Controlled Design Research Articles

Establishing construct validity for dynamic measures of behavior using naturalistic study designs.

There has been a recent surge of naturalistic methodology to assess complex topics in psychology and neuroscience. Such methods are lauded for their increased ecological validity, aiming to bridge a gap between highly controlled experimental design and purely observational studies. However, these measures present challenges in establishing construct validity. One domain in which this has emerged is research on theory of mind: the ability to infer others' thoughts and emotions. Traditional measures utilize rigid methodology which suffer from ceiling effects and may fail to fully capture how individuals engage theory of mind in everyday interactions. In the present study, we validate and test a novel approach utilizing a naturalistic task to assess theory of mind. Participants watched a mockumentary-style show while using a joystick to provide continuous, real-time theory of mind judgments. A baseline sample's ratings were used to establish a "ground truth" for the judgments. Ratings from separate young and older adult samples were compared against the ground truth to create similarity scores. This similarity score was compared against two independent tasks to assess construct validity: an explicit judgment performance-based paradigm, and a neuroimaging paradigm assessing response to a static measure of theory of mind. The similarity metric did not have ceiling effects and was significantly positively related to both the performance-based and neural measures. It also replicated age effects that other theory of mind measures demonstrate. Together, our multimodal approach provided convergent evidence that dynamic measures of behavior can yield robust and rigorous assessments of complex psychological processes.

Non-Pharmacological Sleep Interventions after Cardiac Surgery: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.

To synthesise up-to-date research evidence for non-pharmacological interventions to improve various sleep outcomes (e.g., sleep quality, duration) in postsurgical cardiac patients. Sleep disturbances are common amongst postsurgical cardiac patients, yet the effectiveness of non-pharmacological interventions in improving various sleep outcomes has not been comprehensively reviewed. A systematic review and meta-analysis guided by the PRISMA protocol. CINAHL, PubMed, PsycINFO, Embase, Web of Science, and Cochrane Library were searched for relevant research in May 2023. Included studies used a randomised controlled trial design that applied a non-pharmacological intervention for postsurgical cardiac patients and reported sleep as an outcome. For the meta-analysis, mean effect sizes were separately calculated for studies with regular and reverse-scored scales. Of 37 studies included, the most common cardiac surgery was coronary artery bypass graft. Most interventions were performed within the first postoperative week and assessed sleep quality outcomes using the Pittsburgh Sleep Quality Index. The interventions are categorised into five types. Human resource-based strategies emerged as the most effective. The meta-analysis of 27 eligible studies showed a mean effect size of 0.76 for studies with regular scoring scales and - 1.04 for those with reverse-scored scales, indicating medium to large effect sizes. Our findings provide strong evidence that non-pharmacological interventions, particularly human resource-based strategies, significantly improve sleep quality in postsurgical cardiac patients. The medium to large effect sizes underscore the clinical significance of these findings. Healthcare professionals should consider incorporating non-pharmacological interventions, especially human resource-based strategies, in care plans for postsurgical cardiac patients to improve sleep outcomes and promote recovery. These interventions should be tailored to individual physical and cultural differences for maximum effectiveness. Future research should evaluate the long-term effects of these interventions on various sleep outcomes, using both objective and subjective measures to provide a comprehensive assessment of their efficacy. This study adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Patient and public contributions were not required for this review.

Enhancing pro-environmental behavior through nature-contact environmental education: an empirical analysis based on randomized controlled experiment design

Environmental education is vital for promoting pro-environmental behavior, and nature-contact environmental education has progressively emerged as an important form of environmental education. Therefore, exploring the effects and mechanisms of nature-contact environmental education is crucial to enhancing pro-environmental behavior. This manuscript focuses on the Qinling ecological environmental education course at a Chinese university, which exemplifies a form of nature-contact environmental education. The research employs the randomized controlled experimental design as the research methodology. A total of 112 students who participated in the course served as the study sample, with the aim of investigating whether nature-contact environmental education can effectively improve students’ pro-environmental behavior. Additionally, the study also explores the underlying mechanisms driving this effect. The findings indicate that nature-contact environmental education significantly contributes to improving students’ pro-environmental behavior. Furthermore, environmental attitudes and environmental responsibility are identified as key mediators in the relationship between nature-contact environmental education and pro-environmental behavior. These conclusions provide valuable insights for both theoretical research and practical applications of environmental education and pro-environmental behavior.

