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BACKGROUND: While some individuals engage in recreational pornography use (PU), others may develop an uncontrolled pattern of use termed problematic pornography use (PPU). PPU is characterized by persistent, excessive, or compulsive engagement with pornographic content, despite distress and adverse consequences. Impulsivity has been identified as a factor associated with PU and PPU. AIM: The present meta-analysis aims to sum up the existing research on the relationship between impulsivity and PU/PPU and investigate whether age and gender could moderate this relationship. METHODS: A keyword-based systematic literature search was performed to identify articles that assessed PU/PPU and impulsivity. Extracted correlations were converted into Fisher's Z. Meta-regression analyses were also performed. Publication bias was assessed by Egger's regression intercept. OUTCOMES: Outcomes included general impulsivity and its dimensions (ie, negative and positive urgency, lack of premeditation and perseverance), sensation seeking, PU, and PPU. RESULTS: Meta-analytic results of the random effects model showed a significant positive correlation between impulsivity as total score and PU (n = 1504, k = 4, Fisher's Z = 0.21, P < .001) and PPU (n = 20174, k = 13, Fisher's Z = 0.17, P < .001). Significant and positive associations were also found between sensation seeking and PU (n = 11707, k = 11, Fisher's Z = 0.14, P < .001) and PPU (n = 20152, k = 9, Fisher's Z = 0.06, P < .001). Concerning the relationship between PPU and different dimensions of impulsivity, almost all the associations were significant and positive. The dimension of positive urgency and attentional and nonplanning impulsivity showed the strongest association. Age (ß = -0.50, Q = 101.26, df = 11, P < .001) and gender (female = 1; ß = -0.46, Q = 102.54, df = 12, P < .001) moderated the association between general impulsivity and PPU. No risk of publication bias emerged. CLINICAL IMPLICATIONS: Prevention programs of PPU should focus on impulsivity and certain key dimensions (eg, positive urgency, attentional and nonplanning impulsivity) and be tailored to individual impulsivity profiles, considering age and gender differences. STRENGTHS AND LIMITATIONS: The primary strength of this meta-analysis is that it considers various conceptualizations of impulsivity. However, the results are to be interpreted with caution since >30% of relevant studies had to be excluded because information could not be gathered from the study authors. CONCLUSION: These results suggest that general impulsivity is linked to PU and PPU and that specific dimensions of impulsivity (ie, attentional impulsivity, nonplanning impulsivity, and positive urgency) can serve as risk factors for PPU.

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Praise is thought to affect children's responses to failure, yet other potentially impactful messages about effort have been rarely studied. We experimentally investigated the effects of praise and "easy" feedback after success on children's persistence and self-evaluations after failure. Children (N = 150; Mage = 7.97 years, SD = 0.58) from the mid-Atlantic region of the United States (73 girls; 79% White) heard one of five types of feedback from an experimenter after success on online tangram puzzles: process praise ("You must have worked hard on that puzzle"), person praise ("You must be good at puzzles"), process-easy feedback ("It must have been easy to rotate and fit those pieces together"), person-easy feedback ("It must have been an easy puzzle for you"), or a control. Next, children failed to complete a harder tangram puzzle. Preregistered primary analyses revealed no differences in persistence and self-evaluation between person and process praise or between person-easy and process-easy feedback. Exploratory analyses showed that hearing process praise led to greater persistence after failure than the control condition (d = .61) and that process-easy feedback led to greater strategy generation than the control condition. The effects of adult feedback after success may be more context dependent than previously thought.

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Depression amongst medical students is a crucial matter. Grit, which is a potentially modifiable psychological factor, has been inversely linked to depressive symptoms. However, it remains unclear how grit is associated with depression. This study aims to examine the relationship between grit and depressive symptoms and to further investigate the potential effect modification by academic performance on the association between grit and depression among medical students. We focus on the total grit score and its subscales, namely perseverance of effort and consistency of interest. A cross-sectional study was conducted using data from second-year medical students at Tokyo Medical and Dental University in Japan from 2020 to 2023. The participants responded to questionnaire surveys comprising the Center for Epidemiologic Studies Depression Scale and the Short Grit Scale. Linear regression analysis was performed to assess the association between grit and depressive symptoms. We also tested for effect modification by first-year Grade Point Average (GPA) on the association between grit and depression. The total grit score and its subscales, perseverance of effort and consistency of interest, were all inversely associated with depressive symptoms (b = -4.7 [95%CI - 6.7 to - 2.6], b = -3.7 [95%CI - 5.3 to - 2.1], b = -1.8 [95%CI - 3.5 to - 0.2], respectively). While the interaction term for the total grit score and GPA was not significant, the interaction term for perseverance of effort and GPA was significant, indicating that the association between perseverance of effort and depression was stronger among the higher-achieving students. The interaction term for consistency of interest and GPA was also significant, indicating that the association was stronger among the lower-achieving students. We reveal a novel aspect of the association between grit and depressive symptoms in light of academic performance. The findings will contribute to future research on depression amongst medical students.

