Differences In Effect Sizes Research Articles

Esthetic Perception of Different Clinical Situations of Maxillary Lateral Incisor Agenesis According to Populations with Dental and Non-Dental Backgrounds: A Systematic Review and Meta-Analysis

Treatment of unilateral or bilateral maxillary lateral incisor agenesis is challenging, time-consuming, expensive, and requires careful treatment planning, predictability, and esthetics. This review aimed to identify differences in esthetic perception among orthodontists, general dentists, differentiated dentists, and laypersons, which may interfere with treatment options. EBSCO, PubMed, ScienceDirect, Cochrane Library databases, and Google Scholar were searched using keyword pairing and a Boolean expression, “(congenitally missing OR agenesis OR hypodontia) AND (maxillary lateral incisors) AND (esthetic perception OR smile) AND (laypersons OR dental professional OR general dentist OR orthodontists).” Reviews and case studies were excluded. A total of 13 studies were selected for qualitative analysis (adapted ROBINS-I) and 11 were selected for meta-analysis (p < 0.05) after being sub-grouped into “Opening vs. Closure” and “No remodeling vs. Dental remodeling vs. Dental and gingival remodeling” groups. A meta-analysis evaluated the magnitude of the difference between groups based on differences in means and effect sizes (α = 0.05; 95% CI; Z-value 1.96), revealing that the esthetic perception of maxillary lateral incisor agenesis treatment remains controversial even among professionals. Gingival remodeling was not valued compared to isolated dental remodeling. Studies lack rigorously comparable methodologies. Discussion with the patient is pertinent in doubtful situations, as the best treatment option remains unclear, and overtreatment should be avoided.

Impact of Oncological Treatment on Perceived Stigmatization - A Register-Based Study

Studies on stigmatization of cancer patients show a moderate or high relevance of perceived stigmatization. To date, there are no studies with explicit focus on stigma in relation to oncological therapy. We investigated the role of oncological therapy on perceived stigma in a large sample. Quantitative data from 770 patients (47,4% women; 88%≥50 years) with breast, colorectal, lung, or prostate cancer were analyzed as part of a registry-based bicentric study. Stigma was assessed with the German version of the SIS-D; the validated instrument includes four subscales in addition to a total score. Data were analyzed using the t-test and multiple regression with various sociodemographic and medical predictors. Of the 770 cancer patients, 367 (47,7%) received chemotherapy, possibly in combination with other therapy (surgery, radiotherapy). All stigma scales showed significant mean differences (effect sizes up to d=0,49) with higher scores for patients receiving chemotherapy. The multiple regression analyses of the respective SIS-scales demonstrate a significant influence of the variables age (ß≤- 0,266) and depressivity (ß≤0,627) on perceived stigma in all five models, and (in four models) a significant influence of the variable chemotherapy (ß≤0,140). Radiotherapy shows only a weak influence in all models and surgery has no relevance. The explained variance ranges from R2=27 to 46,5%. The findings support the assumption of an association of oncological therapy, especially chemotherapy, on the perceived stigmatization of cancer patients. Relevant predictors are depression and younger (<50) age. These (vulnerable) groups should therefore receive special attention and psycho-oncological care in clinical practice. Further research on the course and mechanisms of therapy-related stigmatization is also necessary.

Comparative Effectiveness of Digital Cognitive Behavioral Therapy vs Medication Therapy Among Patients With Insomnia

