8-week Program Research Articles

Residents as learning facilitators inside and outside of interprofessional education: a faculty development program in postgraduate pediatric training

IntroductionChanging learning environments in health professions are an important challenge of interprofessional education (IPE). When students experience IPE activities during their undergraduate training, they are often guided by trained learning facilitators. Students still spend more time in non-IPE settings, often guided by residents. Residents rarely undergo specific training for core teaching competencies that are crucial in both IPE and non-IPE contexts. At our pediatric hospital, some residents were trained as learning facilitators on an interprofessional training ward. To bridge the gap between IPE and non-IPE learning facilitation for the other residents, we developed the resident-as-teachers course “How to teach pediatrics.”Methods“How to teach pediatrics” was implemented as a 4-week blended learning program based on the framework of Core Competencies for Medical Teachers (KLM). The intended learning outcomes were to reflect on residents’ role modelling and professionalism as well as personal teaching practice, emphasize learner centeredness and foster social and communicative competencies. Participants self-assessed their teaching competencies pre/post-course using a validated questionnaire (FKM_L). Oral feedback was gathered by group reflection and qualitative feedback by open-ended survey questions.Results26 residents participated in the course, of which N = 22 qualified for the pre/post-course self-assessment via the FKM_L (return rate: n = 9; 40.9%). Participants reported an increase in the competency fields of “didactical activities in medicine,” “social and communicative competence,” “role model and professional behavior” as well as “reflection and further development of own teaching practice.” Participants evaluated the course overall as “very good,” stated a high learning gain and estimated the course to be a good preparation for teaching students.Discussion“How to teach pediatrics” shows the feasibility of integrating faculty development as part of resident training. We observed a self-assessed increase in core competencies for medical teachers after participating in the course. Although more participants need to be included and long-lasting effects still need to be proven, such faculty development programs for learning facilitators might be an opportunity to ensure a more consistent and high-quality learning experience for students in both IPE and non-IPE teaching and learning activities.

Shoulder Musculoskeletal Disorder Rehabilitation Using a Robotic Device Based on Electromyography (EMG) Biofeedback: A Retrospective Cohort Study

Background and Objectives: While shoulder injuries represent the musculoskeletal disorders (MSDs) most encountered in physical therapy, there is no consensus on their management. In attempts to provide standardized and personalized treatment, a robotic-assisted device combined with EMG biofeedback specifically dedicated to shoulder MSDs was developed. This study aimed to determine the efficacy of an 8-week rehabilitation program (3 sessions a week) using a robotic-assisted device combined with EMG biofeedback (RA-EMG group) in comparison with a conventional program (CONV group) in patients presenting with shoulder MSDs. Materials and Methods: This study is a retrospective cohort study including data from 2010 to 2013 on patients initially involved in a physical rehabilitation program in a private clinic in Chicoutimi (Canada) for shoulder MSDs. Shoulder flexion strength and range of motion were collected before and after the rehabilitation program. Forty-four patients participated in a conventional program using dumbbells (CONV group), while 73 completed a program on a robot-assisted device with EMG and visual biofeedback (RA-EMG group); both programs consisted of two sets of 20 repetitions at 60% of maximal capacity. Results: We showed that the RA-EMG had significantly greater benefits than the CONV group for shoulder flexion strength (4.45 [2.6;6.15] kg vs. 2.3 [0.90;4.775] kg, U = 761, p = 0.013) and for normalized strength (77.5 [51.3;119.1] % vs. 39.1 [16.6;89.2] %, U = 755, p = 0.016). In addition, the RA-EMG group showed a trend to greater absolute gain of ROM than the CONV group (10.0 [0;24.3] degrees vs. 5.5 [0;12.0] degrees, U = 1931, p = 0.067), and a greater benefit in normalized ROM was observed for the RA-EMG (7.4. [0;17.7] %) than the CONV group (4.6 [0;10.8], U = 1907, p = 0.046). Conclusions: The current retrospective cohort study showed that a specific and tailored 8-week rehabilitation program with constant effort by automatic adjustment of the level of resistance by EMG feedback induced greater benefits for shoulder flexion strength and a trend to improve range of motion compared to conventional rehabilitation in patients with shoulder MSDs. Future research should be pursued to determine the added potential of this approach for abduction and external rotation with a randomized controlled design.

