Treatment elements in transdiagnostic interventions for children and adolescents with emotional problems: A scoping review.

Using Antalya province as a case study, this research investigates access to essential public services for individuals with physical, hearing, and visual impairments and the factors influencing it. Data were collected via face-to face interviews and questionnaires from 61 individuals with physical disabilities, 60 with hearing impairments, and 60 with visual impairments. Independent samples t-tests were employed to assess geographic disparities in access, while ordinal logistic regression analysis identified predictive factors. Analysis revealed that individuals with physical and visual disabilities experienced Limited Access (Level 2) in both rural and urban areas. In contrast, individuals with hearing disabilities demonstrated Full Access (Level 1) in urban areas but Limited Access in rural settings. The results indicate that while place of residence (rural versus urban) did not significantly impact access for the physically disabled group, rural residence negatively affected service access for those with hearing and visual impairments. Public services should therefore be reconfigured to address specific barriers for different disability groups and to implement effective oversight to improve overall accessibility.

Interpersonal synchronization is a key component of effective teaching and learning, but little is known about how it differs between face-to-face and remote settings. This study investigates interpersonal synchronization in face-to-face (FTF) versus remote learning (RL) environments through electroencephalography (EEG) and electrocardiography (ECG) hyperscanning. Eight groups of 3 students and 1 lecturer (N = 32) engaged in both conditions, consisting of a baseline, a 20-minute lecture, and a 20-minute interactive task. Neural synchronization was assessed using inter-individual Euclidean Distance (EuDist) across five EEG frequency bands (delta, theta, alpha, beta, gamma). Cardiac synchronization was assessed via intersubject correlation of heart rate (ISCHR). Learning outcomes and perception were measured through a series of self-report measures and validated questionnaires. Results revealed a modest but significant effect of learning condition across all EEG bands, with significantly lower EuDist values in the FTF condition compared to RL, indicating higher inter-individual neural alignment when participants were physically co-present. Additionally, task-specific effects emerged in delta, theta, beta, and gamma bands, with interactive tasks generally associated with lower dissimilarity. Furthermore, ISCHR was significantly higher in the FTF condition compared to the RL condition, while no significant task-specific differences emerged. Self-report measures further indicated higher perceived interpersonal closeness and lesson satisfaction in the FTF condition, while learning outcomes remained stable across modalities. These findings demonstrate that physical co-presence enhances both cortical and autonomic synchronization during instruction, particularly under dialogic conditions, and underscore the role of embodied interaction in promoting shared cognitive and affective engagement in educational contexts.

Training in ultrasound-guided central venous catheterization (CVC) is constrained by limited hands-on opportunities and instructor availability. Pre-class instructional videos may improve procedural learning; however, the optimal filming perspective—first-person point-of-view (POV) versus face-to-face (F-t-F) side-view—remains unascertained. We compared the effects of video perspectives on ultrasound-guided CVC training-related skill acquisition. This prospective, randomized, single-blind study included 70 postgraduate physicians in pre-class POV video (n = 23), pre-class F-t-F side-view video (n = 23), or control (no pre-class video, n = 24) groups. Participants completed pre-training assessments, one-on-one hands-on training, and post-training evaluations, with outcomes including a 17-item checklist score (0–34, Competency-Based Assessment Tool for Ultrasound-Guided Central Venous Catheter Placement), global rating (1–10), completion time, and self-rated confidence analyzed with the Kruskal–Wallis and Mann–Whitney U tests with Bonferroni correction. Baseline demographics were comparable. The POV group showed the highest pre-training median global rating score, which significantly exceeded that of other groups (p < 0.001). Both video groups had significantly higher pre-training self-rated confidence than controls (p = 0.01), without differences between POV and F-t-F (p = 0.553). Overall time to pre-training assessment completion did not differ significantly among groups in the primary analysis; post-hoc as-treated analysis showed significantly faster task completion in POV compared with the control group (p = 0.007). Pre-training videos significantly enhanced training efficiency. POV and F-t-F videos improved learners’ competency and confidence than in controls. Overall procedural efficiency did not differ significantly between POV and F-t-F; the POV group achieved higher global rating scores, suggesting a potential advantage of the first-person perspective. The trial was retrospectively registered at ClinicalTrials.gov (Identifier: NCT06947733, registered on 23 April 2025).