Randomized controlled trial of a pilot PrEP linkage intervention for individuals leaving incarceration in a southern state: Design and baseline characteristics.

We report baseline characteristics of a pilot intervention, PrEP-Link, which uses a community health worker (CHW) model to provide navigation to PrEP, the daily HIV preventative medication, and other medical and social services upon release from incarceration. This pilot study uses a randomized controlled trial design. The control group receives enhanced standard of care, and the intervention receives enhanced standard of care plus personalized navigation services from the CHW for up to one year. PrEP-Link is modeled after the Transitions Clinic Program, where a CHW who has lived experience of incarceration builds close relationships with individuals and community partners. After COVID-19 restrictions prevented recruitment within local jails, recruitment for this study took place in local reentry centers which house individuals as they near completion of their jail or prison sentence. Data are collected at baseline, 6 months, and 12 months. Planning and reporting was guided by the CONSORT 2010 checklist. We enrolled 80 participants between September 2021 and April 2023. Thirty-nine participants were assigned to the control group and forty-one to the intervention group. Data collected at baseline included measures of PrEP usage, HIV risk, drug and alcohol use, healthcare usage, and history of incarceration. Analysis of baseline characteristics show comparability of both demographic and HIV-related risk factors between the two arms. At baseline, participants had high clinical indication for potential PrEP benefit, particularly with respect to self-reported intravenous drug use and condomless sex. Participants responded with high PrEP acceptability within both study arms. Participants reported low preventative healthcare utilization at baseline. Barriers to accessing PrEP among the study population are significant. Results of this pilot RTC will help inform CHW lead PrEP-linkage interventions for people leaving incarceration.

Insights Into the Thermal Stability and Proton Transport Mechanism of PTFE‐Nafion Composite Membranes

ABSTRACTThe controllable design of proton exchange membranes (PEMs) with outstanding temperature resistance and efficient proton conduction is essential for high‐temperature PEM fuel cells. In this study, a polytetrafluoroethylene (PTFE)‐Nafion composite PEM was prepared using immersion and high‐temperature heat treatment methods. To understand the thermal stability, the glass transition temperatures of the PTFE‐Nafion and Nafion membranes were tested using static thermomechanical analysis. The PTFE‐Nafion membrane had a higher glass transition temperature than the Nafion membrane. In terms of the microstructure, the PTFE‐Nafion composite membrane exhibited a slightly larger ion domain structure than the Nafion membrane, and the first scattering peak of the PTFE‐Nafion composite membrane appeared at q ≈ 0.018 nm−1, while the pure Nafion membrane peak was located at q ≈ 0.022 nm−1. The PTFE‐Nafion composite membrane also exhibited higher proton conductivity than the Nafion membrane, and the activation energy of the Nafion membrane was approximately 3.5 times higher than that of the PTFE‐Nafion composite membrane. These results demonstrated the difference in proton transport mechanism for the PTFE‐Nafion composite and pure membranes, which may help guide the rational design of PEMs for fuel cells operating in high‐temperature and low‐humidity environments.