Although digital cognitive behavioral therapy for insomnia (dCBT-I) has been studied in many randomized clinical trials and is recommended as a first-line treatment option, few studies have systematically examined its effectiveness, engagement, durability, and adaptability in clinical settings. To evaluate the clinical effectiveness, engagement, durability, and adaptability of dCBT-I. This retrospective cohort study was conducted using longitudinal data collected via a mobile app named Good Sleep 365 between November 14, 2018, and February 28, 2022. Three therapeutic modes (ie, dCBT-I, medication, and their combination) were compared at month 1, month 3, and month 6 (primary). Inverse probability of treatment weighting (IPTW) using propensity scores was applied to enable homogeneous comparisons between the 3 groups. Treatment with dCBT-I, medication therapy, or combination therapy according to prescriptions. The Pittsburgh Sleep Quality Index (PSQI) score and its essential subitems were used as the primary outcomes. Effectiveness on comorbid somnolence, anxiety, depression, and somatic symptoms were used as secondary outcomes. Cohen d effect size, P value, and standardized mean difference (SMD) were used to measure differences in treatment outcomes. Changes in outcomes and response rates (≥3 points change in PSQI score) were also reported. A total of 4052 patients (mean [SD] age, 44.29 [12.01] years; 3028 [74.7%] female participants) were selected for dCBT-I (n = 418), medication (n = 862), and their combination (n = 2772). Compared with the change in PSQI score at 6 months for participants receiving medication alone (from a mean [SD] of 12.85 [3.49] to 8.92 [4.03]), both dCBT-I (from a mean [SD] of 13.51 [3.03] to 7.15 [3.25]; Cohen d, -0.50; 95% CI, -0.62 to -0.38; P < .001; SMD = 0.484) and combination therapy (from a mean [SD] of 12.92 [3.49] to 6.98 [3.43]; Cohen d, 0.50; 95% CI, 0.42 to 0.58; P < .001; SMD = 0.518) were associated with significant reductions; dCBT-I had a comparable effect as combination therapy (Cohen d, 0.05; 95% CI, -0.05 to 0.15; P = .66; SMD = 0.05), but showed unstable durability. Outcomes of dCBT-I improved steadily and rapidly during the first 3 months, and then fluctuated. The response rates with dCBT-I and combination therapy were higher than with medication. Changes in secondary outcomes indicated statistically significant benefits from dCBT-I and combination therapy. The results of subgroup analysis were consistent with the main findings, demonstrating the superiority of dCBT-I vs medication therapy in various subpopulations. In this study, clinical evidence suggested that combination therapy was optimal, and dCBT-I was more effective than medication therapy, with long-term benefits for insomnia. Future studies are needed to analyze its clinical effectiveness and reliability in distinct subpopulations.

Кросс-культурное исследование особенностей самооценки студентов

&lt;p&gt;Personal Self-concept can be viewed as an antecedent of ones&amp;rsquo; educational and career achievements. It is a complex multidimensional construct. This study examines aspects of academic self-esteem: mathematical and verbal. An important factor influencing the formation of self-esteem is the environment &amp;ndash; cultural values and economic development of the country. Previous empirical studies have shown differences in overall self-esteem among individuals from individualistic and collectivistic cultures. We decided to investigate self-esteem in more details and consider the differences and similarities in self-esteem by two factors "Mathematical self-esteem" and "Verbal self-esteem" of students from Russia and Kyrgyzstan. These countries share a common historical background and a similar educational system, but differ at the cultural level. This pilot study was conducted among students from Russia and Kyrgyzstan, using the questionnaire "Self Description Questionnaire". The research sample included 510 undergraduate students aged 18 to 27 years (60% &amp;ndash; Russia, 40% &amp;ndash; Kyrgyzstan). Statistical analysis of the data was performed using Cohen's d to determine the effect size for significant differences between the means. The results of the study indicate a higher level of mathematical self-concept among students from Russia, which can be explained by differences in cultural dimensions &amp;ndash; individualism and collectivism. At the same time, no significant differences in verbal self-esteem were found. This is due to its complexity. So, the communicative aspect of verbal self-esteem is more pronounced in the Eastern culture, and the speech aspect &amp;ndash; in the Western one.&lt;/p&gt;

Effects of high-intensity interval training on aerobic capacity and sports-specific skills in basketball players

