Effect Size Estimates Research Articles

Randomized controlled trial of the parents as teacher home visiting program: Outcomes of the intervention on families at six month follow-up

Family support programs are considered central to improving the health and development of children, and home visitation remains one of the most frequently used early intervention strategies. This study utilized a randomized controlled trial (RCT) design to test the effectiveness of the Parents as Teachers (PAT) home visiting program intervention on child and caregiver outcomes, measured at six months post enrollment, with families randomized to study groups. Four PAT affiliates selected for the study are “blue ribbon” programs that meet certain quality standards. A total of 461 families (a 69 % retention rate) completed both baseline and 6-month data collection, including n = 295 for intervention and n = 166 for control. Differential attrition was 3.7 %. Baseline equivalency tests confirmed that the random assignment was effective and the groups were equivalent. Significant differences were observed between intervention and control groups, favoring the PAT intervention group, in 3 of the 4 domains assessed: child development, including Vineland-II Listening and Understanding and Talking and frequency of reading to the child; parenting practices, including improved sense of parenting efficacy and hopefulness; and family health and safety, including improved safety practices at home and reduced risk scores that capture depression and parenting stress. Estimated effect sizes for significant measures ranged from 0.12 to 0.28 and thus were in the range of what would be considered to have meaningful impact when compared with similar studies. Our findings contribute significantly to the understanding of home visitation program outcomes and adds to existing research by showing gains in child development that can be attributed to the PAT program. The RCT provides valuable evidence supporting the PAT program’s role in enhancing child development, improving parenting practices, and ensuring family health and safety. However, the lack of difference in service utilization between groups and the challenges faced during the study highlight the need for consideration of external factors, such as the impact of the COVID-19 pandemic on service availability and utilization. This study contributes to the broader understanding of early childhood interventions and their efficacy in real-world, community settings.

Visualizing and diagnosing spillover within randomized concurrent controlled trials through the application of diagnostic test assessment methods

BackgroundSpillover of effect, whether positive or negative, from intervention to control group patients invalidates the Stable Unit Treatment Variable Assumption (SUTVA). SUTVA is critical to valid causal inference from randomized concurrent controlled trials (RCCT). Spillover of infection prevention is an important population level effect mediating herd immunity. This herd effect, being additional to any individual level effect, is subsumed within the overall effect size (ES) estimate derived by contrast-based techniques from RCCT’s. This herd effect would manifest only as increased dispersion among the control group infection incidence rates above background.Methods and resultsThe objective here is to explore aspects of spillover and how this might be visualized and diagnosed. I use, for illustration, data from 190 RCCT’s abstracted in 13 Cochrane reviews of various antimicrobial versus non-antimicrobial based interventions to prevent pneumonia in ICU patients. Spillover has long been postulated in this context. Arm-based techniques enable three approaches to identify increased dispersion, not available from contrast-based techniques, which enable the diagnosis of spillover within antimicrobial versus non-antimicrobial based infection prevention RCCT’s. These three approaches are benchmarking the pneumonia incidence rates versus a clinically relevant range, comparing the dispersion in pneumonia incidence among the control versus the intervention groups and thirdly, visualizing the incidence dispersion within summary receiver operator characteristic (SROC) plots. By these criteria there is harmful spillover effects to concurrent control group patients.ConclusionsArm-based versus contrast-based techniques lead to contrary inferences from the aggregated RCCT’s of antimicrobial based interventions despite similar summary ES estimates. Moreover, the inferred relationship between underlying control group risk and ES is ‘flipped’.

Widespread natural selection on metabolite levels in humans.

