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The article presents the author's views on the diagnosis of gestational diabetes mellitus (GDM) in the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study. They opine that clarification of the risk of adverse outcomes associated with maternal glucose intolerance is the aim of the HAPO study. They comment that consensus among experts about the diagnosis of GDM remains elusive despite reviewing the same scientific evidence.

OBJECTIVE: To determine whether HLA-B27 misfolding and the unfolded protein response (UPR) result in cytokine dysregulation and whether this is associated with Th1 and/or Th17 activation in HLA-B27/human beta(2)-microglobulin (Hubeta(2)m)-transgenic rats, an animal model of spondylarthritis. METHODS: Cytokine expression in lipopolysaccharide (LPS)-stimulated macrophages was analyzed in the presence and absence of a UPR induced by chemical agents or by HLA-B27 up-regulation. Cytokine expression in colon tissue and in cells purified from the lamina propria was determined by real-time reverse transcription-polymerase chain reaction analysis, and differences in Th1 and Th17 CD4+ T cell populations were quantified after intracellular cytokine staining. RESULTS: Interleukin-23 (IL-23) was found to be synergistically up-regulated by LPS in macrophages undergoing a UPR induced by pharmacologic agents or by HLA-B27 misfolding. IL-23 was also increased in the colon tissue from B27/Hubeta(2)m-transgenic rats concurrently with the development of intestinal inflammation, and IL-17, a downstream target of IL-23, exhibited robust up-regulation in a similar temporal pattern. IL-23 and IL-17 transcripts were localized to CD11+ antigen-presenting cells and CD4+ T cells, respectively, from the colonic lamina propria. Colitis was associated with a 6-fold expansion of CD4+ IL-17-expressing T cells. CONCLUSION: The IL-23/IL-17 axis is strongly activated in the colon of B27/Hubeta(2)m-transgenic rats with spondylarthritis-like disease. HLA-B27 misfolding and UPR activation in macrophages can result in enhanced induction of the pro-Th17 cytokine IL-23. These results suggest a possible link between HLA-B27 misfolding and immune dysregulation in this animal model, with implications for human disease. [ABSTRACT FROM AUTHOR]

OBJECTIVE: HLA-B27 is implicated in the pathogenesis of spondylarthritis (SpA), yet the molecular mechanisms are incompletely defined. HLA-B27 misfolding has been associated with endoplasmic reticulum stress and activation of the unfolded protein response (UPR) in macrophages from HLA-B27/human beta(2)-microglobulin-transgenic (B27-transgenic) rats. This study was performed to assess the mechanisms that drive activation of the HLA-B27-induced UPR and to determine whether splenocytes respond in a similar manner. METHODS: Splenocytes were isolated and bone marrow macrophages were derived from B27-transgenic and wild-type rats. Cells were treated for up to 24 hours with cytokines that induce class I major histocompatibility complex expression. HLA-B27 expression and misfolding were assessed by real-time reverse transcription-polymerase chain reaction, flow cytometry, and immunoblotting. Activation of the UPR was measured by quantifying UPR target gene expression and X-box binding protein 1 messenger RNA (mRNA) splicing. RESULTS: HLA-B27 mRNA up-regulation was accompanied by a dramatic increase in the accumulation of misfolded heavy chains and preceded robust activation of the UPR in macrophages. When macrophages were treated with various cytokines, the magnitude of the UPR correlated strongly with the degree of HLA-B27 up-regulation. In contrast, B27-transgenic splenocytes exhibited only low-level differences in the expression of UPR target genes after exposure to interferon-gamma or concanavalin A, which resulted in minimal HLA-B27 up-regulation. CONCLUSION: These results suggest that HLA-B27-associated activation of the UPR in macrophages is attributable to the accumulation of misfolded heavy chains, and that certain cell types may be more susceptible to the effects of HLA-B27 misfolding. Strategies that eliminate HLA-B27 up-regulation and/or the accumulation of misfolded heavy chains may be useful in evaluating the role of these events in the pathogenesis of SpA. [ABSTRACT FROM AUTHOR]