Clinical outcomes of asynchronous telerehabilitation through a mobile app are equivalent to synchronous telerehabilitation in patients with fibromyalgia: a randomized control study

BackgroundThis study aimed to compare the effectiveness of exercise therapy delivered via a smartphone mobile app, using asynchronous video-based tools, with synchronous telerehabilitation models using videoconferencing for individuals with fibromyalgia syndrome (FMS).MethodsThe research, utilizing a randomized clinical study design, involves sixty-six FMS patients in an 8-week exercise program. Participants are divided into synchronous (n: 33) and asynchronous (n: 33) groups. Assessments, pain intensity (VAS), functional limitations (FIQr), health-related quality of life (SF 12), catastrophizing (PCS), anxiety and depression (HADS), functional capacity (6MWT), muscle strength (Arm curl test), and joint position sense (LI-RATT), are conducted at baseline, mid-treatment (week 4), end of treatment (week 8).ResultsNo significant group-time interaction was found for total VAS, FIQ, SF 12, PCS, HADS, 6MWT, Arm curl tests, LI-RATT extension, LI-RATT flexion, LI-RATT right rotation scores (p > 0.05). Significant effects of time and interactions between groups and time were observed in the neck (p = 0.010, ES = 0.19) and back region (p = 0.039, ES = 0.19) of the Visual Analog Scale, left rotation score of the LI-RATT (p = 0.008, ES = 0.36), and HADS Anxiety Score (p = 0.029, ES = 0.31). Group differences were significant at all-time points for the outcomes (p < 0.001), except for the right rotation of LI-RATT (p = 0.633).ConclusionThe study suggests that asynchronous telerehabilitation is comparable to synchronous methods in addressing pain, quality of life, and other factors in FMS patients. The asynchronous approach may offer advantages in reducing the burden on healthcare professionals and being cost-effective. Future research should explore diverse telerehabilitation protocols and their impact on overall care burdens.Trial registrationNCT06299527 (01/03/2024).

Effectiveness of PEER Intervention on Older Adults’ Physical Activity Time Series Using Smoothing Spline ANOVA

Falls are a major cause of injury among older adults. The Physio-fEedback Exercise pRogram (PEER) combines physio-feedback, cognitive reframing, and guided exercises to reduce fall risk. However, its impact on physical activity (PA) over time is underexplored. Functional time-series analysis offers insight into behavior patterns and sustainability. This preliminary study assessed PEER’s effectiveness in improving PA levels immediately and over time. A total of 64 community-dwelling older adults were cluster-randomized into PEER (N=33) or control groups (N=31). Participants wore Fitbit trackers, generating time-series data on activity. The PEER group completed an 8-week program, while the control group received CDC fall prevention pamphlets. PA data were analyzed using smoothing spline analysis of variance (SSANOVA), chosen for its flexibility in modeling complex, non-linear relationships in time-series data and its ability to handle skewed distributions and repeated measures. Unlike traditional parametric models, SSANOVA decomposes temporal trends into interpretable components, capturing both smooth trends and abrupt changes, such as those occurring on group workout days. This capability ensures robust and nuanced analysis of intervention effects. Results showed PEER participants significantly increased evenly and had very active minutes and reduced sedentary behavior during the intervention. No significant effect was found for light active minutes. Specifically, during the intervention period, PEER participants engaged in an average of 6.7% fewer sedentary minutes per day, 13.8% additional fairly active minutes per day, and 2.8% additional very active minutes per day compared to the control group. While the reduction in sedentary minutes and increase in fairly active minutes were not statistically significant, the increase in very active minutes was significant. However, our functional time-series analysis revealed these improvements diminished over the 15-week follow-up, indicating challenges in maintaining PA. In conclusion, PEER boosts PA and reduces sedentary behavior short-term, but strategies are needed to sustain these benefits. In conclusion, PEER boosts PA and reduces sedentary behavior short-term, but strategies are needed to sustain these benefits. Public health policies should emphasize technology-driven fall risk assessments, community-based prevention programs, and initiatives that promote physical activity, home safety, and chronic condition management.

Prognostic Factors for Responders of Home-Based Pulmonary Rehabilitation—Secondary Analysis of a Randomized Controlled Trial

Background: Home-based pulmonary rehabilitation (PR) is an effective alternative to center-based PR. However, not all participants exhibit sufficient therapeutic improvement, highlighting the need to identify appropriate candidates to maximize cost-effectiveness. This study aimed to identify the factors associated with favorable outcomes in home-based PR, focusing on the role of digital therapeutics (DTx). Methods: This secondary analysis used data from a randomized controlled trial. Participants with chronic respiratory disease (CRD) were divided into responders and non-responders based on a change in 6 min walk distance (6MWD) and patient-reported outcome measures (PROM) representing dyspnea and health-related quality of life. Factors such as baseline 6MWD, DTx use, and pulmonary function were analyzed for their predictive value in improving 6MWD and PROM scores. Results: Responders, particularly those using DTx, showed significantly greater improvements in 6MWD than non-responders. Participants with a baseline 6MWD under 500 m demonstrated a higher likelihood of exceeding the minimum clinically important difference in 6MWD. DTx use strongly predicted improvements in both 6MWD and PROM scores. The baseline diffusing capacity of the lungs for carbon monoxide was also a significant factor influencing improvements in the modified Medical Research Council scale. Conclusions: Responders to 8-week program of home-based PR exhibited a relatively lower baseline health status. Encouraging participants with poorer baseline health could improve adherence to PR and enhance cost-effectiveness. Additionally, improvements in 6MWD and PROM scores were associated with the use of DTx. Considering the functions of DTx, proper supervision for home-based exercise may be crucial for achieving optimal outcomes.