Natural selection acts ubiquitously on complex human traits, predominantly constraining the occurrence of extreme phenotypes (stabilizing selection). These constraints propagate to DNA sequence variants associated with traits under selection. The genetic signatures of such evolutionary events can thus be detected via combining effect size estimates from genetic association studies and the corresponding allele frequencies. Although this approach has been successfully applied to high-level traits, the prevalence and mode of selection acting on molecular traits remain poorly understood. Here, we estimate the action of natural selection on genetic variants associated with metabolite levels, an important layer of molecular traits. By leveraging summary statistics of published genome-wide association studies with large sample sizes, we find strong evidence of stabilizing selection for 15 out of 97 plasma metabolites, with nonessential amino acids displaying especially strong selection signatures. Mendelian randomization analysis reveals that metabolites under stronger stabilizing selection display larger effects on a range of clinically relevant complex traits, suggesting that maintaining a disease-free profile may be an important source of selective constraints on the metabolome. Metabolites under strong stabilizing selection in humans are also more conserved in their concentrations among diverse mammalian species, suggesting shared selective forces across micro- and macroevolutionary timescales. Overall, this study demonstrates that variation in metabolite levels among humans is frequently shaped by natural selection and this may act through their causal impact on disease susceptibility.

Effectiveness of smartphone app-based interventions after surgery on quality of recovery among cancer patients: a systematic review and meta-analysis

Background Postoperative recovery in patients with cancer is a complex process that influences quality of life, functional recovery, and mental well-being. Smartphone app-based interventions have emerged as potential tools for improving various aspects of health and well-being in cancer patients. However, the existing literature lacks a consensus on the efficacy of these interventions, leading to conflicting outcomes. Methods We searched multiple databases, including PubMed, Web of Science, Cochrane Library, Scopus, EMBASE, and MEDLINE Complete (EBSCO). We exclusively selected randomized controlled trials meeting the inclusion criteria for our systematic review and meta-analysis. Utilizing a random-effects model, we derived the pooled effect size estimates for the meta-analysis. Where applicable, we calculated the pooled standardized mean difference (SMD) with 95% confidence interval (CI). The Cochrane Collaboration tool (Cochrane ROB) was used to evaluate bias in randomized trials. The primary outcome was the quality of life. The secondary outcomes were psychological symptoms, health conditions, satisfaction, and self-efficacy. Results Of 731 screened articles, 15 were included, comprising 1,831 participants. Our meta-analysis revealed that app-based interventions potentially improved quality of life (SMD = −0.58, 95% CI −1.00 to −0.16), alleviated psychological symptoms (SMD = −0.43, 95% CI −0.72,−0.15; p = .003), and enhanced self-efficacy (SMD = 0.90, 95% CI 0.26 to 1.53; p = 0.001). However, there was no statistically significant effect on satisfaction (SMD = 1.25, 95% CI-1.06 to 3.57; p = 0.23). Conclusions Our findings suggest that mobile health apps hold promise in improving the well-being of cancer patients after surgery by enhancing their quality of life, health status, and self-efficacy, while also reducing anxiety and depression.

The Influence of Nutrition Intervention on the P1NP and CTX-1 Response to an Acute Exercise Bout: A Systematic Review with Meta-Analysis.