This study examined the relationship between three midlife transitions and depressive symptoms among 952 women 50 to 59 years of age. Using longitudinal data from women interviewed for the 1992 and 2000 Health and Retirement Study, the study described changes in marital status, change to a parental caregiving role, and changes in perceived health across the eight years. Further, it examined the impact of these changes on mental health. The findings indicate that becoming widowed, becoming a caregiver, and perceiving health declines significantly increased depressive symptoms in the year 2000, even when controlling for pre-transition levels of depressive symptoms. The findings are consistent with the lifecourse perspective that individual development occurs in context and across the lifespan. The findings confirm and add to current midlife research literature. [ABSTRACT FROM AUTHOR]

We studied the effects of age and gender on cardiovascular responses to beta-adrenergic stimulation with the use of two-dimensional echocardiography in 16 young (aged 20-31) and 20 older (aged 60-75) healthy individuals. Following administration of atropine, each subject was given an infusion of isoproterenol at incremental doses from 0.010 to 0.030 microgram kg-1 min-1. The slopes of the fractional shortening-end-systolic wall stress (FS-sigma es) relationships were steeper in the young men (-0.87 +/- 0.28, n = 8) compared to the older men (-0.41 +/- 0.13, n = 10), and in the young women (-0.55 +/- 0.14, n = 8) compared to the older women (-0.38 +/- 0.13, n = 10). Furthermore, the magnitude of the age-associated differences in these slopes was larger in the men (old vs young) than in the women (old vs young) which, in the absence of changes in preload, suggests a greater decline in the contractile response to isoproterenol with advancing age in men compared to women. Furthermore, the men exhibited a greater attenuation of chronotropic response to isoproterenol than did the women. These observations suggest that gender plays a significant role in the age-associated decline in inotropic and chronotropic responses to beta-adrenergic stimulation, with men exhibiting a greater decline with aging than women. [ABSTRACT FROM AUTHOR]

Helping professionals working with people who have experienced trauma are at risk of developing psychological distress. To date, most studies exploring psychological distress among helping professionals have focused on risk factors associated with the development of adverse reactions to secondary trauma, and few have identified strengths or protective factors, which may buffer and/or alleviate distress. Therefore, this scoping review uses the Resilience Portfolio Model (Grych et al., 2015) to synthesize literature on individual and environmental strengths, which may mitigate adverse reactions to secondary trauma in helping professionals. Utilizing the CINAHL, PsycArticles, PsycInfo, and MEDLINE databases, 43 articles published between 1990 and May 2023 from over 20 countries were identified. The findings suggest that professionals draw upon a portfolio of meaning-making, regulatory, interpersonal, and ecological strengths to increase their protective resources. Most studies identified were quantitative, and usually explored organizational factors, such as supervision. Further empirical investigations could help identify individual strengths that could be targeted within interventions to protect professionals against the impact of secondary traumatic stress. Additionally, more research is needed to investigate the interconnectedness of individual, organizational, and systemic factors that buffer helping professionals from the deleterious effects of trauma work., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Collective violence-such as armed conflict, state-sponsored violence, and terrorism-represents a profound form of trauma, which can harm individuals, communities, and societies. Existing research has largely examined risk factors and negative psychosocial outcomes from collective violence, neglecting the potential for survivors to draw upon a range of strengths that may allow them to perceive benefits from their experiences, known as posttraumatic growth (PTG). This scoping review uses the resilience portfolio model to highlight a potential portfolio of meaning-making, regulatory, and interpersonal-ecological strength-based resources and assets that are conducive to perceived PTG (PPTG) and possible better functioning following collective violence. The present review identified 52 papers from CINAHL, MEDLINE, PsycArticles, and PsychInfo, spanning from January 1995 to May 2023, which specifically focused on strengths and PTG in populations who reside (or had resided) in over 20 countries. This review highlights individual- and group-level meaning making, regulatory, and interpersonal strengths used by survivors in both individualistic and collectivist societies, providing a more comprehensive understanding of resilience and PPTG after collective violence. Some strengths, such as religious coping, positive reappraisal, and social support, demonstrated mixed relations with PPTG. The research also identified previously uncategorized ecological/systemic supports for PPTG such as political climate, access to education, and sanitation infrastructure, which require more research. The findings call for culturally sensitive approaches that recognize and promote individual and community efforts to enhance well-being among populations disproportionately affected by collective violence., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Until recently, research examining the application of Rational Emotive Behavior Therapy (REBT) in sports settings was virtually absent in South Africa. Despite the growing evidence of REBT's potential as a psychological intervention in Western nations, its use within the multicultural and sports-fervent context of South Africa remains unexplored. Moreover, limited research has addressed the impact of REBT on rugby players, with only a few case studies being reported. The current experiment employs a cluster randomized trial (CRT) to compare the effects of a 7-week preferential REBT program with a 7-week Mindfulness-Acceptance-Commitment (MAC) program on irrational beliefs, competitive anxiety and subjective performance, among adolescent South African rugby players. We also include a wait-list control group who received neither REBT nor MAC. Results indicate that athletes receiving REBT reported greater improvements in irrational beliefs, anxiety, and subjective performance, while that athletes receiving MAC also reported some improvements in anxiety. This study highlights the potential of REBT as a valuable psychological intervention in the context of South African adolescent rugby players., Competing Interests: Declaration of competing interest “A cluster randomized trial of a v-emotive behavior therapy program and a mindfulness-acceptance-commitment program, with South African adolescent rugby players," The aforementioned authors affirm that we tried to adhere to the highest ethical standards and scientific integrity when conducting and writing about this research. We affirm that the results presented in this manuscript are based solely on the data collected and analyzed during the course of the study, and they are reported with objectivity and impartiality., (Copyright © 2024. Published by Elsevier Ltd.)