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The Scanning Habitable Environments with Raman and Luminescence for Organics and Chemicals (SHERLOC) instrument onboard the Mars 2020 Perseverance rover detected so far some of the most intense fluorescence signals in association with sulfates analyzing abraded patches of rocks at Jezero crater, Mars. To assess the plausibility of an organic origin of these signals, it is key to understand if organics can survive exposure to ambient Martian UV after exposure by the Perseverance abrasion tool and prior to analysis by SHERLOC. In this work, we investigated the stability of organo-sulfate assemblages under Martian-like UV irradiation and we observed that the spectroscopic features of phthalic and mellitic acid embedded into hydrated magnesium sulfate do not change for UV exposures corresponding to at least 48 Martian sols and, thus, should still be detectable in fluorescence when the SHERLOC analysis takes place, thanks to the photoprotective properties of magnesium sulfate. In addition, different photoproduct bands diagnostic of the parent carboxylic acid molecules could be observed. The photoprotective behavior of hydrated magnesium sulfate corroborates the hypothesis that sulfates might have played a key role in the preservation of organics on Mars, and that the fluorescence signals detected by SHERLOC in association with sulfates could potentially arise from organic compounds.

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Introduction: In medical education, the clerkship phase is a demanding period during which medical students learn to navigate the responsibilities of medical school and clinical medicine. Grit, a personal quality regarded as a non-cognitive trait, refers to perseverance and passion; specifically, it represents the ability to endure hardship and work industriously toward a goal. Most studies analysed grit as a single concept and few studies have investigated the effect of grit on the well-being of medical students through the whole-specialty training (i.e. surgical and non-surgical specialty rotations) required in clinical clerkships. Therefore, this study investigated whether associations exist between medical students' grit, measured by the two subconstructs of perseverance and passion, and their well-being during clerkships in surgical and non-surgical specialty units. Methods: This one-year prospective web-based questionnaire study enrolled fifth-year medical students at a tertiary medical centre in central Taiwan between September 2017 and July 2018 in their first-year clerkship. The students' sex, age, and grit were measured at the start of their clerkship. Routine surveys were conducted over one year to assess burnout and compassion satisfaction for students' well-being, and the training specialty characteristics of the surgical and non-surgical specialty departments were recorded. This study included 92 medical students and 1,055 survey responses from individual specialty rotations. Descriptive, univariate and multivariate analyses were performed. Results: Our results revealed that medical students' perseverance, as part of grit, was related to lower burnout and higher compassion satisfaction during clerkships, but not the subconstruct of passion. Moreover, the positive trait of perseverance measured in our study had greater explanatory power for compassion satisfaction than for burnout. Furthermore, the results revealed that older medical students suffered from less burnout than their younger counterparts, and that male medical students expressed higher compassion satisfaction than their female counterparts. Discussion: Perseverance, as a subconstruct of grit, is a positive personal quality for medical students' clerkships, and methods driving the cultivation of perseverance in medical education should be considered. In addition, even though positive traits such as perseverance equipped medical students for compassion satisfaction, additional factors attributed to medical students' burnout must be identified.

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The first home visit (VAD) by a nurse from the medical-psychological center (CMP) for a patient who has been out of psychiatric care for a very long time, or who has never benefited from it, is decisive for the follow-up and continuity of care. The attitude and posture of the caregiver are decisive. VAD is an intrusion into a place of life, intimacy and suffering. It upsets a person who has walled himself into a shell, a cocoon, from which the fear of coming out is often massive. Anguish prevents any mobilization towards care. It takes a great deal of skill to create a bond of trust to initiate the idea of care.