Effects of Exergame Training on Executive Function and Heart Rate Variability in Middle-Aged and Older Adults: ARandomized Controlled Study.

Exergame has become widely popular and offers great levels of cognitive demands, thus may facilitate cognitive benefits. In addition, researchers have proposed that cardiac autonomic function, assessed via heart rate variability (HRV), is associated with cognitive executive function. However, few exergame training studies have investigated this relationship. This study aimed to investigate the effects of 10-week exergame training on executive function and HRV in middle-aged and older adults. Ninety-one participants were randomly assigned to either an exergame training group (63.73±4.48years) or a control group (62.46±4.77years). The training program was 50min per session, twice per week for 10weeks. The control group was instructed to maintain their usual lifestyle. All participants completed questionnaires and received assessments of executive functions and electrocardiography at baseline and postintervention. Results revealed significant group-by-time interaction effects for the three indices of the digit span test and the total initiation time of the Tower of London task with better postintervention performances achieved by the exergame group. The 6 min walk test also improved significantly in the exergame group but not in the control group. No significant change in HRV was observed for both groups. There were significant correlations between HRV and digit span test scores. Our results suggest that the 10-week exergame training program was effective in improving executive functions of working memory, inhibitory control, and planning ability as well as aerobic fitness in middle-aged and older adults. Moreover, HRV was associated with improved executive function.

Eight-Week Flywheel Training Enhances Jump Performance and Stretch-Shortening Cycle Function in Collegiate Basketball Players.

The effects of flywheel (FW) training on jump performance, muscle function, and muscle mass in athletes have not been fully clarified. The purpose of the present study was to evaluate the effects of an 8-week FW training program on jump performance, stretch-shortening cycle (SSC) function, muscle strength, peak power and muscle thickness in collegiate basketball players. Twenty male college basketball players (mean age: 19.8±1.3years, height: 179.1±6.7cm, body mass: 72.9±6.3kg) were randomly assigned to either the FW training (n=11) or control group (n=9). The FW training group performed squat exercises, 5 sets of 8 repetitions, twice a week using the FW device. Baseline and post-training assessments of jump heights of squat jumps (SJs), countermovement jumps (CMJs), and drop jumps (DJs) were performed in both groups. Additionally, the reactive strength index (RSI), representing SSC function; isometric maximum voluntary contraction (MVC) torque during knee joint extension; peak power during squats; and quadriceps muscle thickness were evaluated. As the results, we observed that the FW training group demonstrated significant increases in post-training SJ height (15.1%, p=0.03), DJ height (23.2%, p=0.01), RSI (36.8%, p=0.04), MVC, peak power and muscle thickness compared with pre-training levels. Furthermore, between-group comparisons indicated significantly higher post-training SJ height, DJ height, RSI, MVC, peak power, and muscle thickness in the FW training group (p<0.05). Therefore, the FW training program effectively enhanced jump performance and SSC function in male basketball players and proved beneficial for muscle strength and hypertrophy.

The effects and durability of an 8-week dynamic neuromuscular stabilization program on balance and coordination in adult males with intellectual disabilities: a randomized controlled trial

BackgroundIndividuals with intellectual disabilities (IDs) often exhibit lower levels of physical fitness, including reduced balance and neuromuscular coordination, compared to the general population. Dynamic neuromuscular stabilization (DNS) training has been proposed as a potential intervention to improve physical fitness in this population, but its effectiveness and durability on specific fitness components remain underexplored. This study aims to investigate the effects and durability of an 8-week DNS program on balance and coordination in adult males with IDs.MethodsThirty-one participants were randomly assigned to either an intervention group (n = 16) or a control group (n = 15). Balance and neuromuscular coordination were assessed at baseline, immediately after the intervention, and two months post-intervention using the Balance Error Scoring System (BESS), walking forward heel-to-toe test, and bilateral coordination test. The intervention group participated in the DNS training program for 8 weeks, with three sessions per week, while the control group maintained their usual activities.ResultsAnalysis of the outcome measures revealed significant time, group, and time-group interaction effects. Post-hoc analyses indicated that the DNS group showed significantly greater improvements in BESS scores and coordination compared to the control group (p < 0.01). These improvements were maintained at the two-month follow-up assessment.ConclusionThis study provides robust evidence that DNS exercises can significantly enhance balance and neuromuscular coordination in middle-aged males with IDs, with improvements maintained over two months post-training. However, the exclusive focus on male participants limits the extrapolation of these findings to the broader population of individuals with IDs, particularly females. Future investigations should aim to address this limitation by including more diverse samples to advance the generalizability and applicability of DNS-based interventions in this field.Trial registrationRTC, Registered prospectively at the registry of the clinical trial (UMIN000053560), Registered on 07/02/2024.