Background and Objectives: Examination anxiety is a common occurrence, and is potentially detrimental to student attainment. In recent theorizing, it has been suggested that cognitive appraisals, as put forth in cognitive appraisal theory, and irrational beliefs, as put forth in rational emotive behavior therapy, may interact to predict affectivity. The current research examines the antecedents and associates of examination affect and academic self-concept in undergraduate students., Design: A preliminary study applied confirmatory factor analysis (CFA) to test the factor structure of an irrational beliefs inventory. Study 1 utilized a cross-sectional and correlational approach to testing core theoretical assumptions. Study 2 took a two-wave longitudinal and path analytical approach to examine temporal effects between target variables., Method: All self-report data collection took place in the United Kingdom with university students. We recruited n  = 1150, n  = 362, n  = 662 for preliminary, study 1, and study 2, respectively., Results: Across studies, data indicated that a pattern of adaptive cognitive appraisal was associated with more advantageous affectivity, and better academic self-concept., Conclusions: Reciprocal temporal relationships were revealed between many variables, supporting an interactive and bidirectional view of how cognition and affect are related pertaining to examination anxiety.

The Cognitive Mediation Beliefs Questionnaire is a 15-item tool that assesses individuals' emotion beliefs about the cognitive mediation of emotions. It measures two emotion beliefs: stimulus-response generation beliefs and cognitive mediation change beliefs. This study aimed to reduce the number of items and test the validity of a briefer version of the Cognitive Mediation Beliefs Questionnaire. We combined data from 13 unpublished data sets collected between 2019 and 2023 and reached a final sample of 2,872 participants. While this data set is relatively large and diverse (e.g., participants from 53 nationalities), most were from developed countries, and the data were not fully representative across demographic characteristics, such as age and ethnicity. The data were randomly split by 50%/25%/25% (60%/40% female/male) to conduct one exploratory factor analysis and two confirmatory factor analyses. Using an iterative process in the exploratory factor analysis, seven items were deleted for failing to meet item retention criteria, resulting in an eight-item solution across two factors. Across two confirmatory factor analyses with independent samples, the eight-item and the 15-item solutions were tested. The eight-item model was superior in terms of model fit in both samples. These results were in line with our hypothesis in that an eight-item Short Cognitive Mediation Beliefs Questionnaire confirmed the validity of the two-factor structure. The present study offers a valid and efficient measure of emotion beliefs that can be used to make a rapid assessment of beliefs about emotions and to support clinical interventions, particularly cognitive behavioral therapy approaches, where cognitive change is fundamental. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Determine whether urine biomarkers NGAL (neutrophil gelatinase-associated lipocalin), KIM-1 (kidney injury molecule 1) and IL-18 (interleukin-18) are associated with abnormal MRI findings in neonates with hypoxic-ischemic encephalopathy (HIE) who underwent therapeutic hypothermia (TH)., Study Design: Secondary analysis of a multicenter, prospective study of neonates with HIE requiring TH. Urine biomarkers were obtained at 12 and 24 h of life (HOL). Brain MRI was scored per NICHD criteria. Association between biomarkers and MRI stage was determined., Results: In 57 neonates with HIE, only IL-18 at 24 HOL was significantly increased in neonates with MRI Stage 2B or greater, compared to Stage 2A or less (mean 398.7 vs. 182.9 pg/mL, p = 0.024.) A multivariate model including IL-18 at 24 HOL and 5-min Apgar performed best, with an AUC of 0.84 (SE = 0.07, p = 0.02)., Conclusions: Elevated urine IL-18 at 24 HOL was associated with more severe brain MRI abnormalities among neonates with HIE., (© 2024. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Against the backdrop of the COVID-19 pandemic, workplace wellbeing is a key priority for employers. Severe market and health conditions continue to bring inevitable problems that could be reduced with the application of psychological interventions to prevent mental and physical health issues, making this study a highly pertinent and valuable contribution to the field. This paper reports the effects of a rational emotive behaviour therapy (REBT) programme on the irrational beliefs and emotional reactivity of 56 office-based sales professionals located in the northwest region of the UK. A pre-test, post-test experimental design was utilised, and a mixed model ANOVA (repeated measures) was adopted to assess changes in mean differences concerning irrational beliefs and emotional reactivity at pre and post-test stages for the intervention group, in comparison to a control group. Results indicate that those in the REBT group reported significant reductions in irrational beliefs and emotional reactivity, whilst those in the control group reported no such changes. It is recommended that future research studies consider utilizing a mixed methods design and focus on a strategic collaboration of organisational and individual level interventions for improving the psychological wellbeing and performance of sales personnel., (© 2024 The Authors. Stress and Health published by John Wiley & Sons Ltd.)