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Background: There is a paucity of knowledge concerning the psychological variables that serve to facilitate the connection between physical activity and self-efficacy, and the factors capable of moderating these pathways. This study aimed to examine the relationship between physical activity and self-efficacy among college students, with a focus on the mediating effect of grit and the moderating effect of gender. Methods: This study recruited 3,228 undergraduate students from a university in Shanghai, China. They completed the General Self-Efficacy Scale, the Short Grit Scale, and the International Physical Activity Questionnaire. Statistical analysis was conducted using SPSS 26.0 and the Process v4.0 plugin. Results: Physical activity had both a direct effect on self-efficacy (ß = 0.07, 95% CI [0.04-0.11]) and an indirect effect through the two dimensions of grit: perseverance of effort (ß = 0.06, 95% CI [0.04-0.07]) and consistency of interest (ß = 0.03, 95% CI [0.02-0.04]). The mediating effect explained 53.27% of the total effect. Furthermore, gender moderated the relationship between perseverance of effort and self-efficacy, with a stronger effect observed in males (ß = 0.08, t = 3.27, p < 0.01). Conclusion: The results revealed that grit is an underlying psychological mechanism that links physical activity and self-efficacy. Moreover, gender moderates the effect of perseverance of effort on self-efficacy, with a stronger effect observed in males. These findings have practical implications for educators to design tailored physical activity interventions that foster grit and self-efficacy among college students.

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Background: The aim of the present study is to translate the Grit questionnaire into Hungarian and validate specifically within the context of sports. The second goal is to assess the questionnaire in Hungarian as a pilot study in the athlete population and to compare the grit trait with the coaches' athlete evaluation. Methods: Two hundred and sixty nine athletes, including 40 national team players, took part in the study, with an average age of 18.17 years (SD = 5.51). For the preliminary assessment, the Cloninger Temperament and Character Questionnaire (TCI-RH) was used; the coaches' athlete evaluation was modeled on a talent map. Results: The confirmatory factor analysis confirmed the fit of the two-factor structure, and the internal reliability of the questionnaire scales also proved to be adequate. 2. There is no relationship between adolescents' perceived grit and coach ratings. 3. The national team players achieved a higher grit score. Conclusion: Based on the psychometric indicators, the validity and reliability of the questionnaire proved to be adequate. Therefore, it is applicable and useful for psychological practitioners and researchers in the Hungarian population within the context of sports.

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Coach leadership style has long been positively correlated with athlete experiences such as motivation, health (i.e., burnout), and performance outcomes (i.e., enhanced execution time to complete tasks) (24). More recently, grit (18) has been positively correlated with athlete experiences such as engagement (39) and decreased burnout (32). Given the impact coaches have on their athletes and the positive psychological benefits of grit, it is reasonable to explore the intersections of coaching behaviors and grit. As such, the purpose of the current study was to examine the relationship between athlete perceptions of coach leadership behaviors and athlete grit. Intercollegiate athletes completed measures of grit and the leadership behaviors of their coach. A significant positive relationship was observed between the grit perseverance subscale and the leadership behavior of training and instruction (r =.30, p < .05). Additional analyses revealed that athletes' perceptions of coach positive feedback significantly predicted their perseverance. Taken together, these findings suggest a link between positive coach feedback and athlete perseverance. Implications of these results for professional practice and future research are discussed.

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This study aims to investigate the relationships between personality traits of impulsivity, using the UPPS-P Impulsive Behaviour Scales shortened version, and prefrontal cortex (PFC) activity during the IOWA Gambling Task (IGT) in young adult women. The study included a sample of 83 young, healthy females (19.8 ± 1.4 years), who voluntarily took part in the study. Repeated measures analysis during the IGT revealed a significant increase in HbO (all p <.001; ηp2 >.31) and a decrease in Hbr (all p <.003; ηp2 >.08) in all prefrontal quadrants. This increase in oxygenation occurs primarily during the choice period under ambiguity (r =.23; p =.039). Additionally, there was a significant linear decrease in selecting the decks associated with a high frequency of losses (p <.001), while the favorable deck with low losses showed a linear increase (F = 12.96; p <.001). Notably, discrepancies were found between UPPS-P and IGT impulsivity ratings. The Lack of Perseverance and Lack of Premeditation scales from the UPPS-P were identified as significant predictors of HbO levels, mainly in the two quadrants of the left hemisphere's, lateral (adjusted R2 =.23; p <.001; f2 =.34) and rostral (adjusted R2 =.13; p <.002; f2 =.17). These findings suggest that young adult women predominantly adopt a punishment-avoidance strategy during IGT, exhibiting increased activation in the left hemisphere, especially during the task's initial phase characterized by ambiguity.