Effects of Lifestyle Modification on Sasang Constitution Classification Using the Questionnaire for Sasang Constitution Classification II (QSCC II)

OBJECTIVES Sasang Constitution is a traditional Korean medical system that classifies individuals into four types, Taeyangin, Taeeumin, Soyangin, and Soeumin, based on physical and psychological traits. Sasang Constitution is widely used for disease prevention and treatment, emphasizing the potential of personalized healthcare. However, concerns about the accuracy and reliability of diagnostic tools like the Questionnaire for Sasang Constitution Classification II (QSCC II) persist. This study investigates the impact of an 8-week lifestyle modification on Sasang Constitution classification using QSCC II, aiming to enhance the reliability and applicability of this diagnostic tool.METHODS A total of 124 sedentary college students participated in an 8-week lifestyle modification program. The participants were assessed with the QSCC II before and after the program to detect changes in their Sasang Constitution classification. The program consisted of self-directed aerobic and resistance training, performed 3 days/week for 40 minutes, along with dietary changes based on Korean nutrition guidelines.RESULTS After 8 weeks, 33.9% of participants (42 out of 124) experienced changes in their Sasang Constitution classification, with the majority of changes observed in the Soyangin group. Decision tree analysis revealed that changes were strongly influenced by four key QSCC II items.CONCLUSIONS This study demonstrates that the lifestyle modification program influenced responses to certain QSCC II items. The observed changes in responses related to psychological and interpersonal factors may have been due to the insufficient discriminative power of the items themselves. In contrast, physical factors may be influenced by the program, suggesting that these factors could potentially impact the results of Sasang Constitution classification when using the QSCC II.

Aerobic exercise regulates gut microbiota profiles and metabolite in the early stage of Alzheimer's disease.

Aerobic exercise (AE) has been shown to offer significant benefits for Alzheimer's disease (AD), potentially influencing the gut microbiota. However, the impact of changes in intestinal flora in early Alzheimer's disease induced by aerobic exercise on metabolic pathways and metabolites is not well understood. In this study, 3-month-old APP/PS1 and C57BL/6 mice were divided into two groups each: a control group (ADC for APP/PS1 and WTC for C57BL/6) and an aerobic exercise group (ADE for APP/PS1 and WTE for C57BL/6). The exercise groups underwent a 20-week aerobic training program on a motorized treadmill before the behavioral test (both the Morris water maze experiment (MWM) and the eight-arm maze test). Fecal samples were collected to analyze gut microbiota profiles via 16S rRNA gene sequencing. At the same time, the metabolic pathway analysis and the detection of metabolites were carried out. At the phylum level, the ADE group exhibited a significant reduced in the relative abundance of Bacteroidetes compared to the ADC group. At the genus level, both Ileibacterium and Faecalibaculum were found to be more abundant in the ADE group than in the ADC group. Additionally, PICRUSt analysis revealed that lipid metabolism and bile acid metabolism pathways were significantly enriched in the cecal microbiota of mice in the ADE group. The metabolites detected further confirmed the changes in the metabolic pathways mentioned above. Aerobic exercise may modify gut microbiota profiles and metabolites in APP/PS1 mice, thereby potentially playing a beneficial role in delaying cognitive impairment associated with early-stage Alzheimer's disease.