Although nutrition and exercise both influence bone metabolism, little is currently known abouttheir interaction, or whether nutritional intervention can modulate the bone biomarker response to acute exercise. Improved understanding of the relationships between nutrition, exercise and bone metabolism may have substantial potential to inform nutritional interventions to protect the bone health of exercising individuals, and to elucidate mechanisms by which exercise and nutrition influence bone. The aim was to synthesise available evidence related to the influence of nutrition on the response of the bone biomarkers procollagen type 1 N-terminal propeptide (P1NP) and C-terminal telopeptide of type 1 collagen (CTX-1) to acute exercise, using a systematic review and meta-analytic approach. Studies evaluating the influence of nutritional status or intervention on the bone biomarker response to an acute exercise bout were included and separated into four categories: (1) feeding status and energy availability, (2) macronutrients, (3) micronutrients and (4) other. Studies conducted on healthy human populations of any age or training status were included. Meta-analysis was conducted when data from at least five studies with independent datasets were available. In the case of insufficient data to warrant meta-analysis, results from individual studies were narratively synthesised and standardised mean effect sizes visually represented. Twenty-two articles were included. Of these, three investigated feeding status or energy availability, eight macronutrients, eight micronutrients (all calcium) and six other interventions including dairy products or collagen supplementation. Three studies had more than one intervention and were included in all relevant outcomes. The largest and most commonly reported effects were for the bone resorption marker CTX-1. Meta-analysis indicated that calcium intake, whether provided via supplements, diet or infusion, reduced exercise-induced increases in CTX-1 (effect size - 1.1; 95% credible interval [CrI] - 2.2 to - 0.05), with substantially larger effects observed in studies that delivered calcium via direct infusion versus in supplements or foods. Narrative synthesis suggests that carbohydrate supplementation may support bone during acute exercise, via reducing exercise-induced increases in CTX-1. Conversely, a low-carbohydrate/high-fat diet appears to induce the opposite effect, as evidenced by an increased exercise associated CTX-1 response, and reduced P1NP response. Low energy availability may amplify the CTX-1 response to exercise, but it is unclear whether this is directly attributable to energy availability or to the lack of specific nutrients, such as carbohydrate. Nutritional intervention can modulate the acute bone biomarker response to exercise, which primarily manifests as an increase in bone resorption. Ensuring adequate attention to nutritional factors may be important to protect bone health of exercising individuals, with energy, carbohydrate and calcium availability particularly important to consider. Although a wide breadth of data were availablefor this evidence synthesis, there was substantial heterogeneity in relation to design and intervention characteristics. Direct and indirect replication is required to confirm key findings and to generate better estimates of true effect sizes.

Impact of intrapartum quality improvement interventions on stillbirths and other adverse pregnancy outcomes: A protocol for systematic review and meta-analysis.

Stillbirths are a major global health concern. Half of stillbirths occur during intrapartum period, mostly in low- and middle-income countries of sub-Saharan Africa and South Asia. Achieving a stillbirth rate of less than 12 per 1000 births by 2030 is the global target of Every Newborn Action Plan and Sustainable Development Goals. Evidence suggests that improving intrapartum quality of care can help reduce stillbirths and other adverse pregnancy outcomes. This study will explore whether quality improvement (QI) packages at intrapartum care points can reduce stillbirths and other outcomes such as maternal and neonatal mortality. We will conduct a systematic literature review and meta-analysis. Comprehensive search strategy will be developed for databases PubMed, Web of Science, ScienceDirect, ProQuest, Cochrane and China National Knowledge Infrastructure. We will include randomized controlled trials, controlled non-randomized trials, controlled clinical trials, interrupted time series, cohort studies, case-control and nested case-control studies which assess the impact of QI interventions at intrapartum points of care on stillbirths and other adverse pregnancy outcomes. We will search grey literature such as unpublished research studies, dissertations and unfinished trials. English and non-English language articles will be included to avoid language bias. We will also evaluate reporting quality and risk of bias. Sensitivity tests will be carried out for heterogeneity. Pooled estimates of effect sizes will be computed with random-effects models. Supplementation of the quantitative synthesis with a qualitative narrative synthesis would be added, if deemed necessary. We will explore publication bias using funnel plot and Egger's regression test will be used for evaluation, if needed. We will report pooled effectiveness of different intrapartum QI interventions across multiple settings in averting stillbirths and other adverse outcomes such as maternal mortality and neonatal mortality.

Cognitive Symptoms Are Not Associated with Cognitive Performance in Post-Acute mTBI.