IntroductionHigh intensity interval training (HIIT) are widely used to improve the cardiac performance in Basketball players. The current study aims to evaluate the effectiveness of High-Intensity Interval Training on the Aerobic Capacity and sports-specific skills in basketball players. Methods40 male basketball players in the age group 18–25 years were recruited after necessary ethical clearance. Athletes were categorized into two groups of 20 people each: Group 1 control group (age: 21.9 ± 2.4 years, height: 184.6 ± 12.1 cm BMI: 23 ± 3 kg/m2) and Group 2 study group with HIIT (age: 21.4 ± 2.6 years, height: 177.4 ± 6.0 cm BMI: 22.1 ± 2.3 kg/m2). The study group players underwent 5 weeks (10 sessions) of HIIT training. Pre and post intervention evaluation of the Aerobic Capacity (VO2 max) and sports-specific skills were quantified for both the groups. Statistical analysis was performed using one tailed t-test with p < 0.05 for significance. Cohen's D method was used to calculate the effect size and minimum important difference. ResultThere was a significant increase (p < 0.05) in VO2 max (pre:52.8 ± 2.3 ml/min/kg to post: 54.5 ± 2.4 ml/min/kg) in Group 2 whereas in Group 1 the change was not significant (pre:51.1 ± 2.6 ml/min/kg to post: 51.4 ± 2.9 ml/min/kg). Similarly, there was an increase in agility for Group 2 (pre:11.0 ± 1.0 s to post: 10.1 ± 1.0 s) compared to Group 1. In sports specific skills: Control Dribble, passing skills, Lower body power and shooting skills there was a significant increase in post HIIT training for Group 2, whereas in Group 1 there was no significant difference. DiscussionThe HIIT training improved the aerobic capacity (VO2 max) and sports-specific skills in basketball players. ConclusionA 5-week HIIT training improved the aerobic capacity and sports specific skills and may be included as a part of training regime to improve the athletic performance in basketball players.

A comparability study of handwritten versus typed responses in high-stakes English language writing tests

This paper investigates fairness in writing test scores in terms of candidates who completed a writing test either by hand or typed, on a computer. The data for this large-scale comparability study comprise candidates taking English language writing tests at four CEFR levels – B1 to C2 in the period 2019–2022. The data were analysed via effect size differences and equivalence tests. Measured by effect size, a small amount of difference was apparent in scores obtained between the two production modes at B1, B2 and C1 levels. At C2 level, there was a medium effect size, indicative of a difference in favour of computer-produced scripts. Differences observed on equivalence tests – an adaptation of the standard t-test – were not found to be statistically significant. The contribution of the research to knowledge lies in the fact that (with the exception of C2 level) – whether writing tests are written by hand or on computer, while there is a slight skew towards higher scores with computer-processed texts, candidates generally receive similar scores in both modes. Practically, candidates may elect to write either on paper or on computer without fear of bias.

Campus Carry Attitude, Intention, Behavior, and Impact: A Multilevel Meta-analysis

Numerous studies have examined the correlates and predictors of campus carry among various campus communities. There were, however, too many risk factors included, raw effect sizes were too small, and the differences in effect sizes were negligible, making comparisons prohibitively difficult or even worthless. To address this issue, a multilevel meta-analysis was conducted to investigate thirteen domains of risk factors as potential predictors of four campus carry-related outcomes including attitudes, intentions, behaviors, and impacts. Thirty-seven studies were included, with 703 effect sizes in a unique population of 55,115 campus members. A series of three-level meta-analyses revealed that different risk domains contribute to different campus carry outcomes. Generally, social life- and campus life-related risk factors were strongly related to campus carry intentions and behaviors, while the political ideology domain influenced both attitudes and behaviors. Statistically significant effects were observed in multiple moderator analyses for the number of universities from which data were collected and sample affiliations, however, these effects were relatively small. An in-depth review of the literature, synthesis of empirical evidence, and discussion of implications provided a clear path for future research and policymaking.

Age Differences in Motivated Cognition: AMeta-Analysis.