Combination of Manual Therapy and Dry Needling Effectively Improves Acute Neck Pain and Muscular Tone and Stiffness in Combat Sports Athletes: A Randomized Controlled Study

This study aimed to compare the effects of manual therapy combined with dry needling (MTDN) to a control group, focusing on the impact on pressure pain threshold (PPT), muscle tone (MT), muscle stiffness (MS), muscle strength, and range of motion in the neck muscles of adult combat sports athletes. A randomized controlled study design was employed, with one group of athletes (n = 15) receiving MTDN intervention, while the other group (n = 15) underwent a control treatment (CG) involving a quasi-needle technique combined with manual therapy. Both groups participated in three sessions, either in the MTDN intervention or the control condition. All athletes, who were experiencing neck pain, were evaluated at rest, after one session, after three sessions, and again 72 hours after the third session. Muscle tone (MT) and muscle stiffness (MS) were measured using myotonometry, pressure pain threshold (PPT) was assessed with an algesiometer, muscle strength was evaluated using a handheld dynamometer, and range of motion was measured with an electronic goniometer. Group comparisons revealed significantly higher MT in CG compared to MTDN after the 3rd session (p < 0.001; d = 1.50). Additionally, CG showed significantly greater MS than MTDN after the 3rd session (p < 0.001; d = 1.75) and at 72 hours post-session (p < 0.001; d = 2.45). Conversely, MTDN exhibited significantly greater PPT than CG at 72 hours post-session (p < 0.001; d = 1.80). Our results suggest that MTDN is significantly more effective in improving muscle tone, stiffness, and acute pain compared to manual therapy alone. However, no significant impact was observed on maximal strength or neck range of motion. A combined approach may offer benefits by more rapidly reducing neck pain and better preparing muscle properties for future activities.

Smaller Formats of Volleyball Lead to Greater Improvements in Lower Limb Strength and Power, As Well As Reductions in Landing Forces: A Randomized Controlled Study in Girls

The purpose of this study was to compare the adaptations in muscular strength, power, and landing forces of young female volleyball players enrolled in two experimental programs: one using smaller formats of the game (SFG) and the other using larger formats of the game (LFG), with a third group serving as a control. This study employed a randomized controlled design, with an 8-week intervention period and pre- and post-intervention evaluations. Fifty-six trained/developmental participants (age: 14.7 ± 0.5 years) voluntarily participated in this study. Each experimental group received additional training twice a week. The SFG group participated in 2v2 and 3v3 formats on smaller courts (covering 2/6 of the court's available zones) with a regular net, while the LFG group played in 4v4 and 5v5 formats on larger courts (covering 4/6 of the court's available zones). Assessments were conducted using force platforms and included the following tests: (i) isometric mid-thigh pull test (IMTP), measuring peak force; (ii) squat jump test (SJ), measuring peak force; (iii) countermovement jump test (CMJ), measuring peak power and landing force; and (iv) drop jump test (DJT), measuring the reactive strength index. Significant differences emerged post-intervention across all outcomes (p < 0.05). The SFG exhibited significantly greater IMTP peak force compared to both the LFG (p = 0.012) and control groups (p = 0.035). Additionally, the SFG showed significantly greater SJ peak force than the LFG (p = 0.036) and control groups (p = 0.023). Regarding CMJ peak power, significantly higher values were observed in the SFG compared to the LFG (p = 0.042) and control groups (p = 0.046). Moreover, the SFG had significantly lower CMJ peak landing force than both the LFG (p = 0.049) and control groups (p = 0.046). Finally, RSI was significantly higher in the SFG than in the LFG (p = 0.046) and control groups (p = 0.036). This study highlights the significant benefits of incorporating 2v2 and 3v3 SFG formats to enhance muscular strength, power, and landing forces in young female volleyball players, contrasting with less effective outcomes observed with 4v4 and 5v5 LFG formats, suggesting potential neuromuscular advantages crucial for improving volleyball performance.