This study examines how face-to-face (FtF) and computer-mediated communication (CMC) contribute to relationship maintenance and resilience in dual-earning families, a largely overlooked area in family communication research. Guided by the theory of resilience and relational load (TRRL), we test how ongoing FtF and CMC maintenance behaviors predicted well-being across a week among 62 families (i.e., two parents and one adolescent). Using a week-long daily diary and physiological measures (cortisol and IL-6 assays), we assess perceived stress, mental health, and loneliness. Findings suggest that both FtF and CMC maintenance are associated with lower stress and better well-being, with FtF showing somewhat stronger associations on certain outcomes such as loneliness. Additionally, perceived gaps between desired and received maintenance predicted higher and more erratic stress and diminished mental health, underscoring the importance of meeting relational needs. These results highlight how families balance FtF and digital maintenance in everyday life and extend the TRRL by incorporating mixed-media contexts and perceived maintenance gaps.

Intergroup communication (IC) serves as a critical arena in which narratives, worldviews, and group behaviors are expressed, confronted, and translated into concrete communicative practices. Within this unique space of interaction, divergent narratives may remain rigid and unchanging, manifesting as parallel monologues that coexist without genuine engagement. Yet, under certain conditions, such communication can also open the door to dynamic processes of mutual challenge, development, and transformation. This narrative literature review aims to strengthen the growing connection between the scholarship on narratives in societies embroiled in intractable conflict and the well-established research tradition on intergroup contact. Specifically, it seeks to enhance our understanding of the interplay between narratives, behaviors, and communication practices in both face-to-face (FTF) and online contexts of IC. While the discussion includes broader global perspectives, the primary case study centers on the ongoing conflict and communicative interactions between Israeli Jews and Palestinians.

Abstract This study examined the impact of video-based synchronous computer-mediated communication (SvCMC) on engagement in collaborative pre-task planning and L2 content used in task performance. One hundred twenty-eight Hong Kong learners of English were assigned to either a face-to-face (FTF) group (n = 64) or an SvCMC group (n = 64), where they completed planning for a monologic task. Based on Philp and Duchesne’s multidimensional model, planning was analyzed for cognitive (negotiation of meaning, semantically engaged talk), social (affiliative responses) and emotional engagement (enjoyment, anxiety), and task performance was coded for L2 content. Results showed that FTF mode led to significantly lower anxiety, more semantically engaged talk, and more affiliative responses, as well as conceptually richer task performances. Use of planned content was predicted by L2 proficiency and semantically engaged talk and negatively predicted by anxiety. Our findings contribute to an understanding of engagement in SvCMC and FTF modes and their impact on L2 learning.

Non-therapeutic male circumcision is often performed in outpatient settings and has physical and emotional implications for children and families. To evaluate the effectiveness of a nurse-led intervention in reducing parental anxiety and child pain during non-therapeutic male circumcision. An open-label, parallel-group, randomized trial was conducted at Policlínica Maresme (Spain) for review between March and May 2022. A total of 314 family members and 192 children aged 0 to 3 years were randomly assigned (1:1) to either a nurse-led intervention or standard care. The intervention included a face-to face preoperative educational session, guided use of non-pharmacological pain relief techniques during surgery, and structured postoperative follow-up. The control group received routine care comprising written postoperative instructions and follow-up calls. Primary outcomes were preoperative parental anxiety, assessed using the Hamilton Anxiety Rating Scale (HAM-A), and immediate postoperative child pain, measured with the Face, Legs, Activity, Cry, Consolability (FLACC) tool. Secondary outcomes included pain at 24 to 48 hours and 8 to 10 days, caregiver-reported home care difficulties, and complication rates. Baseline parental anxiety did not differ between groups (mean difference -0.29; 95% confidence interval [CI] -2.22 to 1.64). Children in the intervention group had significantly lower postoperative pain (mean FLACC 0.72 vs. 1.39; mean difference -0.66; 95% CI -0.98 to -0.35) and were more often pain-free (55.4% vs. 32.6%; odds ratio [OR] 2.55; 95% CI 1.42-4.59). Pain at 24 to 48 hours and caregiver-reported difficulties were also reduced. No group differences were found in complication rates. The nurse-led intervention improved children's pain outcomes and caregiver preparedness for home care, although it did not significantly reduce parental anxiety. Structured, nurse-led education combined with non-pharmacological strategies can enhance pediatric pain management and caregiver preparedness, particularly in healthcare settings where non-therapeutic male circumcision is performed for cultural or religious reasons. ClinicalTrials.gov: NCT05387291.