The goal of this preregistered study was to synthesize empirical findings on age differences in motivated cognition using a meta-analytic approach, with a focus on the domains of cognitive control and episodic memory. A systematic search of articles published before July 2022 yielded 27 studies of cognitive control (N = 1,908) and 73 studies of memory (N = 5,837). Studies had to include healthy younger and older adults, a within-subjects or between-subjects comparison of motivation (high vs low), and a measure of cognitive control or memory. The Age × Motivation effect size was meta-analyzed using random-effects models, and moderators were examined using meta-regressions and subgroup analyses. Overall, the Age × Motivation interaction was not significant in either cognitive domain, but the effect sizes in both domains were significantly heterogeneous, indicating a possible role of moderating factors in accounting for effect size differences. Moderator analyses revealed significant moderation by incentive type for episodic memory, but not for cognitive control. Older adults' memory was more sensitive to socioemotional rewards, whereas younger adults' memory was more sensitive to financial gains. Findings are discussed with reference to the dopamine hypothesis of cognitive aging and to life-span theories of motivational orientation. None of these theories is fully supported by the meta-analysis findings, highlighting the need for an integration of neurobiological, cognitive process, and life-span-motivational perspectives.

Technology-enhanced simulation in emergency medicine: Updated systematic review and meta-analysis 1991-2021.

Over the past decade, the use of technology-enhanced simulation in emergency medicine (EM) education has grown, yet we still lack a clear understanding of its effectiveness. This systematic review aims to identify and synthesize studies evaluating the comparative effectiveness of technology-enhanced simulation in EM. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, ERIC, Web of Science, and Scopus to identify EM simulation research that compares technology-enhanced simulation with other instructional modalities. Two reviewers screened articles for inclusion and abstracted information on learners, clinical topics, instructional design features, outcomes, cost, and study quality. Standardized mean difference (SMD) effect sizes were pooled using random effects. We identified 60 studies, enrolling at least 5279 learners. Of these, 23 compared technology-enhanced simulation with another instructional modality (e.g., living humans, lecture, small group), and 37 compared two forms of technology-enhanced simulation. Compared to lecture or small groups, we found simulation to have nonsignificant differences for time skills (SMD 0.33, 95% confidence interval [CI] -0.23 to 0.89, n= 3), but a large, significant effect for non-time skills (SMD 0.82, 95% CI 0.18 to 1.46, n= 8). Comparison of alternative types of technology-enhanced simulation found favorable associations with skills acquisition, of moderate magnitude, for computer-assisted guidance (compared to no computer-assisted guidance), for time skills (SMD 0.50, 95% CI -1.66 to 2.65, n= 2) and non-time skills (SMD 0.57, 95% CI 0.33 to 0.80, n= 6), and for more task repetitions (time skills SMD 1.01, 95% CI 0.16 to 1.86, n= 2) and active participation (compared to observation) for time skills (SMD 0.85, 95% CI 0.25 to 1.45, n= 2) and non-time skills (SMD 0.33 95% CI 0.08 to 0.58, n= 3). Technology-enhanced simulation is effective for EM learners for skills acquisition. Features such as computer-assisted guidance, repetition, and active learning are associated with greater effectiveness.

Between-case standardized mean differences: Flexible methods for single-case designs

Single-case designs (SCDs) are a class of research methods for evaluating the effects of academic and behavioral interventions in educational and clinical settings. Although visual analysis is typically the first and main method for analysis of data from SCDs, quantitative methods are useful for synthesizing results and drawing systematic generalizations across bodies of single-case research. Researchers who are interested in synthesizing findings across SCDs and between-group designs might consider using the between-case standardized mean difference (BC-SMD) effect size, which aims to put results from both types of studies into a common metric. Currently available BC-SMD methods are limited to treatment reversal designs with replication across participants and across-participant multiple baseline designs, yet more complex designs are sometimes used in practice. In this study, we extend available BC-SMD methods to several variations of the multiple baseline design, including the replicated multiple baseline across behaviors or settings, the clustered multiple baseline design, and the multivariate multiple baseline across participants. For each variation, we describe methods for estimating BC-SMD effect sizes and illustrate our proposed approach by re-analyzing data from a published SCD study.