Robust Predefined Time Stability of nth-Order Systems Subject to Deterministic Matched Disturbances

Speed of convergence and robustness against disturbances affecting a dynamical system are of great importance in real-life applications. To satisfy these requirements, another approach called predefined time control has been developed in the last decade, which ensures the convergence of the states of a class of dynamical systems to the desired reference value in a time set by the control designer at will. However, previously proposed predefined time control algorithms have drawbacks that need to be tackled. For this reason, the authors present another form of predefined time control algorithm that can be coupled with any observer (in the case where not all the states of the system can be measured) or any other robust controller to robustify the system against matched disturbances. The development shows that the necessary form of the control law can be obtained using basic integration and backstepping. The performance of the control law is demonstrated through a series of numerical simulations utilizing the mathematical model of a permanent magnet synchronous motor (PMSM). The results show that the proposed control algorithm is, indeed, robust against any matched disturbance, and the convergence of the system states is ensured independently of any initial condition in the time set by the control designer at will.

Rational design of cobalt oxide nanocubes arrays on Ni foam as durable and robust electrocatalyst for urea electro-oxidation

BackgroundCobalt oxide (Co3O4) is a promising electrocatalyst for efficient urea electro-oxidation, tackling power consumption and environmental challenges. The controllable design of free-standing Co3O4 nanostructures grown on Ni foam (NF) substrates was achieved using a green and facile hydrothermal approach. Different reducing agents were applied to synthesize various morphological structures of Co3O4, including nanoparticles, nanowires, and nanocubes (NCs) morphologies.ResultsThe as-fabricated electrodes were investigated as electrocatalysts for enhanced urea electro-oxidation. Because of its 3D nanostructure with minimal agglomeration and a large interfacial surface area with adequate electroactive sites, the Co3O4 NCs/NF had the best energy conversion efficiency of any electrode toward the urea oxidation process. These distinctive features facilitated the electron and urea routes used in the urea electro-oxidation process. It had a low-onset potential of 194.2 mV (vs. Hg/HgO) and a current density of 90.2 mA cm−2 in a 1 M KOH electrolyte. The electrocatalyst demonstrated excellent anodic activity for urea electro-oxidation with an onset potential of 196.7 mV and a current density of 256.1 mA cm−2 in 1 M KOH + 0.3 M urea concentration. Furthermore, the Co3O4 NCs/NF exhibited long-term stability, as shown by chronoamperometry and stepwise tests after 3600 s in the presence of urea under various operating conditions.ConclusionsCompared to all the fabricated Co3O4 nanostructures, the Co3O4 nanocubes revealed the highest electrocatalytic performance toward urea electro-oxidation in all concentrations. Therefore, Co3O4 NCs/NF is a promising, robust, and efficient electrocatalyst for direct urea fuel cell applications.

Deprescribing anticholinergics to preserve brain health: reducing the risk of dementia through deprescribing (R2D2): study protocol for a randomized clinical trial

BackgroundOlder adults commonly experience chronic medical conditions and are at risk of cognitive impairment as a result of age, chronic comorbidity, and medications prescribed to manage multiple chronic conditions. Anticholinergic medications are common treatments for chronic conditions and have been repeatedly associated with poor cognitive outcomes, including delirium and dementia, in epidemiologic studies. However, no study has definitively evaluated the causal relationship between anticholinergics and cognition in a randomized controlled trial design. Utilizing our prior experience in deprescribing anticholinergic medications in various clinical environments, we designed an outpatient deprescribing intervention to prospectively test the potential causal relationship between anticholinergics and cognition in primary care older adults.MethodsThis cluster randomized clinical trial will be conducted to evaluate the impact of an anticholinergic deprescribing intervention compared to usual care on outcomes of cognition and safety in primary care older adults. Participants will include those aged 65 years and over, receiving primary care in the greater Indianapolis area, using a strong anticholinergic within the last 2 weeks or with evidence of high-risk exposure in the past year. Those excluded will have a diagnosis of Alzheimer’s disease or related dementia, or serious mental illness. The trial plans to enroll 344 participants who will be cluster-randomized at the level of primary care physician to avoid contamination. Participants will complete outcome assessments every 6 months up to 2 years by blinded outcome assessors. The primary outcome of the study is a composite measure of cognition that includes domains assessing executive cognitive function, language, and memory. Secondary outcomes include patient-reported measures of pain intensity, depression, anxiety, sleep disturbance, and health-related quality of life.DiscussionThe R2D2 trial will be the largest and longest prospective randomized trial testing the impact of an anticholinergic-specific deprescribing intervention on cognition in primary care older adults. Results could influence deprescribing methodology and provide new insight on the relationship between anticholinergics and cognition.Trial registrationClinicalTrials.gov NCT04270474. Registered on February 17, 2020.