Digital technologies are now firmly ingrained in our daily lives and have become inevitable tools for interacting with a romantic partner. Beyond helping partners feel connected when apart, technology-mediated communication (TMC) is also widely used to discuss conflictual issues within romantic relationships. Given that managing conflicts efficiently is central to relationship maintenance, couple satisfaction, and intimacy, it is important to understand whether TMC facilitates this process, or whether it introduces additional challenges. The aim of this systematic review was to summarize empirical research that statistically compared TMC and face-to-face (FtF) conflict management with respect to conflict-level outcomes (e.g., emotions, perceived conflict resolution) and broader relationship-level outcomes (e.g., satisfaction). More specifically, it sought to determine whether managing couple conflicts through TMC leads to better, worse, or similar outcomes compared to traditional FtF conflict management. A systematic literature search across various databases identified 15 quantitative studies that met the inclusion criteria. Overall, findings suggested that using TMC to discuss conflicts is linked to similar outcomes as FtF interactions. However, some studies highlighted potential moderators such as attachment style, self-esteem, and relationship satisfaction, indicating that the effect of TMC in conflict management is not universal and depends on individual and relational factors. The review also addresses methodological considerations as well as directions for future research.

BackgroundDepression is a highly prevalent disorder. Yet, there is still a considerable treatment gap because of capacity issues across clinical services, which create barriers to access to effective psychological therapies. In addition, many individuals with depression do not seek treatment, and waiting lists for psychotherapy are typically very long. Blended psychotherapy, which combines online components and in-person sessions, may help bridge the treatment gap as a cost-effective intervention that complements other types of treatment for depression, as it may reduce therapist time and potentially lower the threshold for people to seek treatment for their depression.ObjectiveThis study aims to investigate the clinical effectiveness and cost-effectiveness of blended psychodynamic therapy (PDT) and cognitive behavioral therapy (CBT) for depression compared with face-to-face (FTF) PDT and CBT.MethodsA pragmatic, single-blind, multisite, noninferiority trial will randomize adult patients referred to mental health care centers in Flanders, Belgium, and diagnosed with major depressive disorder (MDD; n=504), to FTF or blended PDT and CBT. The primary outcome is to investigate whether blended therapy for depression (ie, blended PDT and CBT) is noninferior from baseline to 6-month follow-up after treatment termination compared with FTF PDT and CBT in terms of severity of depression assessed with the Beck Depression Inventory-II (BDI-II) based on intention-to-treat analyses. Secondary outcomes include severity of depression as measured with the BDI-II at 1 and 2 years after treatment termination; recovery from depression as assessed with the Structured Clinical Interview for DSM-5 disorders – Clinical Trials Version (SCID-5-CT) and the Patient Health Questionnaire-9 (PHQ-9) at treatment termination and at 6-month, 1-year, and 2-year follow-up; and quality of life as measured with the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) at treatment termination and at 6-month, 1-year, and 2-year follow-up. The feasibility of implementing blended care will be investigated, and health economic analyses will address the cost-effectiveness of blended care versus FTF psychotherapy. Exploratory analyses will focus on possible predictors of treatment outcome and mechanisms of change. Sensitivity analyses will address the potential impact of the COVID-19 pandemic on therapeutic outcomes. Finally, a qualitative substudy aims to address patients’ and therapists’ subjective experience of blended psychotherapy.ResultsThe study was funded in July 2018, and the first patient was included in April 2019. As of September 2025, we have enrolled 463 patients. The first data lock (primary outcome) will take place in October 2025, and the results of the primary outcome are expected in February 2026. The second data lock is expected in March 2027, and the results of the 2-year follow-up are expected in September 2027.ConclusionsThis trial promises to inform decisions concerning the implementation of blended versus FTF therapy for individuals with depression in routine clinical care.