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The importance of self-related constructs in predicting academic achievement has been increasingly emphasized in recent decades. Typically, bivariate associations of self-related variables with achievements have been reported. Research quantifying the combined predictive power of more than two self-variables has been scarce. Moreover, except for the academic self-concept, these variables have almost always been measured across domains, i.e., without considering the specifics of individual school subjects. The current study aimed to statistically predict academic achievement (operationalized via school grades) in three major subjects (Chinese (native language), mathematics, and English (foreign language)) by using subject-tied scales, namely academic self-concept, conscientiousness, need for cognition, perseverance of effort, and consistency of interest. The sample comprised 791 Chinese adolescents. Each scale was related separately to each of the three school subjects. Hierarchical linear regression analyses were run. The control variable, biological sex, accounted for 2% of Chinese grades and 8% of English grades, but not of mathematics grades. Adding subject-specific self-concept scales increased the explained variance to 7% (Chinese), 16% (mathematics), and 32% (English). Further additions to the other four self-related scales did not increase the variances that were accounted for. The discussion underlines the relevance of subject-specific academic self-concepts as predictors for subject-tied academic achievements.

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Individuals with autism spectrum disorder (ASD) are at higher risk for developing common chronic diseases. Engagement in physical activity (PA) can prevent health issues; however, people with ASD are known to engage in lower levels of PA in comparison to their peers. This study evaluated the effect of a long-term, 12-month PA intervention on the fitness and quality of life of adults with ASD. A quantitative approach was implemented to assess participants' fitness, functional ability, quality of life, and participation in a range of PA classes at three different time points. Qualitative data were collected via in-depth, semi-structured interviews with three participants with ASD and three staff members. A total of 34 adults with ASD (mean age 39.76 + 7.27) participated in the quantitative part of the study. Approximately 53% of the participants exhibited perseverance and conducted adequate PA each month. Significant improvements were found in one fitness component and two quality-of-life components. Factors revealed for the program's success were the individuals' free choice of the PA classes and supporting people and a budget that tailored the project. Policymakers who plan health promotion programs for adults with ASD should consider long-term PA programs, with freedom of choice among PA modalities and schedules.

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OBJECTIVE: To examine treatment outcomes for classes of ADHD drugs in conjunction with physicians' prescribing rationales and the utility of treatment perseverance in treatment effectiveness. METHODS: A retrospective non-interventional study using physician-provided chart data for treated adolescent and adult ADHD patients in the United States (April-June 2019). Multivariable analyses compared the effectiveness and tolerability of drug classes. RESULTS: Among the 1,232 ADHD patients included in this study, 37.7% experienced one, 11.8% two, and 6.7% three treatment changes post their first prescribed regimen. These changes were mostly attributed to lack of rapid onset and duration of effect. Achieving best response correlated with the number of previous treatments for adolescents, but not adults. Maintaining full response correlated with the length of current treatment for adolescents and adults. CONCLUSION: Physicians' prescribing rationales targeted duration of effect and tolerability. ER monotherapy demonstrated potential advantages over other regimens. Treatment perseverance is integral to effective ADHD management.

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For research purposes, it is generally accepted that experimental ostracism manipulations can lead to a reduction of participants' well-being. To eventually restore participants' well-being, researchers rely on post-experimental debriefings that discredit prior deception. However, evidence suggests that discredited beliefs can persevere. The present research investigates whether a potent debriefing procedure restores participants' well-being after an experimentally induced ostracism experience. In two studies, participants were either excluded or included in a Cyberball game, indicated their well-being, and were debriefed. In two additional conditions, participants were debriefed before indicating their well-being. Ostracism compared to inclusion led to decreased positive and increased negative mood. The debriefing did not counteract this effect (Studies 1 & 2). Unwanted aftereffects of the manipulation persevered for more than one day after the experimental session (Study 2). These findings question the effectiveness of debriefings and raise issues about research ethics.