Atopic dermatitis results in diminished barrier function and altered production of antimicrobial peptides. Dendritic epidermal T cells (DETCs) play an important role in the wound repair and inflammation process. Our previous work identified an IL-4-dependent loss of DETCs in Stat6VT mice and in the MC903-induced skin inflammation mouse model. However, the mechanisms through which IL-4 mediates the loss of DETCs are unclear. In this study, we show that IL-4Rα germline knockout mice (Il4ra-/-) have increased DETCs, faster wound healing, and increased epidermal differentiation complex gene and fibronectin expression. The absence of IL-4Rα minimized the MC903-induced loss of DETCs, and reciprocal bone marrow chimera experiments in Il4ra-/- and wild-type mice demonstrated structural nonhematopoietic IL-4-responsive cell-mediated DETC homeostasis. Skin keratinocyte-derived IL-15 decreased dramatically in the MC903 model, while injection of IL-15 rescued DETC loss by promoting DETC proliferation and limiting apoptosis. Conditional deletion of IL-4Rα from keratinocytes using Il4rafl/fl K14-Cre mice showed an increase of DETCs, increased IL-15 production, and diminished skin inflammation following wounding. These results suggest that IL-4-dependent effects on DETCs in allergic skin inflammation are mediated by the IL-4Rα receptor of keratinocytes., (Copyright © 2024 by The American Association of Immunologists, Inc.)