This article pulls together diverse published findings on computer-mediated communication (CMC) to test the hypothesis that it reduces psychological engagement and impact compared with face-to-face (FTF) interactions. Although gaps and questions remain, the evidence mostly confirms reduced engagement and impact. Compared with FTF interactions, CMC elicits less positive emotion, with mixed results for negative emotions. Physiological arousal is often lower. Relationships, trust, and group cohesion develop more slowly (although perhaps eventually reaching the same levels). Information processing is reduced. Inhibitions are also reduced, leading to greater willingness to criticize, to bring up alternate perspectives and suggestions, and to neglect to respond. The disinhibition may improve participation by shy persons. Group performance and group decision-making are often impaired, although some studies found no difference. Teaching and learning go less well. Impact and engagement lose more with asynchronous than synchronous CMC. FTF interactions boost well-being compared with not interacting, but CMC is in between. When CMC augments FTF relationships, there may be benefits, but when it replaces them, there are psychological costs. Technology has enabled marvelous advances in long-distance communication, but there is still no fully satisfactory substitute for actually being together in person.

Training to introduce savings and loan accounting applications is a form of community service activity carried out by lecturers from STIE YAPAN. The partners in this activity are the management and members of the PKK RW 07 Candi Lontar savings and loan group. The savings and loan activity is an economyc activity commonly carried out by PKK women in RW 07 Candi Lontar. However, manual transaction recording often causes difficulties in financial management and reporting. Therefore, this community service activity aimed to provide training on the use of savings and loan accounting applications to PKK women in RW 07 Candi Lontar. The implementation method included five stages: socialization and needs assessment, face-to face training, application implementation, post-training assistance, and evaluation, and program sustainability. The results showed an increase in participants' understanding and skills in using the application. It was evident that participants are able to record savings, loan, and installment transactions digitally, as well as create simple financial reports. The sustainability of this program is expected to help manage the PKK savings and loan unit's finances to be more accountable and efficient.

Transcutaneous tibial nerve stimulation (TTNS) is used to treat overactive bladder (OAB) syndrome. We hypothesized that TTNS instruction delivered via telehealth (TH) would be as effective as face-to-face (FtF) instruction in improving OAB symptoms. In this prospective cohort study, 99 women with OAB self-selected FtF (n = 79) or TH (n = 20) instruction for TTNS setup. Groups received standardized education on device placement and usage. Primary outcome was the between-group comparison of change in International Consultation on Incontinence Questionnaire (ICIQ-SF) scores at 3 and 12months. Secondary outcomes included between-group comparisons of Patient Global Impression of Improvement (PGI-I) score at 3months and treatment persistence at 12months. Between-group differences were analyzed using Student's t tests. At 3months, FtF and TH groups showed mean ICIQ-SF score reductions of 2.3 ± 1.8 and 1.9 ± 1.6 points respectively (between-group difference 0.4 points; 95% CI -1.79, 2.59; p = 0.60). PGI-I scores indicated improvement in 48.1% of FtF and 50.0% of TH participants. At 12months, treatment persistence was 60.8% for FtF and 55.0% for TH groups. Among continued treatment responders, sustained improvement was observed, with mean ICIQ-SF reductions of 3.6 ± 2.4 points (FtF) and 4.0 ± 2.6 points (TH) from baseline (p = 0.48). Progression to third-line therapies was comparable between groups (FtF 24.0%, TH 25.0%). Telehealth shows promise as an effective method for initiating TTNS treatment for OAB, providing comparable outcomes with FtF instruction. The approximate 50% response rate and sustained benefits among responders support TTNS as a viable treatment. Findings support broader implementation of TH TTNS instruction, potentially improving treatment access for suitable patients.