Modulating heart rate oscillation affects plasma amyloid beta and tau levels in younger and older adults

Slow paced breathing via heart rate variability (HRV) biofeedback stimulates vagus-nerve pathways that counter noradrenergic stress and arousal pathways that can influence production and clearance of Alzheimer's disease (AD)-related proteins. Thus, we examined whether HRV biofeedback intervention affects plasma Αβ40, Αβ42, total tau (tTau), and phosphorylated tau-181 (pTau-181) levels. We randomized healthy adults (N = 108) to use slow-paced breathing with HRV biofeedback to increase heart rate oscillations (Osc+) or to use personalized strategies with HRV biofeedback to decrease heart rate oscillations (Osc−). They practiced 20–40 min daily. Four weeks of practicing the Osc+ and Osc− conditions produced large effect size differences in change in plasma Aβ40 and Aβ42 levels. The Osc+ condition decreased plasma Αβ while the Osc− condition increased Αβ. Decreases in Αβ were associated with decreases in gene transcription indicators of β-adrenergic signaling, linking effects to the noradrenergic system. There were also opposing effects of the Osc+ and Osc− interventions on tTau for younger adults and pTau-181 for older adults. These results provide novel data supporting a causal role of autonomic activity in modulating plasma AD-related biomarkers.Trial registration: NCT03458910 (ClinicalTrials.gov); first posted on 03/08/2018.

Egg size effects on nestling mass in jackdaws Corvus monedula: a cross‐foster experiment

Variation in developmental conditions is known to affect fitness in later life, but the mechanisms underlying this relationship remain elusive. We previously found in jackdaws Corvus monedula that larger eggs resulted in larger nestlings up to fledging. Through a cross‐foster experiment of complete clutches we tested whether this association can be attributed to egg size per se, or to more proficient parents producing larger eggs and larger nestlings, with the latter effect being more or less independent of egg size. Due to other manipulations post‐hatching, we primarily investigated effects on nestling mass on day 5, which we show to predict survival until fledging. We introduce a new statistical approach to compare the competing hypotheses and discuss the multiple advantages of this approach over current practice of which we report the results for comparison. We conclude that 92% of the slope of the association between egg size and nestling mass can be attributed to a direct effect of egg size. The remaining 8% of the slope can be attributed to aspects of parental chick rearing ability as reflected in egg size, but this component did not deviate significantly from zero. Intriguingly, the effect of egg size on day 5 nestling mass was steeper (1.7 g cm−3) than the effect of egg size on day 1 hatchling mass (0.7 g cm−3). Early growth is exponential, and the difference in effect size may therefore be explained by hatchlings from large eggs being further in their development at hatching. The direct effect of egg size on nestling mass raises the question what causes egg size variation in jackdaws.

Hand preference and the corpus callosum: Is there really no association?

Originating from a series of morphometric studies conducted in the 1980s, it appears a widely held belief in cognitive neuroscience that the corpus callosum is larger in left or mixed handers than in right handers (RH). However, a recent meta-analysis challenges this belief by not finding significant differences in corpus callosum size between handedness groups. Yet, relying on the available published data, the meta-analysis was not able to account for a series of factors potential influencing its outcome, such as confounding effects of brain size differences and a restricted spatial resolution of previous callosal segmentation strategies. To address these remaining questions, we here analysed N = 1057 participants' midsagittal corpus callosum of from the Human Connectome Project (HCP 1200 Young Adults) to compare handedness groups based on consistency (e.g., consistent RH vs. mixed handers, MH) and direction of hand preference (e.g., dominant RH vs. dominant left handers). A possible relevance of brain-size differences was addressed by analysing callosal variability by both using forebrain volume (FBV) as covariate and utilising relative area (callosal area/thickness divided by FBV) as a dependent variable. Callosal thickness was analysed at 100 measuring points along the structure to achieve high spatial resolution to detect subregional effects. However, neither of the conducted analyses was able to find significant handedness-related differences in the corpus callosum and the respective effect-sizes estimates were small. For example, comparing MH and consistent RH, the effect sizes for difference in callosal area were below a Cohen's d = 0.1 (irrespective of how FBV was included), and narrow confidence intervals allowed to exclude effects above |d| = 0.2. Analysing thickness, effect sizes were below d = 0.2 with confidence intervals not extending above |d| = 0.3. In this, the possible range of population effect sizes of hand preference on callosal morphology appears well below the effects commonly reported for factors like age, sex, or brain size. Effects on cognition or behaviour accordingly can be considered small, questioning the common practise to attribute performance differences between handedness groups to differences in callosal architecture.