Acceptability, feasibility, and effectiveness of internet-based cognitive behavior therapy for obsessive–compulsive disorder (OCD-NET): a naturalistic pilot trial during the COVID-19 pandemic in a psychiatric outpatient department in Germany

BackgroundCognitive behavior therapy (CBT) is the gold-standard treatment for obsessive–compulsive disorder (OCD). However, access to CBT and specialized treatments is often limited. This pilot study describes the implementation of a guided Internet-Based CBT program (ICBT) for individuals seeking treatment for OCD in a psychiatric outpatient department in Leipzig, Germany, during the COVID-19 pandemic. The aim of the study was to investigate the acceptability, feasibility, and effectiveness of the ICBT program for OCD.MethodsIn an open, naturalistic pilot trial, N = 57 patients with OCD received a 10-week ICBT program (called “OCD-NET”). It consisted of 10 different modules covering psychoeducation, cognitive restructuring, exposure with response prevention, and overall therapist support and guidance through the program. The primary outcome was feasibility and acceptance of the OCD-NET program assessed via recruitment and retention rate, adherence and user satisfaction. Secondary outcomes were OCD symptoms at the end of treatment, assessed using the self-report Obsessive Compulsive Inventory – Revised (OCI-R) and self-rated measures of depressive symptoms, quality of life, self-efficacy, and psychological distress. Additionally, treatment credibility, working alliance, and satisfaction were assessed.ResultsOn average, participants completed 6.30 (SD = 3.21) modules, and n = 19 (33.9%) participants completed all 10 modules of the program. Overall, n = 45 (78.9%) were treatment completers (minimum 4 modules completed), n = 11 (19.3%) were non-completers, and n = 1 (1.8%) was a dropout. Satisfaction with the program was high, with a majority of participants indicating that they would recommend it to others (n = 56, 98.2%) and that it provided the support they needed (n = 49, 86.0%).Mixed-effect models showed a significant reduction in OCD symptoms (OCI-R), with large within-group effect sizes in both intention-to-treat (ITT) and completer analyses. In ITT analyses, the OCI-R decreased significantly with a within-group effect size of d = 1.13 (95% CI 0.88 – 1.38). At post-treatment, n = 17 (29.8%) participants showed a treatment response on the OCI-R (≥ 40% reduction). The treatment also resulted in statistically significant improvements in depressive symptoms (d = 0.90 [0.65; 1.15]) and self-efficacy (d = -0.27 [-0.53; -0.00]). No significant differences were observed in quality of life (WHOQOL-BREF) or psychological distress (Mini-SCL GSI) scores between baseline and post-treatment, in either the ITT or completer analyses.ConclusionsThe OCD-NET program is overall highly acceptable and appears to meet patients’ needs in routine care, even under pandemic constraints. ICBT with therapist guidance significantly reduces OCD and depressive symptoms in real world settings. The results also suggest that this ICBT program could be integrated into routine psychiatric outpatient treatments. However, future research should investigate how upscaling and sustainable implementation could be effectively achieved.Trial registrationGerman Clinical Trials register (DRKS): DRKS00021706, registration date: 15.05.2020.

TPACK 발달 단계를 고려한 강의를 통해 나타난 초·중등 예비 교사의 테크놀로지 활용 수업에 관한 인식

Objectives This study examined the perceptions of 10 pre-service teachers from a teacher training university lo cated in a mid-sized city regarding technology-integrated instruction after participating in lectures designed based on the TPACK developmental stages. Methods To achieve this, a 15-week lecture program was developed based on prior research, considering the TPACK developmental stages. Subsequently, data were collected from pre-service teachers, including their tech nology-integrated lesson objectives, group lesson rehearsal observation reports, and reports on the development of their technology integration competencies. The pre-service teachers’ lesson objectives for technology-in tegrated instruction were rephrased and categorized into two main themes, and their perceptions of technology were analyzed. Additionally, changes in their preconceptions and perspectives on technology-integrated instruction were examined using the group lesson rehearsal observation reports and the competency development reports. Results The analysis of pre-service teachers’ objectives for technology-integrated instruction revealed two dis tinct groups. One group responded with a desire “to develop the ability to create teaching and learning materials using technology (TCK),” while the other expressed a goal “to gain the ability to conduct effective lessons using technology (TPK).” Pre-service teachers in the TCK group demonstrated positive and progressive perceptions of technology-integrated instruction. In contrast, those in the TPK group exhibited negative or reflective perceptions. Additionally, pre-service teachers initially faced challenges in conducting technology-integrated instruction on topics related to the humanities and social sciences. However, throughout the lecture program in this study, they experienced a shift in perception, overcoming these difficulties. Conclusions The results of this study indicate that pre-service teachers who aimed to develop TCK competencies rather than TPK competencies through the lecture program based on TPACK developmental stages held more positive perceptions of technology-integrated instruction. Additionally, their perceptions of conducting technol ogy-integrated lessons on humanities and social science topics showed notable improvement. Based on these findings, it is necessary to enhance pre-service teacher education programs to better support the development of competencies required for effective technology-integrated instruction.

Testing the Feasibility, Acceptability, and Potential Efficacy of an Innovative Digital Mental Health Care Delivery Model Designed to Increase Access to Care: Open Trial of the Digital Clinic.