Optimizing parenting and child outcomes following parent–child interaction therapy – toddler: a randomized controlled trial

BackgroundParent–Child Interaction Therapy—Toddler (PCIT-T) is an attachment-informed intervention model designed to meet the specific developmental needs of toddlers aged 12–24 months presenting with challenging behaviors.MethodsThis study used a randomized controlled design to evaluate outcomes of PCIT-T for children aged 14–24 months with disruptive behaviors. Ninety toddlers with parent-reported disruptive behavior were randomly allocated to PCIT-T (intervention), an active control condition (Circle of Security– Parenting™; COS-P), or a non-treatment control condition (wait-list; WL). Outcomes were assessed at baseline (Time 1), post treatment/post waitlist (Time 2) and 4-month follow-up (Time 3).ResultsAt follow-up, the PCIT-T group displayed the highest levels of parenting sensitivity and positive parental verbalizations, and the lowest levels of negative child-directed verbalizations and non-attuned mind-minded statements. Of the three groups, the PCIT-T group showed the greatest degree of change on these variables, followed by the COS-P group and then the non-treated controls. The PCIT-T group were also the only group to show significant within-group improvements in sensitivity, self-reported parental reflectiveness, empathy and emotional understanding, parent-reported child social competence, child internalizing problems, and general behavior issues. Significant reductions in parental stress, child externalizing behaviors and parenting behaviors were seen for both the PCIT-T and COS-P groups.ConclusionsDelivered in the early intervention period of toddlerhood, Parent–Child Interaction Therapy—Toddler has the potential to bring about significant changes for children presenting with early onset behavioral issues.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR), 12,618,001,554,257. Registered 24 September 2018 – retrospectively registered, https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12618001554257.

Community Versus Facility-Based Services to Improve the Screening of Active Hepatitis C Virus Infection in Cambodia: The ANRS 12384 CAM-C Cluster Randomized Controlled Trial-Protocol for a Mixed Methods Study.

In Cambodia, hepatitis C constitutes a significant public health challenge, particularly among older adults (>45 years) for whom prevalence is estimated to be 5%. To facilitate the elimination of hepatitis C among the general population, enhancing access to screening and treatment is imperative. In this regard, the evaluation of community-based screening programs emerges as a crucial step toward improving health care accessibility. This study aims to assess the comparative efficacy of a community-based versus a facility-based approach in enhancing the uptake of hepatitis C antibody testing among the general population older than 40 years of age in Cambodia. The CAM-C (Community Versus Facility-Based Services to Improve the Screening of Active Hepatitis C Virus Infection in Cambodia) study uses a cluster-randomized controlled trial design across two Cambodian provinces to compare community-based and facility-based hepatitis testing interventions. Sampling involves a multistage cluster approach, targeting individuals older than 40 years of age due to their higher prevalence and risk of chronic hepatitis complications. This study incorporates a qualitative analysis of acceptability and a cost-effectiveness comparison. Interventions include facility-based testing with subsequent referral and community-based testing with direct in-home assessments. Follow-up for positive cases involves comprehensive management and potential direct-acting antiviral treatment. This study aims to identify a significant increase in testing uptake, requiring the screening of 6000 individuals older than 40 years of age, facilitated by a structured sampling and intervention approach to minimize contamination risks. The final protocol including the quantitative, qualitative, and cost-effectiveness part of the study was registered and was approved in 2019 by the National Ethical Cambodian for Health Research. Inclusions were completed by mid-2024, with analyses starting in May 2024. Using a mixed methods approach that combines a robust methodology (cluster-randomized controlled trial) with a cost-effectiveness analysis and qualitative research, such a study should provide invaluable information to guide the Ministry of Health in its hepatitis C virus screening strategy and move toward elimination. ClinicalTrials.gov NCT03992313; https://clinicaltrials.gov/study/NCT03992313. DERR1-10.2196/63376.