Cross-national harmonization of neurocognitive assessment across five sites in a global study.

Cross-national work on neurocognitive testing has been characterized by inconsistent findings, suggesting the need for improved harmonization. Here, we describe a prospective harmonization approach in an ongoing global collaborative study. Visuospatial N-Back, Tower of London (ToL), Stop Signal task (SST), Risk Aversion (RA), and Intertemporal Choice (ITC) tasks were administered to 221 individuals from Brazil, India, the Netherlands, South Africa, and the USA. Prospective harmonization methods were employed to ensure procedural similarity of task implementation and processing of derived task measures across sites. Generalized linear models tested for between-site differences controlling for sex, age, education, and socioeconomic status (SES). Associations with these covariates were also examined and tested for differences by site with site-by-covariate interactions. The Netherlands site performed more accurately on N-Back and ToL than the other sites, except for the USA site on the N-Back. The Netherlands and the USA sites performed faster than the other three sites during the go events in the SST. Finally, the Netherlands site also exhibited a higher tolerance for delay discounting than other sites on the ITC, and the India site showed more risk aversion than other sites on the RA task. However, effect size differences across sites on the five tasks were generally small (i.e., partial eta-squared < 0.05) after dropping the Netherlands (on ToL, N-Back, ITC, and SST tasks) and India (on the RA task). Across tasks, regardless of site, the N-Back (sex, age, education, and SES), ToL (sex, age, and SES), SST (age), and ITC (SES) showed associations with covariates. Four out of the five sites showed only small between-site differences for each task. Nevertheless, despite our extensive prospective harmonization steps, task score performance deviated from the other sites in the Netherlands site (on four tasks) and the India site (on one task). Because the procedural methods were standardized across sites, and our analyses were adjusted for covariates, the differences found in cognitive performance may indicate selection sampling bias due to unmeasured confounders. Future studies should follow similar cross-site prospective harmonization procedures when assessing neurocognition and consider measuring other possible confounding variables for additional statistical control. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Visual attention span capacity in developmental dyslexia: A meta-analysis

The visual attention span (VAS) deficit theory of developmental dyslexia (DD) indicates that impaired VAS may cause reading disabilities. However, whether people with dyslexia have VAS deficit is still controversial. The current review evaluates the literature regarding the relationship between VAS and poor reading, as it also examines the possible moderators in measuring the VAS capacity of individuals with dyslexia. A total of 25 papers, with participants of 859 readers with dyslexia and 1048 typically developing readers were included in the meta-analysis. The sample sizes, means and standard deviations (SDs) of the scores in VAS tasks were extracted separately from the two groups, which were used to calculate the effect sizes of group differences in SDs and means by the robust variance estimation model. Results showed higher SDs and lower averages of the VAS test scores for readers with dyslexia than those for typically developing readers, revealing high individual variability and remarkable deficits in VAS of DD. Further subgroup analyses showed that the characteristics of VAS tasks, background languages, and participants modulated the group differences in VAS capacities. Particularly, the partial report task with symbols of relatively high visual complexity and key pressing may be the optimal measurement of VAS skills. A greater VAS deficit in DD was observed in more opaque languages, with a trend of developmental increase in attention deficit, especially at the primary school level. Moreover, this VAS deficit seemed to be independent of the phonological deficit of dyslexia. These findings to some extent supported the VAS deficit theory of DD and (partially) explained the controversial relationship between VAS impairment and reading disabilities.