Mental health concerns have become increasingly prevalent; however, care remains inaccessible to many. While digital mental health interventions offer a promising solution, self-help and even coached apps have not fully addressed the challenge. There is now a growing interest in hybrid, or blended, care approaches that use apps as tools to augment, rather than to entirely guide, care. The Digital Clinic is one such model, designed to increase access to high-quality mental health services. To assess the feasibility, acceptability, and potential efficacy of the Digital Clinic model, this study aims to conduct a nonrandomized open trial with participants experiencing depression, anxiety, or both, at various levels of clinical severity. Clinicians were trained in conducting brief transdiagnostic evidence-based treatment augmented by a mental health app (mindLAMP); digital navigators were trained in supporting participants' app engagement and digital literacy while also sharing app data with both patients and clinicians. Feasibility and acceptability of this 8-week program were assessed against a range of benchmarks. Potential efficacy was assessed by calculating pre-post change in symptoms of depression (Patient Health Questionnaire-9; PHQ-9), anxiety (7-item Generalized Anxiety Disorder; GAD-7), and comorbid depression and anxiety (Patient Health Questionnaire Anxiety and Depression Scale; PHQ-ADS), as well as rates of clinically meaningful improvement and remission. Secondary outcomes included change in functional impairment, self-efficacy in managing emotions, and flourishing. Of the 258 enrolled participants, 215 (83.3%) completed the 8-week program. Most were White (n=151, 70.2%) and identified as cisgender women (n=136, 63.3%), with a mean age of 41 (SD 14) years. Feasibility and acceptability were good to excellent across a range of domains. The program demonstrated potential efficacy: the average PHQ-9 score was moderate to moderately severe at baseline (mean 13.39, SD 4.53) and decreased to subclinical (mean 7.79, SD 4.61) by the end of the intervention (t126=12.50, P<.001, Cohen d=1.11). Similarly, the average GAD-7 score decreased from moderate at baseline (mean 12.93, SD 3.67) to subclinical (mean 7.35, SD 4.19) by the end of the intervention (t113=13, P<.001, Cohen d=1.22). Participation in the program was also associated with high rates of clinically significant improvement and remission. Results suggest that the Digital Clinic model is feasible, acceptable, and potentially efficacious, warranting a future randomized controlled trial to establish the efficacy of this innovative model of care.

Alleviating occupational stress in Chinese junior high school teachers: the role of mindfulness-based interventions

IntroductionOccupational stress is a significant issue among junior high school teachers in China, contributing to negative outcomes such as reduced mental health, impaired coping abilities, and decreased job satisfaction.MethodsThis quasi-experimental study investigates the impact of mindfulness-based interventions on occupational stress and mental health among junior high school teachers in China. A total of 118 teachers participated in the study, with a randomly assigned experimental group undergoing an 4-week mindfulness training program, while the control group received no intervention. Standardized measures of occupational stress, mental health, coping self-efficacy, and mindfulness were used to assess the outcomes before and after the intervention.FindingsThe findings revealed that teachers who participated in the mindfulness program experienced significant reductions in occupational stress and improvements in mental health and coping self-efficacy compared to the control group. Additionally mindfulness levels increased significantly among participants who underwent the training.DiscussionThe results suggest that mindfulness-based interventions can effectively alleviate occupational stress and enhance psychological wellbeing among junior high school teachers in China, highlighting the importance of implementing such programs to support educators in managing stress and maintaining mental health.

Evaluating the impact of an after-school program on overhand throwing and perceived motor competence among students from low socio-economic backgrounds in the U.S.

The study examined the effect of a 5-week Comprehensive School Physical Activity Program (CSPAP) on overhand throw skills and perceived motor competence in students from low socio-economic backgrounds. Participants were children recruited from a Title 1 school in the Southwest U.S. Students were assigned to either CSPAP condition (n = 60, 26 boys, 34 girls; Mgrade = 4.27, SD = .43) or a control condition (n = 20, 7 boys, 13 girls; Mgrade = 4.00, SD = .35). Overhand throwing and perceived motor competence were assessed at baseline and post-intervention using the Test of Gross Motor Development—2nd Edition and Perceived Motor Competence for Children (PMC-C). The Analysis of Covariance test showed that students who participated in the CSPAP performed statistically significant improvements in the overhand throw compared to control students in the post-test p &amp;lt; .001, with a moderate effect size. However, there was no significant difference in the PMC-C score after the 5-week intervention between the CSPAP students and control students. CSPAP can improve overhand throwing in students from low-income families, but new strategies are needed to enhance perceived motor competence in after-school contexts.