Subjective cognitive symptoms are commonly reported after mild traumatic brain injury (mTBI) but are often not associated with objective cognitive performance. This may be due to limitations in traditional cognitive performance measures, which may not be sensitive to subtle variations in cognition in post-acute mTBI. This study explored associations between objective and subjective cognition using computer-based tasks of increasing cognitive load, proposed to be more sensitive to subtle differences in performance. Individuals with mTBI (n = 68) and trauma controls (n = 40) were prospectively recruited and assessed approximately 8weeks post-injury. Participants completed measures of subjective symptom reporting, objective cognitive performance (including two computer-based tasks of increasing cognitive load), and psychological distress. There were no significant associations between subjective and objective cognition reporting in the mTBI group, both in bivariate correlations (|r| = 0.01-0.20, p> .05) and when controlling for psychological distress (|r| = 0.00-0.17, p> .05). A similar pattern of results was observed in trauma controls, suggesting that the limited relationships between objective and subjective cognition in mTBI may not be specific to this population. Despite employing measures of cognitive performance proposed to be more sensitive than traditional tasks, no significant relationships were observed between objective and subjective cognition in post-acute mTBI, and estimated effect sizes were small to negligible. This provides further evidence that at a group level 8weeks after mTBI subjective cognitive symptoms primarily reflect factors aside from objective cognition.

Estimating the causal effect of filter ventilation levels in cigarettes on past 30-day smoking.

Cigarettes with higher levels of filter ventilation are misperceived as less harmful and may be more appealing to consumers. Setting limits on filter ventilation has been considered as a policy, but a better understanding of any potential unintended consequences is needed. Filter ventilation (0.2-61.1%) measured for 114 subbrands was merged with Wave 1 (2012-2013) of the Population Assessment of Tobacco Use and Health (PATH) data, restricted to adults 25+ years of age who smoked daily, and examined by quartiles. Inverse probability of exposure weights were used to estimate the causal effect of filter ventilation on past-30 day smoking at subsequent waves while accounting for potential confounders including demographics, menthol, heaviness of smoking and past quit attempts. Compared to those in the 1st (lowest) quartile of filter ventilation, those in the 2nd, 3rd and 4th quartiles had 1.02 (95% confidence interval: 0.57, 1.82), 0.86 (0.42, 1.73) and 1.52 (0.90, 2.56) times the odds of no past 30-day smoking at Wave 2 (approximately 1 year later, p=0.163), and 1.28 (0.80, 2.07), 1.11 (0.67, 1.83) and 1.65 (1.01, 1.24) times the odds of no past 30-day smoking at Wave 4 (3 years later, p = 0.238). This observational study found no strong evidence of a causal effect of filter ventilation on past 30-day smoking at approximately 1 and 3 years follow-up. However, our effect size estimates were not precise and thus an increase in the ability to quit smoking due to higher filter ventilation levels cannot be ruled out. Setting a maximum limit on filter ventilation (FV) in cigarettes could address the misperception that highly ventilated cigarettes are less harmful and the link between FV and lung adenocarcinoma. It is important to understand whether such a policy would have unintended consequences on longer-term smoking behavior. We found no strong evidence that FV affects past 30-day smoking 1-3 years later, but could not rule out the possibility that higher FV increases cessation rates. If future studies confirm these epidemiologic findings, this could mean that setting a limit on FV would not lead to reductions in the ability to quit smoking.

Optimizing Individual HIV Testing and Counseling for Emerging Adult Sexual Minority Men (Aged 18 to 24) in Relationships: A Pilot Randomized Controlled Trial of Adjunct Communication Components.

The majority of new HIV infections in the US occur among sexual minority men (SMM) with older adolescent and emerging adult SMM at the highest risk. Those in relationships face unique HIV prevention challenges. Existing sexual HIV transmission risk interventions for male couples often encounter implementation challenges and engaging younger SMM early in relationships may be particularly difficult. This pilot randomized controlled trial evaluated the acceptibility and feasibility of We Test HIV testing - a behavioral health intervention tailored for younger SMM in realtionships - and generated preliminary estimates of effect size. The intervention comprises two adjunct moduls - video-based communication skills training as well as communication goal setting and planning - delivered in conjunction with routine HIV testing and counseling in individual or dyadic formats. A sample of 69 SMM aged 17 to 24 were recruited online. Following baseline assessment, youth were randomized to receive either the experimental, We Test, intervention or routine HIV testing (the control condition). Follow-up assessments were completed 3 and 6 months post-baseline. Results suggested the study was feasible and the individually delivered format was acceptible. We Test HIV testing was associated with significant improvements in communication skills. In addition, youth who remained in a relationship experienced an increase in communal coping to reduce HIV infection risk and relationship power. While groups did not differ with respect to condomless anal sex with casual partners, these psycho-social constructs (communication, communal coping with HIV prevention, and relationship power) may serve as mediators of intervention effects on sexual risk reduction in a larger study.