Patient travel accounts for around 10% of healthcare-related greenhouse gas emissions. Telemedicine (TM) may contribute to reducing emissions. This study aimed to compare CO2 emissions, costs, and satisfaction associated with TM versus face-to-face (FTF) visits for follow-up of pediatric patients with celiac disease (CeD). CeD patients (2-16 years), attending follow-up visits, were invited to choose between FTF or TM visits via Google Meet. Data on carbon footprint, cost, usability, and satisfaction (telehealth usability questionnaire [TUQ]), and dietary adherence (celiac dietary adherence test [CDAT]) were collected using Google Forms. Between March 2023 and November 2024, 300 patients were invited and 131 included (58 TM, 73 FTF). Baseline characteristics were similar (gender, age, and respondent). CDAT scores were comparable (p = 0.9). Compared to FTF, TM visits were shorter (30 vs. 75 min), with lower CO₂ emissions (0.08 vs. 24.00 kg), fewer lost workdays (18.9% vs. 81.1%), and reduced costs (€0.55 vs. €15.7; all p < 0.001); satisfaction was high except for "reliability" (median score: 16). TM is a sustainable alternative for CeD follow-up, reducing CO₂ emissions, costs, and time. High satisfaction supports broader TM implementation in line with environmental goals.

Regulatory bodies require the use of restraints and seclusion in health care settings to be strictly monitored and carefully documented. In our emergency department (ED), an internal audit uncovered low compliance with required patient safety documentation, the so-called "face-to-face (FTF)" assessment, within 1 hour of restraint or seclusion initiation. The primary objective of this quality improvement (QI) study is to evaluate a series of interventions as a mechanism to improve FTF documentation compliance. This project was conducted in a single-site academic ED. Patients requiring restraints and seclusion application from November 2021 to June 2024 were included. We implemented 3 plan-do-study-act (PDSA) cycles: (1) development of FTF documentation flowsheet with delayed best practice alert (BPA) trigger, (2) direct audit and clinician feedback via email, and (3) modification to immediate BPA trigger. Our primary outcome was a change in the rate of FTF documentation completion within 60 minutes of restraint or seclusion application. We used descriptive analysis to evaluate adherence rates. There were 856 qualifying instances during the study period. Our intervention bundle was associated with an increase in documentation adherence from a preintervention baseline of 10.96% to a final performance of 81.28%, an absolute increase of 70.32% (P<0.001). Our series of interventions, including direct feedback and technical solutions, was effective in increasing clinician FTF documentation adherence. By deploying these interventions iteratively, our approach supported practice change and behavioral modification among ED clinicians, highlighting the importance of an incremental process in changing practice and culture.

Objective: Teleneuropsychology (TeleNP) shows promise as an alternative visit type for patients in which face-to-face (FTF) neuropsychological evaluation is not a viable option. Undergoing FTF presurgical deep brain stimulation (DBS) neuropsychological evaluations may represent a hardship for some patients with movement disorders, yet comparison of performance for TeleNP and FTF for the commonly used Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) has not been studied in this population. The current study aimed to examine RBANS performance of FTF and TeleNP administration in a cohort of movement disorders patients in a clinical setting, hypothesizing similar performance regardless of modality. Method: Four hundred six patients with Parkinson’s disease or essential tremor completed the RBANS between two medical centers between 2020 and 2024 as part of standard clinical care within their presurgical assessment for candidacy for DBS or High-Intensity Focused Ultrasound thalamotomy. Results: The TeleNP sample was significantly older than the FTF sample (p = .02). There were no statistical differences in gender (p = .18) or education (p = .66) between the samples. After controlling for age and motor diagnosis differences between the two groups, 9 of the 11 RBANS subtests were comparable, with the TeleNP group performing significantly better on the Picture Naming subtest and the FTF group performing significantly better on the Figure Recall subtest. The effect size of these differences were small, indicating relatively low clinical meaningfulness. Conclusions: The findings of the current study suggest the two methods of administration were associated with broadly comparable performances in this movement disorder population, suggesting TeleNP may be a viable option for presurgical evaluation.