Level 4 Triple-P Positive Parenting Program and the Interaction of Parent-child With Special Needs: A Meta-analytic Study in Iran

Background: Since positive parenting program (Triple-P) is one of the ways to improve parent-child interaction, conducting a meta-analysis will help determine its effect size. This study aimed to use meta-analysis to examine the effect of level 4 Triple-P on parent-child interaction with special needs in Iran. Methods: The current study is a meta-analysis review study. Before analyzing the effect size of the mean differences, the PRISMA (preferred reporting items for systematic reviews and meta-analyses) method was used to investigate the decision tree model. Then, the effect size of Triple-P was investigated using the meta-analysis method. Twelve studies (out of the 37) were collected with the keywords “Triple-P” and “parent-child interaction” from Google Scholar, IranDoc, IranMedex, Magiran, and SID according to the inclusion and exclusion criteria. They were conducted in Iran during 2012-2021 and were analyzed through meta-analysis. The inclusion criteria of the articles included written in Persian, having a control group, being interventional, and using original data. The exclusion criteria included duplicate articles and non-compliance with the title with Triple-P level 4. The study instrument was a meta-analysis checklist. Funnel plot, fail-safe number, and Cochran Q test were used to assess the publication bias, expected confidence, and effect size heterogeneity, respectively. The obtained data were analyzed by comprehensive meta-analysis (CMA) software. Results: Findings showed that the effect size of the mean difference rate of level 4 Triple-P on parent-child interaction was 0.59 (P&lt;0.0001), which is medium according to the Cohen table. Fisher’s z indicated a low standard error and no publication bias. The value of the Q test is significant, and the effect sizes are heterogeneous (P&lt;0.0001). Conclusion: Given the moderate impact of level 4 Triple-P, this method of parenting program can play an important role in improving the interaction of parent-child with special needs.

Collegiate Outdoor Orientation Programming as a High-Impact Practice

Outdoor orientation programs (OOPs) use wilderness or adventure experiences as a transition of incoming first-year students to college and university settings. We explored resilience and flourishing outcomes from two OOP trips in Virginia and North Carolina using the Brief Resilience Scale, the Mental Health Continuum Short Form, and a thematic analysis of participant responses to open-ended survey items. Results illustrate a statistically significant, large effect size difference in flourishing between pre- and post-trip responses (d = .89), and the thematic analysis of open-ended post-trip questionnaire items illustrated the attainment of each of the program's OOP objectives. These results mirror previous findings evidencing the continued importance of this form of experiential learning to engender student success in higher education settings and further justify OOPs' inclusion within a high-impact practices framework.

Integrating Depression and Alcohol Use Care Into Primary Care in Low- and Middle-Income Countries: A Meta-Analysis.

Evaluation of the effectiveness of integration of depression and alcohol use disorder care into primary health care in low- and middle-income countries (LMICs) is limited. The authors aimed to quantify the effectiveness of integrating mental health care into primary care by examining depression and alcohol use disorder outcomes. The study updates a previous systematic review summarizing research on care integration in LMICs. Following PRISMA guidelines, the authors included studies from the previous review and studies published from 2017 to 2020 that included adults with alcohol use disorder or depression. Studies were evaluated for type of integration model with the typology developed previously. A meta-analysis using a random-effects model to assess effectiveness of integrated interventions was conducted. Meta-regression analyses to examine the impact of study characteristics on depression and alcohol use disorder outcomes were conducted. In total, 49 new articles were identified, and 74 articles from the previous and current studies met inclusion criteria for the meta-analysis. Overall random effect sizes were 0.28 (95% CI=0.22-0.35) and 0.17 (95% CI=0.11-0.24) for studies targeting care integration for depression or for alcohol use disorder, respectively, into primary care in LMICs. High heterogeneity within and among studies was observed. No significant association was found between country income level and depression and alcohol use outcomes. However, differences in effect sizes between types of integration model were statistically significant (p<0.001). Integration of mental health care into primary health care in LMICs was found to improve depression and alcohol use disorder outcomes. This evidence should be considered when designing interventions to improve mental health screening and treatment in LMICs.