The efficacy of cognitive behavioral therapy for mental health and quality of life among individuals diagnosed with cancer: A systematic review and meta-analysis.

It has long been documented that cognitive behavioral therapy (CBT) has positive impacts on improving mental health (MH) and quality of life (QoL) in the general population, but investigations on its effect on cancer survivors remain limited, especially for QoL outcomes. The purpose of this meta-analysis is to investigate the effects of CBT as compared to control on cancer patients' MH and QoL outcomes. Control is defined in this study as standard therapy, waitlist control, and active/alternative therapy. In total, 154 clinical trials creating a sample size of 1627 individuals were collected. Analysis focusing on MH and QoL excluded 29 clinical trials resulting in a final analysis of 132 clinical trials (and 1030 effect sizes). R Statistical Software (version 4.2.2) and the robumeta package were utilized to complete analysis, which entailed robust variance estimation (RVE) in intercept-only meta-regression, and univariate meta-regression (for moderator analysis). Across 132 clinical trials and 1030 effect size estimates, we identified that CBT moderately improves MH and QoL in cancer patients d = 0.388, 95% CI 0.294-0.483, p < 0.001. Additionally, age and delivery format can influence the efficacy of CBT in this patient population. CBT statistically improves the MH and QoL psychosocial parameters in cancer patients with greater efficacy in younger patients. Important clinical and intervention-related factors, that is, age and delivery, should be considered when oncologists consider CBT as a psychotherapeutic intervention for individuals with cancer.

Replication study: Investigating the effects of maximal anaerobic fatigue on dynamic postural control using the Y-Balance Test

ObjectivesThe aim of this study was to replicate the study titled “Investigating the effects of maximal anaerobic fatigue on dynamic postural control using the Y-Balance Test” by Johnston et al. (2018) as part of a large replication project. This study aimed to determine the effects of maximal anaerobic fatigue on dynamic postural control using the Y-Balance Test, with a specific focus on anterior reach distance. DesignA single session intervention. MethodsForty male and female university students (age: 22 ± 3 years, height: 171.88 ± 8.96 cm, mass: 76.20 ± 14.31 kg) partaking in competitive sport, completed a Y-Balance Test protocol at 20, 10, and 0 min before a modified 60 s Wingate fatiguing protocol. Post-fatigue assessments were completed at 0, 10, and 20 min after the Wingate test. Replication outcomes included significance, direction, and effect size comparison using a z-test. ResultsA one-way repeated measures ANOVA showed a significant effect for maximal anaerobic fatigue on normalised anterior reach direction (F1.82, 69.03 = 7.16, p = 0.002, ηp2 = 0.159; 95 % CI: 0.025, 0.320). Therefore, we replicated the original findings for anterior reach distance in terms of statistical significance (F = 3.818, p = 0.025, ηp2 = 0.376; 95 % CI: 0.00, 0.62). The replication and original effect size estimates for anterior reach direction were compared using a z-test and were deemed compatible (z = 1.65, p = 0.05). ConclusionsOverall, we replicated the original study findings for the effect of maximal anaerobic fatigue on anterior reach distance in a Y-Balance Test.

Quality of Life in Patients Affected by Facial Basal Cell Carcinoma: Prospective Longitudinal Pilot Study and Validation of Skin Cancer Index in Lithuanian Language.