In the absence of a single comprehensive systematic review of Rational Emotive Behaviour Therapy interventions across all settings, we reviewed the methodological quality, effectiveness and efficacy of Rational Emotive Behaviour Therapy interventions on irrational/rational beliefs. We explored the impact of Rational Emotive Behaviour Therapy on wider outcomes (e.g., mental health) and identified the characteristics of successful interventions. PsycARTICLES, PsycINFO, Scopus, SPORTDiscus, and PubMed were systematically searched up to December 2023 with 162 Rational Emotive Behaviour Therapy intervention studies identified which included a validated measure of irrational/rational beliefs. Where possible, effect size for irrational/rational belief change was reported and data was analysed through a qualitative approach. Using the Mixed Methods Appraisal tool, methodological quality within the Sport and Exercise domain was assessed as good, whilst all other domains were considered low in quality, with insufficient detail provided on intervention characteristics and delivery. Most studies were conducted in the United States, within the Education domain, and assessed irrational beliefs in non-clinical adult samples. Overall, studies reported significant reductions in irrational beliefs, increases in rational beliefs and improvements in mental health outcomes (e.g., depression). More successful interventions were delivered by trained Rational Emotive Behaviour Therapy practitioners, adopted the ABC framework and were longer in duration. We highlight the importance of designing and conducting rigorous future Rational Emotive Behaviour Therapy research to generate clearer insights as to its impact on irrational/rational beliefs and mental health outcomes., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 King et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Researchers have intimated that cognitions and emotions can change in the lead up to important events. However, previous research has adopted atemporal cross-sectional designs, making it challenging to understand how cognitions and emotions unfold in the lead up to a competition. In the current study, we extended previous research by examining the temporal patterns of cognitive appraisals, irrational beliefs, and challenge and threat evaluations in predicting pre-competitive affective states (hedonic balance and anxiety) in the lead up to an actual competition, among competitive elite Indian golfers (N = 107). We adopted a within-subjects repeated-measures design and collected data in the lead up to an actual golf tournament, at three timepoints; 1 week before (T1), the night before (T2), and an hour prior (T3). Self-reported measures of cognitive appraisals, irrational beliefs, challenge and threat evaluations, affect, and anxiety were completed. Also, objective golf performance was collected from participants. Crossed-lagged path analysis did not find a causal effect for irrational beliefs on any of the variables across the three time points. On the other hand, hierarchical multiple regression analysis determined that changes in irrational beliefs predicted changes in cognitive appraisals, threat evaluation, cognitive and somatic anxiety, and the directional interpretation of anxiety. The findings of temporal patterns in the current research indicated that sport psychologists should consider the dynamic nature of antecedent cognitions and affective states in the lead up to competition, and accordingly provide adequate support to the athletes. Further, limitations and future research is discussed with reference to the results., (© 2023 The Authors. Stress and Health published by John Wiley & Sons Ltd.)

Background: Diabetic foot syndrome is defined as the presence of a diabetic foot ulcer (DFU) associated with neuropathy, peripheral artery disease and infection. While the use of antimicrobials in the treatment of DFU infection remains a mainstay, the choice of antimicrobial remains problematic owing to the presence of multidrug-resistant polymicrobial infections. In the South African public healthcare sector, the treatment of DFUs is based on the Standard Treatment Guidelines (STGs) and the Essential Drug List. These guidelines are developed using evidence-based medicine and are based on global susceptibility patterns rather than local susceptibility data, and may not provide the most appropriate treatment options., Objectives: To determine the antimicrobial susceptibility patterns of DFUs isolated from patients visiting selected Gauteng provincial public hospitals in order to determine a clinically effective treatment protocol for the management of these infections., Methods: Sample swabs were taken from 51 DFUs using the Levine method. Each sample swab was spread onto blood agar plates, and thereafter individual pathogens were isolated. The antimicrobial susceptibility patterns of all isolated pathogens were determined using zone of inhibition measurements. Pathogens were grouped according to macromorphological characteristics as well as susceptibility patterns, and a representative isolate from each group was then identified., Results: A total of 51 DFU ulcer swabs from 45 patients were included in the study. From the sample swabs, a total of 445 pathogens were isolated. The most effective antimicrobial was found to be gentamicin, followed by ciprofloxacin. Amoxicillin/clavulanic acid, the first-line treatment according to the STGs, was found to be ineffective for many of the isolated pathogens. The most commonly isolated pathogens were Proteus mirabilis, Enterococcus faecalis and Pseudomonas aeruginosa., Conclusion: These findings demonstrate the urgent need to reassess the STGs and base treatment plans on local epidemiological data. This study provides valuable data on common causative pathogens in DFU infections, as well as the resistance patterns of these pathogens, forming a baseline on which to base future DFU treatment plans.