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PURPOSE: The aim of this study was to explore factors that influence stroke survivors' ability to persevere with home-based upper limb practice. METHODS: A qualitative descriptive study embedded within a theoretical framework was conducted. Data were collected through semi-structured focus group, dyadic, and individual interviews. The Theoretical Domains Framework and Capability, Opportunity, Motivation - Behaviour (COM-B) model guided data collection and directed content analysis. FINDINGS: Participants were 31 adult stroke survivors with upper limb impairment, with 13 significant other/s, who were living at home in Queensland, Australia. Three central tenants aligned with the COM-B and six themes were identified. Stroke survivors' capability to persevere was influenced by being physically able to practice and being able to understand, monitor and modify practice, their opportunity to persevere was influenced by accessing therapy and equipment required for practice and fitting practice into everyday life, and their motivation to persevere was influenced by having goals and experiencing meaningful outcomes and having support and being accountable. CONCLUSION: Persevering with practice is multifaceted for stroke survivors. All facets need to be addressed in the design of strategies to enhance stroke survivors' ability to persevere and in turn, enhance their potential for continued upper limb recovery.IMPLICATIONS FOR REHABILITATIONMany stroke survivors do not persevere with long-term home-based upper limb practice despite the belief that high dose practice will promote continued recovery.Therapists need to support stroke survivors to setup individualised goal-based home programs that they can complete independently, or with support, within their everyday life.Stroke survivors need coaching to monitor and modify their practice and map their progress, so that they can recognise and experience meaningful recovery.To optimise upper limb recovery after stroke, strategies to enhance stroke survivors' capability, opportunity, and motivation to persevere across the continuum of recovery, need to be co-designed by stroke survivors, therapists and researchers.

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Limited evidence showed that impulsivity is negatively related to life satisfaction and wellbeing; however, the mechanisms underlying this relationship remain unclear. We aimed through this work to investigate the relationship between impulsivity dimensions and well-being and to explore the moderator role of mindfulness on this relationship in a sample of Lebanese university students. This cross-sectional study was carried out among 363 university students recruited through convenience sampling through several universities in Lebanon's governorates. Higher mindfulness was significantly associated with better wellbeing in the models that considered urgency and sensation seeking as independent variables. A lack of premeditation and a lack of perseverance were both inversely associated with well-being. The interaction lack of perseverance by mindfulness was significantly associated with wellbeing; for students who were low in mindfulness, more lack of perseverance was significantly associated with a lower wellbeing. Our study suggested that mindfulness practice may offer a promising avenue for implementing strategies aiming at improving the well-being of students with high levels of impulsivity.

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In high-performance sport, an athlete's ability to overcome setbacks and sustain their pursuit of long-term goals is essential for success. Grit (i.e., passion and perseverance over long-terms) has been linked to success in a variety of domains but is often critiqued for its limited predictive utility when compared to other psychological variables including self-control, conscientiousness, and mental toughness. The purpose of this study was to examine whether grit predicted important athlete outcomes (i.e., various measures of sport performance and athlete well-being) beyond other determinants of success. Data from 214 collegiate student-athletes (111 women, 103 men; Mage = 21.02, SD = 2.26) from Western Canadian universities were analysed. When predicting performance, the addition of the grit subscales (i.e., consistency of interests, perseverance of effort, adaptability to situations) explained an additional 11% of variance (R2 = 0.37, F[7, 203] = 7.16, p < .001) beyond self-control, conscientiousness, and mental toughness in subjective sport performance perceptions; however, grit did not add unique variance when entered into models predicting athlete goal achievement perceptions or highest level of competition. When predicting well-being, addition of the grit subscales added 18% of unique variance (R2 = 0.43, F[7, 203] = 21.43, p < .001) beyond other determinants of success in eudaimonic well-being, and 5% (R2 = 0.17, F[7, 203] = 6.95, p < .001) in satisfaction with sport, but did not add any unique variance to the model predicting mood. The partial support of the predictive utility of grit illustrates the complexity of forecasting success in sport and offers evidence that grit should continue to be studied as a motivational disposition in the domain of sport.