Effectiveness of family-provider communication interventions on family's psychological health, communication quality, and health care utilization in the ICU: A systematic review and meta-analysis of randomized controlled trials.

Inborn errors of metabolism (IEM) are inherited disorders affecting metabolism which can result in intellectual disability, cognitive impairment or death if left untreated. Nutritional management plays a major role in ensuring adequate growth, nutritional status and development, reducing levels of toxic metabolites, preventing deficiencies and avoiding catabolism in infants with IEM. The aim of this consensus is to provide recommendations for nutritional management of metabolic diseases in neonates and infants in Saudi Arabia, where a high frequency of IEM has been reported.Consensus generation was performed using the Delphi method. Six metabolic dietitians from five hospitals across KSA formed the expert panel. Two face-to face meetings and one virtual meeting were conducted to generate consensus statements. Voting was conducted anonymously on SurveyMonkey to determine the level of agreement with each recommendation.The expert panel reached consensus on 105 recommendations relating to the nutritional management of metabolic disorders, focusing on PA, MMA, GA1, PKU, MSUD, VLCAD, and HCU.These recommendations will facilitate more consistent management of metabolic patients across Saudi Arabia and strive to highlight ongoing challenges faced by dietitians, patients, and caregivers. Future work should focus on outcomes associated with dietary management strategies in Saudi Arabia.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13023-025-03949-0.

Recently, the terms "good governance" are being increasingly utilized in sustainable development. The contemporary globe confronts issues of environmental deterioration and resource mismanagement, prompting various nations to utilize resources judiciously. Good governance plays a pivotal role in promoting sustainable agriculture through the prudent allocation and conservation of resources. This research aim was to assess good governance role in sustainable managing of summer crops. A qualitative methodology was employed, comprising Face-to Face interviews in two focus groups discussions with six members of local authorities at Penjwen district to address research questions related to sustainable crop management. The data were analysed thematically to identify key patterns and insights, which were subsequently utilized to evaluate and interpret good governance dimensions in accordance with SAFA guidelines. The investigation reveals that the local governing bodies within the Penjwen district have attained levels of sustainability that fluctuate between inadequate and intolerable. The authorities have achieved levels of sustainability in accountability, participation, rule of law, and integrated management, which have been assigned a red designation indicating an unacceptable evaluation; meanwhile, corporate ethics has received an orange designation. This outcome underscores the deficiencies of the governmental structures in this particular domain.

Background: A systematic exercise programme using low-cost virtual reality devices can help maintain and improve postural control in older adults. This study aimed to evaluate the effectiveness of two different exergame programme modalities: telerehabilitation (TR) and face-to-face (FF). Methods: A randomised controlled trial was conducted with 16 participants aged 65 to 75. Both groups completed an 18-session exergame intervention over six weeks, with the TR group (exposure) receiving remote sessions and the FF group having in-person (control) sessions with a physiotherapist. Assessments were carried out at baseline, at weeks 2, 4, and 6, with two follow-ups at weeks 8 and 10. Centre of Pressure (CoP) measures in tasks: eyes open (EO), eyes closed (EC), medial-lateral (ML) weight-shifting exergame and anterior–posterior (AP) weight-shifting exergame, and clinical tests were used to evaluate postural control. Results: TR and FF significantly reduced the CoPSway-area during EC (TR: p < 0.01; FF: p = 0.01) at 6 weeks and only FF demonstrated a significant reduction during EO (p < 0.01). Post hoc analysis revealed that TR maintained a significant reduction in the secondary outcomes of the CoP at 8 and 10 weeks, while FF did not sustain these effects over time. Between-group comparisons revealed a greater effect of TR in CoPSway-area, and secondary outcomes during the AP weight-shifting task (p < 0.01) at 6 weeks, whereas the FF had a greater effect in secondary CoP outcomes during the ML weight-shifting task (p < 0.01) at 6 weeks. Conclusion: Both six-week exergame programmes were equally effective at improving postural control. Given the observed specific effects of TR and FF delivery, physiotherapists can consider either modality to suit individual needs and access, or as a complementary approach to maintain and improve postural control in older adults.