White coat syndrome and its variations: differences and clinical impact

Pioli, Mariana Rodrigues; Ritter, Alessandra Mileni Versuti; Faria, Ana Paula de; Modolo, Rodrigo

doi:10.2147/ibpc.s152761

Cited by 82 publications

(60 citation statements)

References 53 publications

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“…Our study has several limitations that should be considered. Similar to the white coat syndrome [18], activity monitoring might be affected by the Hawthorne effect (i.e., an alteration of behavior due to the awareness of being observed) [21]. This effect is problematic if one is interested in the average daily activity, but unlikely to bias the estimated progression rate.…”

Section: Discussionmentioning

confidence: 99%

Accelerometry for remote monitoring of physical activity in amyotrophic lateral sclerosis: a longitudinal cohort study

et al. 2019

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BackgroundThe extensive heterogeneity between patients with amyotrophic lateral sclerosis (ALS) complicates the quantification of disease progression. In this study, we determine the value of remote, accelerometer-based monitoring of physical activity in patients with ALS.MethodsThis longitudinal cohort study was conducted in a home-based setting; all study materials were sent by mail. Patients wore the ActiGraph during waking hours for 7 days every 2–3 months and provided information regarding their daily functioning (ALSFRS-R). We defined four accelerometer-based endpoints that either reflect the average daily activity or quantify the patient’s physical capacity.ResultsA total of 42 patients participated; the total valid monitoring period was 9288 h with a 93.0% adherence rate. At baseline, patients were active 27.9% (range 11.6–52.4%) of their time; this declined by 0.64% (95% 0.43–0.86, p < 0.001) per month. Accelerometer-based endpoints were strongly associated with the ALSFRS-R (r 0.78, 95% CI 0.63–0.92, p < 0.001), but showed less variability over time than the ALSFRS-R (coefficient of variation 0.64–0.81 vs. 1.06, respectively). Accelerometer-based endpoints could reduce sample size by 30.3% for 12-month trials and 44.6% for 18-month trials; for trials lasting less than 9 months, the ALSFRS-R resulted in smaller sample sizes.ConclusionAccelerometry is an objective method for quantifying disease progression, which could obtain real-world insights in the patient’s physical functioning and may personalize the delivery of care. In addition, remote monitoring provides patients with the opportunity to participate in clinical trials from home, paving the way to a patient-centric clinical trial model.

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Section: Discussionmentioning

confidence: 99%

Accelerometry for remote monitoring of physical activity in amyotrophic lateral sclerosis: a longitudinal cohort study

et al. 2019

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“…Moreover, follow‐up in nutritional interventions commonly did not employ blinding, once foodstuffs differ from pills. It is therefore important to mention that the lack of blinding is a confounding factor that has not been controlled, which may positively affect the measurement of BP by an individual believe that dietary intervention will improve this parameter or adversely affect BP simply due to the popular white coat syndrome (Pioli, Ritter, de Faria, & Modolo, 2018).…”

Section: Discussionmentioning

confidence: 99%

Effects of walnut intake on blood pressure: A systematic review and meta‐analysis of randomized controlled trials

Jiang

Santos

et al. 2020

Phytotherapy Research

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The impact of walnuts on blood pressure (BP) is not a well-established fact. Although several studies have assessed the effects of walnut consumption on BP, results are conflicting. Thus, we examined the effects of walnut doses and length of supplementation on BP. Biomedical databases were searched for published trials that compared walnutenhanced diet to control diet. Eighteen trials met eligibility criteria (n = 1,799). Overall, walnut consumption neither did alter SBP (weighted mean difference [WMD]: 0.08 mmHg; 95% CI: −0.69, 0.85) nor DBP (WMD: 0.08 CI: −0.26, 0.42). In subgroup analyses, walnut ingestion ≤40 g was statistically correlated with reduction in SBP (WMD: −0.53 mmHg, 95% CI: −0.79, −0.26) and DBP (WMD: −0.191 mmHg, 95% CI: −0.384, −0.034). Moreover, the length of intervention ≥8 weeks was linked to a significant reduction in SBP (WMD: −1.18 mmHg, 95% CI: −1.30, −1.06). Following dose-response evaluation, walnut intake significantly changed SBP (p = .015) and DBP (p = .026) through a nonlinear fashion at walnut dose up to 40 g/d. Nevertheless, these statistical results cannot be translated into clinical practice, once the changes expressed as WMD are slight taking into consideration the absolute values of BP categories. In conclusion, this metaanalysis does not support walnut consumption as a BP-lowering strategy. K E Y W O R D S blood pressure, cardiovascular risk, diastolic blood pressure, meta-analysis, systolic blood pressure, walnut 1 | INTRODUCTION Hypertension or high blood pressure (BP) is a key modifiable risk factor for cardiovascular diseases (CVD), hence being the main cause of global morbidity and mortality (Bochud, Marques-Vidal, Burnier, &

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“…The researcher, however, needs to be aware of the white coat syndrome in connection with this measure. If the participant self‐reports this syndrome, or if their blood pressure is suspiciously high, it is worth doing a few rounds of measures to see if there is a considerable drop in blood pressure after a few tries (Pioli, Ritter, de Faria, & Modolo, 2018). At the same time, in our experience, many participants are happy to know their blood pressure and are very eager to discuss their results with the researcher.…”

Section: Establishing Biomarkersmentioning

confidence: 99%

The coming of age: How do linguists tease apart chronological, biological and social age?

Hejná

Jespersen

2021

Language and Linguist. Compass

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Age is one of the key variables in the field of language variation and change (LVC). The vast majority of experimental work generally views a speaker's date of birth—chronological age—as a good reflection of both their social age, for example, which generation they identify with and how strongly and their biological age, that is, the physiological age of their body. This paper aims to provide the reader with tools to tease apart these three ways of conceptualising the variable of age. It reviews qualitative and quantitative methods from fields adjacent to LVC that will enable linguists of different theoretical interests to tap into biological and social aspects of ageing. In doing so, it provides a practical manual for linguists wishing to work from a more multifaceted understanding of one of the key variables in many linguistic subfields.

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White coat syndrome and its variations: differences and clinical impact

Cited by 82 publications

References 53 publications

Accelerometry for remote monitoring of physical activity in amyotrophic lateral sclerosis: a longitudinal cohort study

Accelerometry for remote monitoring of physical activity in amyotrophic lateral sclerosis: a longitudinal cohort study

Effects of walnut intake on blood pressure: A systematic review and meta‐analysis of randomized controlled trials

The coming of age: How do linguists tease apart chronological, biological and social age?

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