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El grit implica una actitud apasionada y persistente, ser capaz de mantener el enfoque y la determinación incluso frente a obstáculos y fracasos. La perseverancia en el esfuerzo contribuye al logro de la maestría y la consistencia en los intereses promueve el compromiso con la práctica deliberada en prol de la excelencia. El objetivo del presente estudio fue validar la Escala Portuguesa Grit-S en el contexto del deporte. La muestra estuvo compuesta por 446 atletas federados (328 hombres y 190 mujeres; edad M = 17,60 años; SD = 6,27). Después de eliminar un ítem de la Grit-S, el análisis factorial confirmatorio mostró que la escala de estructura de dos factores es aceptable en la muestra portuguesa. El modelo de medición comprobó su invariabilidad en función del género. Asimismo, encontramos una correlación negativa significativa entre la consistencia de los intereses y la perseverancia en el esfuerzo. En conclusión, la versión portuguesa de la escala reducida del Grit (Grit-S), adaptada para el contexto deportivo, presentó dos factores con propiedades psicométricas adecuadas para ser aplicados en este contexto. Por lo tanto, puede ser aplicable y útil en contextos deportivos de habla portuguesa por parte de entrenadores y psicólogos. (AU)

Grit involves a passion and persistent attitude and being able to sustain focus and determination even in the face of obstacles and failures.Perseverance in effort contributes to the achievement of mastery and consistency in interests promotes the commitment to deliberate practice in pursuit of excellence. The goal of the study was to validate the Portuguese Short Grit Scale specifically within the context of sports.The researchers gathered a sample of 446 federated athletes(328 males and 190 females; M age = 17,60 years; SD = 6,27). After removing one item from the Grit–S, the confirmatory factor analysis indicated that the two-factor structure of the scale is appropriate in the Portuguese context. The measurement model was found be invariant in function of gender. Additionally, we found a significant negative correlation between consistency of interests and persistence. This suggests that the adapted Portuguese Short Grit Scale is a reliable and valid tool that can be used by coaches and sport psychologists to assess grit among portuguese athletes. (AU)

O grit envolve paixão e uma atitude persistente, bem como a capacidade de mantero foco e a determinação apesar dos obstáculos e das falhas. A perseverança no esforço contribui para a conquista da mestria e a consistência nos interesses promove o compromisso com a prática deliberada em prol da excelência. O objetivo deste estudo foi validar a versão reduzida da escala portuguesa de Grit (Grit-S) no contexto do desporto. A amostra foi constituída por 446 atletas federados (328 homens e 190 mulheres; idade M = 17,60 anos; DP = 6,27. O modelo de medida revelou ser invariante em função do sexo. Encontramos uma correlação negativa significativa entre a consistência de interesses e a perseverança no esforço. Em suma, a versão portuguesa da escala de Grit (Grit-S) adaptada para o contexto desportivo, apresentou dois fatores com propriedades psicométricas adequadas-possibilitando a sua aplicação em contextos desportivos de língua portuguesa, por treinadores e psicólogos do desporto. (AU)

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Introduction: This study examines grit as psychological mindsets that explain the link between self-regulatory employability attributes and perceived employability competency expectations in a sample of South African adults (N = 308). Methods: A quantitative, cross-sectional research design approach was used to collect primary data. Results: Results of a mediation analysis through structural equation modelling revealed grit as an important mechanism to strengthen the association between employability attributes (career agility, cultural ingenuity, proactive career resilience) and employability competency expectations (autonomy/leadership skills and personal employability qualities). Discussion: This study makes an important contribution to the role of learning and training through understanding the role of grit in enhancing prospects of employability. This study further adds to the grit literature, highlighting the role that grit plays in the contemporary employment context. Practical implications include supportive practices that strengthen individual workers' grit when confronted with the turbulent changes of today's work world.

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Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease that is associated with significant morbidity, mortality, and healthcare costs. The burden of respiratory symptoms and airflow limitation can translate to reduced physical activity, in turn contributing to poor exercise capacity, muscle dysfunction, and body composition abnormalities. These extrapulmonary features of the disease are targeted during pulmonary rehabilitation, which provides patients with tailored therapies to improve the physical and emotional status. Patients with COPD can be divided into metabolic phenotypes, including cachectic, sarcopenic, normal weight, obese, and sarcopenic with hidden obesity. To date, there have been many studies performed investigating the individual effects of exercise training programs as well as nutritional and pharmacological treatments to improve exercise capacity and body composition in patients with COPD. However, little research is available investigating the combined effect of exercise training with nutritional or pharmacological treatments on these outcomes. Therefore, this review focuses on exploring the potential additional beneficial effects of combinations of exercise training and nutritional or pharmacological treatments to target exercise capacity and body composition in patients with COPD with different metabolic phenotypes.

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