Leveraging female partner influence in health interventions: a study on prostate cancer screening uptake among men in rural Kiambu County, Kenya

Background: Globally, prostate cancer is the second most common cancer affecting men, with considerably high fatality rates. The aim of this study was to assess the effect of a female partner-led brochure method on perception, attitude, and cultural beliefs toward the intention of prostate cancer screening among men in rural Kiambu County, Kenya. Methods: The research adopted a randomized controlled trial design. Multistage sampling was employed in this study. The Chi-square test was used to assess differences in perception, attitude, and cultural beliefs towards intention to undergo prostate cancer screening (PCS) between the control and intervention groups at baseline and end line. Further, data were subjected to structural equation modeling to assess the influence of perception, attitude, and cultural beliefs on PCS intention pre-and post-intervention. Results: The results revealed no significant difference in perception between the control and intervention groups at baseline and end-line. Regarding attitude, there was a 39.8% and 24.7% increase in positive attitudes in the group that used gain-framed and loss-framed brochure methods, respectively, at the end line. In the end, there was a significant reduction in the number of respondents who had fatalistic beliefs, whereby 23.1% and 13.2% of the respondents in the groups’ intervention used gain-framed and loss-framed brochures, respectively. Conclusions: The study recommends the implementation of female partner-led interventions using gain-framed messaging in prostate cancer screening campaigns, as this approach demonstrated superior effectiveness in improving attitudes, reducing fatalism beliefs, and increasing the perceived benefits of screening among men.

Controllable Structure Design of an Organic Gel-Infused Porous Surface for Efficient Anti- and De-icing.

Icing causes many problems in daily life and with equipment stability, and many efforts have been made to remove surface icing. Herein, a novel organic gel-infused porous material is developed to achieve excellent de-icing performance. Porous polydimethylsiloxane (P-PDMS) composites with different pore sizes were prepared by a template method. The two-phase skeletons and/or gel material was obtained by infusing PDMS gel into P-PDMS (GIP-PDMS). The ice adhesion strength of GIP-PDMS under static and dynamic icing conditions was comparatively investigated. The results show that GIP-PDMS displayed excellent anti-icing performance, and the delay freezing time of GIP-PDMS1 was ∼4554 s at -5 °C. The ice adhesion strength of GIP-PDMS was much lower than that of P-PDMS, owing to the distinct modulus between the two-phase skeletons and/or gel. The simulation results indicated that the stress concentration promoted ice fracture and contributed to weak ice adhesion. Molecular dynamics further showed that the state of the molecular chains and the interfacial interaction between ice and PDMS gel at 268 K helped to decrease the shear force.

Pathophysiology-Driven Approaches for Overcoming Nanomedicine Resistance in Pancreatic Cancer.

Tumor heterogeneity poses a significant challenge in cancer therapy. To address this, we analyze pharmacotherapeutic challenges by categorizing them into static and dynamic barriers, reframing these challenges to improve drug delivery, efficacy, and the development of controlled-release nanomedicines (CRNMs). This pathophysiology-driven approach facilitates the design of novel therapeutics tailored to overcome obstacles in pancreatic ductal adenocarcinoma (PDAC) using nanotechnology. Advanced biomaterials in nanodrug delivery systems offer innovative solutions by combining controlled release, stimuli sensitivity, and smart design strategies. CRNMs are engineered to modulate spatiotemporal signaling and control drug release in PDAC, where resistance to conventional therapies is particularly high. This review explores pharmacokinetic considerations for nanomedicine design, RNA interference (RNAi) for stromal modulation, and the development of targeted nanomedicine strategies. Additionally, we highlight the limitations of current animal models in capturing the complexities of PDAC and discuss notable clinical failures, such as PEGylated hyaluronidase (Phase III HALO 109-301 trial) and evofosfamide (TH-302) with gemcitabine (MAESTRO trial), underscoring the need for improved models and treatment strategies. By targeting pathways like Notch and Hedgehog and incorporating stimuli-sensitive and pathway-modulating agents, CRNMs offer a promising avenue to enhance drug penetration and efficacy, reshaping the paradigm of pancreatic cancer treatment.