Parent Training via Internet or in Group for Disruptive Behaviors: A Randomized Clinical Noninferiority Trial

To evaluate if an internet-delivered parent training program is noninferior to its group-delivered counterpart in reducing child disruptive behavior problems (DBP). This noninferiority randomized clinical trial enrolled families seeking treatment in primary care in Stockholm, Sweden, for DBP in a child 3-11 years of age. Participants were randomized to internet-delivered (iComet) or group-delivered (gComet) parent training. The primary outcome was parent-rated DBP. Assessments were made at baseline and 3, 6, and 12 months. Secondary outcomes included child and parent behaviors and well-being and treatment satisfaction. The noninferiority analysis was determined by a one-sided 95% CI of the mean difference between gComet and iComet using multilevel modeling. This trial included 161 children (mean age 8.0); 102 (63%) were boys. In both intention-to-treat and per-protocol analyses, iComet was noninferior to gComet. There were small differences in between-group effect sizes (d=-0.02 to 0.13) on the primary outcome with the upper limit of the one-sided 95% CI below the noninferiority margin at 3-, 6-, and 12-month follow-up. Parents were more satisfied with gComet (d= 0.49, 95% CI [0.26, 0.71]). At 3-month follow-up, there were also significant differences in treatment effect on attention-deficit/hyperactivity disorder symptoms (d= 0.34, 95% CI [0.07, 0.61]) and parenting behavior (d= 0.41, 95% CI [0.17, 0.65]) favoring gComet. At 12-month follow-up, there were no differences in any outcomes. Internet-delivered parent training was noninferior to group-delivered parent training in reducing child DBP. The results were maintained at 12-month follow-up. This study supports internet-delivered parent training being used as an alternative to group-delivered parent training in clinical settings. Randomized Controlled Trial of Comet via the Internet or in Group Format; https://www. gov/; NCT03465384.

Response of peer relations and social activities to treatment with viloxazine extended-release capsules (Qelbree® ): A post hoc analysis of four randomized clinical trials of children and adolescents with attention-deficit/hyperactivity disorder.

Attention-deficit/hyperactivity disorder (ADHD) is associated with impairments related to peer relations (PR) and social activities (SA). The objective of this post hoc analysis was to assess the degree to which viloxazine extended-release (viloxazine ER; viloxazine extended-release capsules; Qelbree® ) improves clinical assessments of PR and SA in children and adolescents with ADHD. Data were used from four Phase III placebo-controlled trials of 100 to 600mg/day of viloxazine ER (N=1354; 6-17 years of age). PR and SA were measured with the Peer Relations content scale of the Conners 3rdEditionParent Short Form'sPeerRelationcontentscale (C3PS-PR) and the Social Activities domain of the Weiss Functional Impairment Rating Scale-ParentReport's(WFIRS-P-SA) at baseline and end of study. ADHD symptoms were assessed weekly with the ADHD Rating Scale, 5th Edition. The analyses relied on the general linear mixed model with the subject as a random effect. Improvement in C3PS-PR (p=.0035) and WFIRS-P-SA (p=.0029) scores were significantly greater in subjects treated with viloxazine ER compared with placebo. When using measures of clinically meaningful response, the C3PS-PR responder rate was significantly higher for viloxazine ER (19.2%) compared with placebo (14.1%) and the difference was statistically significant (p=.0311); the Number Needed to Treat (NNT) was 19.6. The WFIRS-P-SA responder rate was significantly higher for viloxazine ER (43.2%) compared with placebo (28.5%) and the difference was statistically significant (p<.0001); the NNT was 6.8. The standardized mean difference effect size for both PR and SA was 0.09. Viloxazine ER significantly reduces the impairment of PR and SA in children and adolescents with ADHD. Although its effects on PR and SA are modest, many ADHD patients can be expected to achieve clinically meaningful improvements in PR and SA with viloxazine ER treatment for longer than 6 weeks.