Facial basal cell carcinoma (BCC) poses significant challenges due to its potential for local destruction and impact on quality of life (QoL). Continuous research is necessary to identify novel factors influencing the quality of life within this demographic across diverse cultural settings. The aims of this study were to translate, culturally adapt, and validate the Lithuanian version of Skin Cancer Index, subsequently utilizing this questionnaire in the pilot phase of the study to achieve the following: (1) identify the differences in short- and long-term QoL, (2) establish empirical correlations between SCI scores and aesthetic facial regions, evaluate the potential differences between age, gender, and tumor size groups. A prospective longitudinal study was conducted with 100 consecutive patients. The SCI was translated into Lithuanian language, with a rigorous assessment of its psychometric properties to confirm validity. Alongside hypothesis testing, a detailed analysis of variables was conducted. Statistical techniques, including t-tests and ANOVA, were employed to compare scores across demographic and clinical groups, with effect size calculations for further interpretation. Our findings demonstrate that the Lithuanian SCI successfully fulfills the criteria established by the COSMIN checklist. Surgical treatment for facial BCC notably enhances QoL, particularly evident six months post-surgery. Analysis of SCI scores identified demographic and clinical factors associated with lower QoL, including female gender, treatment with skin plasty, and tumor sites in aesthetically sensitive areas like the cheek, nose, and eyelid. The Lithuanian version of the SCI is a reliable and valid tool for assessing QoL in facial BCC patients. Our findings underscore the global relevance of understanding the multifactorial influences on QoL in BCC patients. Early diagnosis, less invasive treatment approaches, and tailored post-operative care are crucial in minimizing the psychological, social, and appearance-related burdens of facial BCC.

글의 길이와 내용, 학생 상하 수준에 따른 고등학생의 문장 중요도 평정 차이

Purpose: This study analyzed differences in high school students’ rating of sentence importance depending on text length, content, and the students’ proficiency level(upper and lower), aiming to improve the teaching and the learning of reading. Methods: A test was conducted with 173 high school students in Changwon, Gyeongsangnam province. Based on the test, an analysis was performed to examine how text length and content affect the rating of importance. Additionally, participants were divided into two groups based on their proficiency levels in rating sentence importance — upper and lower — and the effects of variables within each group were analyzed. Results: First, text length revealed a statistically significant difference in students’ importance rating scores. Second, concerning content, no statistically significant difference was observed in the scores. Third, dividing participants into upper and lower proficiency groups based on the mean score showed a statistically significant difference between the two groups. Fourth, regarding text length, students in the upper group exhibited a superior ability to rate sentence importance in shorter passages compared to longer ones, and this difference was statistically significant. In contrast, for the lower group, no statistically significant difference was observed depending on the text length. Consequently, it was determined that students in the lower group face challenges in rating sentence importance regardless of text length. Fifth, concerning content, no statistically significant differences were observed in importance rating abilities for both upper and lower groups. Nevertheless, upon calculating effect sizes, it was discerned that students in both groups exhibited comparatively higher abilities in passages related to humanities than those related to the Natural Sciences. Conclusion: Students’ proficiency in rating sentence importance varied depending on the length of the text, while no significant difference was observed concerning the content. The upper and lower groups showed a great disparity in proficiency, and the variables that caused statistically significant differences varied depending on the proficiency level. These findings show that it is important to adjust the length and content of texts to match students’ proficiency levels when teaching reading strategies such as sentence importance rating. Furthermore, the introduction of sentence importance rating method, which visually illustrates the reading process, into teaching and learning can contribute to enhancing students’ reading abilities.

Protocol for a randomised controlled unblinded feasibility trial of HD-DRUM: a rhythmic movement training application for cognitive and motor symptoms in people with Huntington’s disease

IntroductionHuntington’s disease (HD) is an inherited neurodegenerative disease causing progressive cognitive and motor decline, largely due to basal ganglia (BG) atrophy. Rhythmic training offers promise as therapy to counteract BG-regulated...

