University, Philippines [29 IR S 3TAY192021]; Universidad de La Frontera Research Directorate, Chile [DI20-0093, DFP19-0012, DI20-1002]; WHO European Office for Prevention and Control of Noncommunicable Diseases