Usable Privacy and Security in Mobile Applications: Perception of Mobile End Users in Saudi Arabia

Privacy and security is very critical for mobile users and in-depth research into the area highlights a need for more scientific literature on the perception and challenges of end users to better align the design of privacy and security controls with user expectations. In this paper, we have explored the perceptions of the usability of privacy and security settings in mobile applications from mobile users in Saudi Arabia. The findings highlight that gender, age, and education level of users do not have any positive correlation with the privacy and security usability perceptions of mobile users. On the other hand, user concerns about privacy and security and the trustworthiness levels of end users regarding mobile phone privacy and security have a positive impact on end users’ perception of privacy and security usability. Furthermore, privacy usability perception has a positive impact on users’ feelings about their control over the privacy and security of their mobile phones. Based on the results of this empirical study, we propose that user-centric design of privacy and security controls, transparent data handling policies, periodic data management status preview and validation by end users, user education guidelines, strict governmental policies, and automated security settings recommendations can enhance the usability of the privacy and security of mobile phone applications. Our study did not take the geographical location of respondents into account, nor were the respondents balanced based on age and gender. In future work, these weaknesses need to be taken into account, and more qualitative studies can help to extract design guidelines for usable and secure mobile applications.

The Impact of Mindfulness-Based Meditation and Yoga on Stress, Body Image, Self-esteem, and Sexual Adjustment in Breast Cancer Patients Undergoing Modified Radical Mastectomy

Background Surgical interventions are commonly utilized in the treatment of breast cancer; however, they can elicit adverse effects on women’s perceptions of femininity, leading to stress, negative body image, diminished self-esteem, and challenges in sexual adjustment. Objective This study investigates the efficacy of mindfulness-based meditation and yoga in alleviating stress, enhancing self-esteem, improving body image, and facilitating sexual adjustment among women undergoing modified radical mastectomy. Methods Using a prospective (pretest, posttest, and second-month follow-up), 2-arm (1:1), randomized controlled experimental design, the study involved 39 women (intervention group = 19, control group = 20) undergoing modified radical mastectomy. The intervention group participated in face-to-face mindfulness-based meditation and yoga sessions lasting approximately 90 minutes each over an 8-week period. Results Following the intervention, significant reductions in perceived stress and the significance attributed to breasts in sexuality were observed (P < .05), accompanied by increases in self-esteem and body perception (P < .05). However, no significant differences were observed in sexual adjustment (P > .05). Conclusions Mindfulness-based meditation and yoga interventions demonstrated efficacy in mitigating perceived stress, enhancing self-esteem, and improving body perception among women undergoing modified radical mastectomy. The findings advocate for the integration of mindfulness-based stress reduction programs, particularly during the preoperative phase, to support oncological patients, particularly those with breast cancer. Implications for Practice Psychosocial aspects such as body image, self-esteem, and sexual adjustment following radical mastectomy are frequently overlooked in clinical care. This research highlights the potential benefits of incorporating mindfulness-based yoga and meditation techniques into nursing interventions to alleviate stress and enhance body confidence among women undergoing mastectomy.