State Policies Regulating Firearms and Changes in Firearm Mortality

Despite high social and public health costs of firearm violence in the United States, the effects of many policies designed to reduce firearm mortality remain uncertain. To estimate the individual and joint effect sizes of state firearm policies on firearm-related mortality. In this comparative effectiveness study, bayesian methods were used to model panel data of annual, state-level mortality rates (1979-2019) for all US firearm decedents, with analyses conducted in October 2023. Six classes of firearms policies: background checks, minimum age, waiting periods, child access, concealed carry, and stand-your-ground laws. Primary outcomes (total firearm deaths, firearm homicide deaths, and firearm suicide deaths) were assessed using the National Vital Statistics System. Bayesian estimation was used to estimate the partial association of changes in firearms policies with subsequent changes in firearm mortality. The estimated effect sizes of individual policies 5 or more years after implementation were generally small in magnitude and had considerable uncertainty. The policy class with the highest probability of reducing firearm deaths was child-access prevention laws, estimated to reduce overall firearm mortality by 6% (80% credible interval [CrI], -2% to -9%). The policy class with the highest probability of increasing firearm deaths was stand-your-ground laws, estimated to increase firearm homicides by 6% (80% CrI, 0% to 13% increase). Estimates of association of implementing multiple firearm restrictions with subsequent changes in firearm mortality yielded larger effect sizes. Moving from the most permissive to most restrictive set of firearm policies was associated with an estimated 20% reduction in firearm deaths (80% CrI, 10% to 28% reduction), with a 0.99 probability of any reductions in firearm death rates. In this comparative effectiveness study of state firearm policies, the joint effect estimates of combinations of firearm laws were calculated, showing that restrictive firearm policies were associated with substantial reductions in firearm mortality. Although policymakers would benefit from knowing the effects of individual policies, the estimated changes in firearm mortality following implementation of individual policies were often small and uncertain.

Project management in healthcare: An examination of organizational competence

This research aims to identify the factors that influence the organizational competence (OC) of hospitals in effectively managing projects. It follows a quantitative approach, analyzing data collected from three Portuguese hospitals (51 respondents) using R software. An organizational competence score (OCS) was calculated based on standardized values across five different competence areas.The results indicate significant associations between the competence areas and project categories, organizational alignment, governance, management, people's competence, and resources. Furthermore, the study explores the relationships between the competence areas and quantitative variables such as the number of project team members and former experience in projects. The OCS is also examined regarding project categories, region, experience in projects, and number of project members.The findings provide insights into the features that impact the OC of hospitals in PM, highlight the importance of organizational alignment, effective governance, competent management, skilled personnel, and adequate resources in enhancing PM capabilities. However, the wide confidence interval for the Odds Ratio indicates a high degree of uncertainty in the effect size estimates, suggesting the need for larger sample sizes and more robust models in future research to obtain more precise estimates.

Heterogeneity in effect size estimates

A typical empirical study involves choosing a sample, a research design, and an analysis path. Variation in such choices across studies leads to heterogeneity in results that introduce an additional layer of uncertainty, limiting the generalizability of published scientific findings. We provide a framework for studying heterogeneity in the social sciences and divide heterogeneity into population, design, and analytical heterogeneity. Our framework suggests that after accounting for heterogeneity, the probability that the tested hypothesis is true for the average population, design, and analysis path can be much lower than implied by nominal error rates of statistically significant individual studies. We estimate each type's heterogeneity from 70 multilab replication studies, 11 prospective meta-analyses of studies employing different experimental designs, and 5 multianalyst studies. In our data, population heterogeneity tends to be relatively small, whereas design and analytical heterogeneity are large. Our results should, however, be interpreted cautiously due to the limited number of studies and the large uncertainty in the heterogeneity estimates. We discuss several ways to parse and account for heterogeneity in the context of different methodologies.