Background: Latine communities in the United States have been disproportionately affected by COVID-19. It is critical to gain a better understanding of the sociocultural determinants that challenge and facilitate COVID-19 testing, vaccination, and booster uptake within these vulnerable communities to inform culturally congruent strategies and interventions., Methods: In summer 2022, our community-based participatory research partnership conducted 30 key informant interviews and 7 focus groups with 64 Spanish-speaking Latine participants in North Carolina. Interviewees consisted of representatives from health and service organizations, most of whom were engaged with direct service to Spanish speakers. Interviews were conducted in either English or Spanish, depending on the preference of the participant; all focus groups were conducted in Spanish. Interviews and focus groups were conducted in person or by videoconference., Results: Twenty themes emerged that we organize into four domains: general perceptions about COVID-19; barriers to COVID-19 testing, vaccination, and booster uptake; facilitators to COVID-19 testing, vaccination, and booster uptake; and recommendations to promote testing, vaccination, and booster uptake., Discussion: Results underscore important sociocultural determinants of ongoing COVID-19 testing, vaccination, and booster uptake to consider in developing interventions for Spanish-speaking Latines in the United States. Based on this formative work, our partnership developed Nuestra Comunidad Saludable (Our Healthy Community). We are implementing the intervention to test whether trained peer navigators can increase COVID-19 testing, vaccination, and booster uptake among Spanish-speaking Latines through blending in-person interactions and mHealth (mobile health) strategies using social media., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Tanner et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Emotion regulation through cognitive reappraisal is well-studied, but less so are the predispositional and superordinate beliefs that influence reappraisal. Recently, researchers developed the cognitive mediation beliefs questionnaire (CMBQ), which measures two emotion beliefs, namely stimulus-response (S-R) generation beliefs and cognitive mediation (C-M) change beliefs. In working populations S-R generation beliefs are inversely related to cognitive reappraisal tendencies and positive mental health, and positively related to emotion reactivity. C-M change beliefs are positively related to cognitive reappraisal tendencies, and inversely related to emotion reactivity and positive mental health. As yet, there is no evidence for the validity of the CMBQ within student samples, or for the associations between its subscales and cognitive reappraisal, emotion reactivity, and positive mental health. Therefore, in the present study the CMBQ is tested for factorial, convergent (associations with cognitive reappraisal), and concurrent (associations with emotion reactivity and positive mental health) validity in a cohort of 621 undergraduate students in the United Kingdom (U.K.). Results indicate support for the factorial and convergent validity of the CMBQ, with mixed evidence for the concurrent validity of the CMBQ. A CM-SR discrepancy score appeared to provide a promising variable when associated with emotion reactivity and positive mental health. The findings are discussed in terms of practical and research implications of the findings., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Turner et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: In the current study, we conducted a comparative analysis involving three distinct groups: one receiving group-based rational emotive behavior therapy (REBT), another undergoing a mindfulness-based intervention (MBI), and a third group serving as the control. The aim of the study was to explore the effectiveness of the two interventions on specific psychological (competitive anxiety, perfectionism, irrational beliefs), physiological (salivary cortisol levels), and neurocognitive (executive functions: working memory, inhibition, cognitive flexibility) functions in Hungarian junior ice hockey players., Methods: The participants consisted of 10 females and 36 males (N REBT =12, N MINDFULNESS =14, N CONTROL =20). We used questionnaires to assess competitive anxiety, perfectionism, and irrational beliefs. The components of executive functions were measured using a computerized testing system, while cortisol levels were examined through salivary samples. Prior to and after the interventions, each participant underwent all measurements, after which we conducted repeated measures ANOVA on our data., Results: We found REBT to be an effective intervention for the regulation of competitive anxiety, perfectionism, and irrational beliefs as well as for improving some components of executive functions (inhibition and cognitive flexibility). Mindfulness was found to improve athletes' processing speed and set-shifting abilities, which are related to cognitive flexibility and metacognitive processes., Conclusion: In conclusion, we explore implications of these findings regarding how each approach is posited to enhance sports performance, using neurocognitive functions as a proxy. These findings are useful for further research and practical implications., (© 2023. The Author(s).)

At the start of the 20th century, cesarean section (CS) was uncommon in obstetrics. By the end of the century, CS rates had increased dramatically worldwide. Although the explanation for the increase is multifactorial, a major driver in the ongoing escalation is the increase in women who are delivered by repeat CS. This is due, in part, to the fact that there has been a sharp fall in vaginal birth after CS (VBAC) rates as fewer women are offered a trial of labor after CS (TOLAC), due principally to fears of a catastrophic intrapartum uterine rupture. This paper reviewed international VBAC policies and trends. A number of themes emerged. The risk of intrapartum rupture and its associated complications is low and may sometimes be overestimated. Individual maternity hospitals in both developed and developing countries are inadequately resourced to safely supervise a TOLAC. Efforts to mitigate the risks of TOLAC by careful patient selection and good clinical practices may be underutilized. Given the serious short-term and long-term consequences of rising CS rates for women and for maternity services generally, a review of TOLAC policies worldwide should be prioritized and consideration given to convening a Global Consensus Development Conference on Delivery after CS., (© 2023 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.)