The effect of game-based learning on the acquisition of intramuscular injection skills

AimThis study aims to determine the efficiency of game-based learning in nursing students' IMI skills training. BackgroundToday, with the unstoppable development of digital technologies, the skills required by modern health services and the needs of nursing students have changed. For this reason, new teaching methods have been researched instead of traditional methods. Game-based learning will choose a dynamic learning environment for the use of game design elements in the acquisition of knowledge and the teaching of psychomotor skills, based on the theory of experimental learning while improving learning experiences with active student participation. However, its use in nursing education is limited. DesignA pretest-posttest randomized controlled experimental study design was used. MethodsThe study was conducted at Ege University Faculty of Nursing in western Turkey. The sample size was determined through stratified randomization method and 135 nursing students participated in the study. Data were gathered by questionnaire method with the Student Descriptive Characteristics Form (SDCF), Intramuscular Injection Knowledge Form (IMIKF), Intramuscular Injection Implementation Checklist (IMIIC), Student Satisfaction and Confidence in Learning Scale (SSCLS) and Visual Comparison (Comfort) Scale (VCS). The chi-square test, the Mann-Whitney U test and the Brunner Langer method were performed in the SPSS 25.0 program. ResultsAfter the Intramuscular Injection Game-Based Learning Practice (IMIGBLP), the mean score of IMIICL (61±4.4) of the intervention group was significantly higher than the mean score of the control group (38±2.1) (p<0.05). The mean score of the students in the intervention group was determined to be significantly higher than the mean score of the control group (p<0.05). A significant difference was detected between the intervention and control group students in terms of their VCS scores after IMIGBLP (p<0.05). ConclusionConsidering the results of the study, it is recommended to use the game-based learning method in psychomotor skill training in nursing.

A pilot randomized controlled trial of a yoga program for alleviating cancer-related fatigue and psychological distress in women with gynecological cancer

PurposeYoga can alleviate cancer-related fatigue and psychological distress while improving health-related quality of life. However, most studies focused on breast cancer. This study aimed to evaluate the feasibility and acceptability of a yoga program for women with gynecological cancer and estimate its preliminary effects on cancer-related fatigue, psychological distress, and health-related quality of life. MethodsThis pilot study used a single-blinded randomized controlled trial design. Participants in the intervention group received the yoga program and usual care, while the control group only received usual care. Feasibility was assessed using eligibility, consent, attrition, and adherence rates. Acceptability was measured using a satisfaction questionnaire. Preliminary effects were evaluated on cancer-related fatigue, psychological distress, and health-related quality of life outcomes. ResultsThe yoga program demonstrated feasibility, with satisfactory rates of eligibility (62.7%), consent (64.9%), attrition (4.2%), and adherence (75%). The participants reported high satisfaction with the program. Significant intervention effects were observed on the behavioral/severity dimension of cancer-related fatigue (Hedges's g = 0.86). The intervention group demonstrated greater reductions in overall and other cancer-related fatigue subscales than the control group. Greater improvements in distress, anxiety, depression, and health-related quality of life were noted in the intervention group than in the control group, with effect sizes of 0.29, 0.77, 0.21, and 0.12, respectively. ConclusionsThe yoga program is feasible and acceptable, showing a trend in reducing cancer-related fatigue and psychological distress and improving health-related quality of life in women with gynecological cancer. A full-scale randomized controlled trial is warranted.

Metal-organic framework-based hybrids with photon upconversion.

Upconversion materials (UCMs) featuring an anti-Stokes type emission establish them as an important category of photoluminescent materials. Metal-organic frameworks (MOFs) are rapidly gaining prominence as a class of versatile materials with favourable physical and chemical properties, including high porosity, controllable pore size, flexible design, and diverse functional sites. To endow MOFs with upconversion capability and improve the properties and performance of UCMs, the hybrids integrating UCMs and MOFs are proven to be successful. This review focuses on the research advancements of upconverting MOF-based hybrids, encompassing classifications, luminescence mechanisms, designs, properties, and applications in energy, catalysis, and biomedical fields. The analyses on the functions of upconversion and MOFs, as well as the advantages and disadvantages of various upconverting MOF-based hybrids, are included. Future research directions spanning from properties and performance to applications are explored. This review will be valuable in highlighting the research accomplishments, inspiring more ideas, facilitating deeper investigations in diverse avenues, and further advancing the research field.