Cluster Set vs. Traditional Set in Plyometric Training: Effect on the Athletic Performance of Youth Football Players

Aim: This study evaluated the effects of plyometric training with different set configurations on sprint speed, change of direction (COD), jump performance, and perceived exertion in youth football players. Method: Twenty-four U-19 players were randomized into three groups: Cluster Set (CLS, n = 8), Traditional Set (TRD, n = 8), and Control (CON, n = 8). CLS performed 8–10 sets of 2–3 repetitions, while TRD completed 2–3 sets of 8-10 repetitions in an 8-week plyometric program (2 sessions/week). The CON group did not train. Performance measures included 10 m, 20 m, and 30 m sprints, COD, Counter Movement Jump (CMJ), Reactive Strength Index (RSI), and Rate of Perceived Exertion (RPE). A repeated measures ANOVA analyzed group*time interactions. Results: Significant improvements were observed in CLS and TRD groups for sprints (10 m: f = 21.44; 20 m: f = 19.40; 30 m: f = 49.56; p &lt; 0.001), COD (f = 14.66; p &lt; 0.001), CMJ (f = 51.50; p &lt; 0.001), and RSI (f = 24.91; p &lt; 0.001). No changes occurred in CON (p &gt; 0.05). Conclusions: CLS and TRD plyometric training improved sprint speed, COD, and jump performance, with CLS showing slightly superior results and better fatigue management.

Development, implementation, and evaluation of an innovative clinical trial operations training program for Africa (ClinOps)

BackgroundAfrica’s involvement in clinical trials remains very low. Although the crucial role of training initiatives in building clinical trial capacity in Africa has been documented, current efforts fall short as they lack alignment with local contexts. This study aimed to design, develop, implement, and evaluate an innovative clinical trial operations training program for Africa.MethodsWe developed ClinOps, a novel 10-week clinical trial operations training program for study coordinators in Africa to enhance their expertise in four fundamental areas: designing, conducting, managing, and reporting clinical trials. To streamline the learning process, we used cloud-based applications that minimize the need for software installations while maximizing student engagement. VoiceThread facilitated interactive content that could be accessed offline. Moodle, an open-source learning management system, offered a platform for sharing learning tools, mentorship, and rubric-driven competency assessments, including quizzes, forums, tutorials, and group assignments. We utilized Zoom for live tutorials and mentoring as required. Effectiveness of the program was evaluated through quantitative pre- and post-surveys, qualitative end-course evaluations, and a comprehensive monitoring and evaluation framework. The pre- and post-surveys measured changes in trainees’ confidence in clinical trial domains and leadership and coordination skills. End-course evaluations gathered feedback on the course content, organization, technology, and instructional methods. We used Wilcoxon rank test to analyze pre- and post-survey scores and thematic analysis to analyze the qualitative data.ResultsIn the initial cohort, 88 study coordinators from 19 countries participated, including 56 (64%) females, with 57 (65%) actively employed as study coordinators during the training, and 85 (97%) possessing prior experience in clinical trial roles. Among these, 71 (81%) successfully completed the course, with 69 (97%) also completing the post-course assessment. Post-training scores demonstrated substantial improvement compared to pre-training scores in each competency area, including in designing (pre-post training median score = 3.6 vs. 4.6, median difference = 1.0, 95% CI 0.8–1.1, p < 0.001), managing (pre-posttest median score = 3.4 vs. 4.2, median difference = 0.6, 95% CI 0.4–0.8, p < 0.001), conducting (pre-post training median score = 3.9 vs. 4.7, median difference = 0.9, 95% CI 0.6-1.0, p < 0.001), and reporting (pre-posttest median score = 3.0 vs. 4.5, median difference = 1.0, 95% CI 0.9–1.5, p < 0.001) clinical trials. The monitoring and evaluation data confirm the program’s adherence to training best practices, including alignment with local priorities, country ownership, pedagogic innovation, institutional capacity building, sustainability, and ongoing partnerships. The end-course evaluation reflects participants’ positive feedback on the program’s structure, content, relevance to their current roles, and overall delivery methods.ConclusionThe ClinOps program, designed by experts from academia and product development partners, enhanced participants’ clinical trial competencies. To effectively build clinical trials capacity on the continent, training programs should provide thorough competency development in designing, conducting, managing, and reporting trials.