Basic aspects of meta-analysis. Part 2

Meta-analysis combines the results of several scientific studies to obtain a summary quantitative estimation of effect size in order to compare the results of several studies and to identify patterns among them and possible sources of biases. Since the research teams, patients, research protocol, clinical guidelines and time intervals are often different between original scientific studies all these sources of difference can influence the results of each study, causing statistical heterogeneity. Meta-analyses are the highest level of credibility within evidence-based medicine, as they allow us to take into account the influence of many confounding factors and publication biases on the true effect size. Understanding the possible sources of erroneous conclusions in papers will allow researchers to analyze the results of such studies correctly and properly plan their own experiments. In this article the reader will be introduced to methods for identifying and quantifying hidden heterogeneity, such as subgroup analysis and meta-regression. In addition, the reader will learn how to calculate effect size in studies, estimate publication bias mathematically and graphically, and incorporate this estimate into the overall average effect size estimate in meta-analyses.

Advanced footwear technology and its impacts on running mechanics, running economy and perception of male and female recreational runners

Studies on advanced footwear technology (AFT) often investigate potential performance benefits for constraint populations, and high running speeds. This research compared running biomechanics, running economy and perception between males and females, when wearing three different AFT conditions at recreational running speeds. An innovation shoe sample (IM) at confirmation stage in the product creation process was compared to two commercial running shoes (MM, MF). Gender and shoe variable means were compared for main and interaction effects (p < 0.05) by a mixed 2 × 3 repeated measures analysis of variance (RM ANOVA), and effect size estimation. A main effect was seen for shoe condition, both the IM and MF showed higher vertical loading rates than MM, and higher peak vertical force 1. IM had less frontal plane rearfoot motion than both the MM and MF. At the MTPJ, IM had lower maximum dorsiflexion angle, dorsiflexion velocity leading to lower negative power and negative work than both the MM and MF. IM and MF showed significantly lower oxygen consumption than the MM. Perception measurements showed IM and MF to be significantly softer, responsive and had better propulsion than the MM. A main effect was seen for gender, females exhibited higher vertical loading rates, reduced frontal plane ankle motion and lower MTPJ motion, and lower oxygen consumption compared to males. There was no gender effect for perception. Despite biomechanical differences, both IM and MF showed improved performance compared to the MM. Males and females exhibit different biomechanics when wearing AFT, however this did not lead to differences in subjective perception. It is concluded that the specific AFT applied for IM samples in this research functions for both groups largely similarly.

Intervening to reduce sedentary behavior among African American elders: the "Stand Up and Move More" intervention.

Reducing sedentary behavior is a promising intervention target for improving health for older adults; however, few interventions include African American communities. The purpose of this research was to extend the reach of an effective sedentary behavior intervention to African American elders. Two pilot studies assessed the feasibility (retention, adherence, and safety) and acceptability (participant and leader perspectives) of a 4-wk "Stand Up and Move More" (SUMM) intervention. Sedentary behavior (self-reported and monitor-derived), function (short physical performance battery), and quality of life (SF-36) were measured at baseline (wk0), postintervention (wk4), and follow up (wk12; study 1) to examine preliminary effectiveness of the intervention. Participants (N=26) attended SUMM or an attention-matched stress management intervention (study 2). The magnitude of treatment effects were determined using Hedge's g effect size calculations [small (g=0.20 to 0.49), moderate (g=0.50 to 0.79), large (g>0.80)]. Retention and adherence rates ranged from 50%-100% and 80%-100%, respectively. There were no adverse events. Participants expressed high satisfaction, and the leader of the SUMM intervention indicated that the intervention content was beneficial. Hedges' g revealed negligible to small changes in sedentary behavior (g<0.50) following SUMM. There were moderate to large improvements in function (g=0.51-0.82) and quality of life (g=0.54-1.07) from wk0 to wk4 in study 1; and moderate to large improvements in function (g=0.51-0.88) from wk0 to wk4 in study 2. There was a moderate improvement in quality of life (SF-36 emotional role limitations g=0.54) in the SUMM group only. Given its feasibility, safety, and acceptability, SUMM may be a promising intervention to improve functioning and well-being among African American elders.