Misalignment or Motivation? A Cluster Analysis Approach to Understanding Young Adolescent Physical Activity Trajectories in Summer Care Programs

Physical activity (PA) decreases during summer months, potentially leading to accelerated weight gain and increased depressive symptoms in adolescents. Summer care programs offer opportunities for PA promotion but understanding how different groups (based on initial perceived and objectively measured PA) respond to these programs is crucial for developing focused interventions. Adolescents (n = 47; mean age = 11.0 years; 51.1% female) who participated in an 8-week summer program wore ActiGraph GT9X accelerometers to measure moderate-to-vigorous physical activity (MVPA) at the beginning and end of the program. Self-reported PA was assessed using the Health Behavior in School-Aged Children survey. Both measures were then transformed into respective z-scores. K-means cluster analysis was performed to identify distinct groups based on device-measured and perceived PA at the beginning of summer. Changes in MVPA were compared across clusters using one-way ANOVA and post hoc Tukey’s HSD tests. Three clusters were identified: “High Accuracy Actives” (n = 17), “Underestimators” (n = 22), and “Overestimators” (n = 8). “Overestimators” showed the largest mean increase in MVPA (30.63 min/day), followed by “Underestimators” (17.76 min/day). “High Accuracy Actives” experienced a mean decrease in MVPA (−7.69 min/day). ANOVA revealed significant differences in MVPA change between clusters (F(2,44) = 4.93, p = 0.01). Summer care programs can positively impact adolescent PA, particularly for those who initially underestimate or overestimate their activity levels. However, strategies are needed to prevent declines among initially highly active participants. For example, adolescents who underestimate their activity levels may benefit from interventions focused on building self-efficacy and providing positive feedback, while those who overestimate might require educational components about PA guidelines and self-monitoring techniques.

Effects of outdoor physical training on VO₂max, endurance, and power in male Sports Science students

Background: Physical fitness is a key component of overall health, particularly for students in physical education programs. Outdoor-based physical training has been explored to enhance specific fitness components, including VO2max, muscle endurance, and leg explosive power. However, evidence on its effectiveness remains limited, particularly in areas such as leg power. Purpose: This study aimed to evaluate the effects of an 8-week outdoor-based physical training program on VO2max, arm muscle endurance, abdominal endurance, and leg muscle power in first-year male students. Materials and Methods: A pre-experimental, one-group pretest-posttest design was employed. Thirty-three first-year students from the Physical Education, Health, and Recreation program at Bung Hatta University were selected using purposive sampling. Physical fitness was assessed before and after the intervention. The following tests were used: VO2max via the bleep test, arm endurance with the 1-minute push-up test, abdominal endurance with the 1-minute sit-up test, and leg power with the standing broad jump test. Data were analyzed using paired t-tests, conducted with Microsoft Excel and SPSS version 25. Results: Significant improvements were observed in VO2max (t = -9.077, p &lt; 0.001), arm endurance (t = -8.433, p &lt; .001), and abdominal endurance (t = -6.571, p &lt; 0.001). However, no significant change was found in leg muscle power (t = 0.924, p = 0.362). Conclusion: Outdoor-based physical training effectively enhances VO2max and muscle endurance. However, it may require a longer duration or increased intensity to improve leg explosive power. This differentiates the program from conventional indoor training methods by emphasizing adaptability and engagement in outdoor settings. Further adjustments to the training program are recommended to optimize overall physical fitness improvements.

Dynamic Adaptation of Hematological Parameters, Albumin, and Non-Esterified Fatty Acids in Saddlebred and Standardbred Horses During Exercise

The response to exercise following a rest period may vary among horse breeds based on the importance of the hematological and hematochemical profiles of athletic horses. Ten Standardbred and ten Italian Saddlebred mares were subjected to a 4-week training program after a seasonal rest, and hematological parameters (red blood cells—RBCs; hemoglobin—Hb; hematocrit—Hct; platelets—PLTs; platelet aggregation—AG; aggregation slope—Slope; fibrinogen—Fb), as well as Albumin (Alb) and non-esterified fatty acids (NEFAs), were analyzed. Blood samples were obtained each week during the training program following a simulated exercise performed at T0 and T4 (T0pre-T0post; T1, T2, T3, and T4pre-T4post). A two-way ANOVA revealed an increase in all assessed parameters post vs. pre at T0 and T4 (p &lt; 0.01) and a decrease in PLTs (p &lt; 0.01) at T0 and T4 in both breeds. A significant effect of breed was observed, with higher values for RBCs and Hb at each time point (p &lt; 0.001); Hct at T0 post, T2, T3, and T4 post; and NEFAs (p &lt; 0.001) at T0 post and T4 post in Standardbred compared to Saddlebred horses. Positive correlations were identified among RBCs, Hb, Hct, PLTs, Alb, and NEFAs in both breeds and between AG and Slope in Saddlebred horses. Negative correlations were identified among AG and RBCs, Hb, Hct, PLTs, Alb, and NEFAs in Standardbred horses and for AG and Slope with RBCs, Hb, Hct, and PLTs in Saddlebred horses. A comparable reaction to training was observed in both breeds following the seasonal rest.