Follow-up Phase Research Articles

Clinical reasoning during dysphagia assessment and management in acute care: A longitudinal qualitative study.

Competent clinical reasoning forms the foundation for effective and efficient clinical swallowing examination (CSE) and consequent dysphagia management decisions. While the nature of initial CSEs has been evaluated, it remains unclear how new information gathered by speech-language therapists (SLTs) throughout a patient's acute-care journey is integrated into their initial clinical reasoning and management processes and used to review and revise initial management recommendations. To understand how SLTs' clinical reasoning and decision-making regarding dysphagia assessment and management evolve as patients transition through acute hospital care from referral to discharge. A longitudinal, qualitative approach was employed to gather information from two SLTs who managed six patients at a metropolitan acute-care hospital. A retrospective 'think-aloud' protocol was utilized to prompt SLTs regarding their clinical reasoning and decision-making processes during initial and subsequent CSEs and patient interactions. Three types of concept maps were created based on these interviews: a descriptive concept map, a reasoning map and a hypothesis map. All concept maps were evaluated regarding their overall structure, facts gathered, types of reasoning engaged in (inductive versus deductive), types of hypotheses generated, and the diagnosis and management recommendations made following initial CSE and during subsequent dysphagia management. Initial CSEs involved a rich process of fact-gathering, that was predominantly led by inductive reasoning (hypothesis generation) and some application of deductive reasoning (hypothesis testing), with the primary aims of determining the presence of dysphagia and identifying the safest diet and fluid recommendations. During follow-up assessments, SLTs engaged in increasingly more deductive testing of initial hypotheses, including fact-gathering aimed at determining the tolerance of current diet and fluid recommendations or the suitability for diet and/or fluid upgrade and less inductive reasoning. Consistent with this aim, SLTs' hypotheses were focused primarily on airway protection and medical status during the follow-up phase. Overall, both initial and follow-up swallowing assessments were targeted primarily at identifying suitable management recommendations, and less so on identifying and formulating diagnoses. None of the patients presented with adverse respiratory and/or swallowing outcomes during admission and following discharge from speech pathology. Swallowing assessment and management across the acute-care journey was observed as a high-quality, patient-centred process characterized by iterative cycles of inductive and deductive reasoning. This approach appears to maximize efficiency without compromising the quality of care. The outcomes of this research encourage further investigation and translation to tertiary and post-professional education contexts as a clear understanding of the processes involved in reaching diagnoses and management recommendations can inform career-long refinement of clinical skills. What is already known on the subject SLTs' clinical reasoning processes during initial CSE employ iterative cycles of inductive and deductive reasoning, reflecting a patient-centred assessment process. To date it is unknown how SLTs engage in clinical reasoning during follow-up assessments of swallowing function, how they assess the appropriateness of initial management recommendations and how this relates to patient outcomes. What this paper adds to the existing knowledge Our longitudinal evaluation of clinical reasoning and decision-making patterns related to swallowing management in acute care demonstrated that SLTs tailored their processes to each patient's presentation. There was an emphasis on monitoring the suitability of the initial management recommendations and the potential for upgrade of diet or compensatory swallowing strategies. The iterative cycles of inductive and deductive reasoning reflect efficient decision-making processes that maintain high-quality clinical care within the acute environment. What are the potential or actual clinical implications of this work? Employing efficient and high-quality clinical reasoning is a hallmark of good dysphagia practice in maximizing positive patient outcomes. Developing approaches to understanding and making explicit clinical reasoning processes of experienced clinicians may assist SLTs of all developmental stages to provide high standards of care.

Effect of Peer Group Support Educational Intervention on the HgA1c Level and Self-care Behaviors of Adolescents with Type 1 Diabetes Referred to Zahedan Diabetes Clinics

Background: Diabetes is a chronic and costly disease that is very common in adolescents. Improving self-care behaviors will be a motivation to continue treatment. On the other hand, peer support and education have been used as an effective method in reducing behavioral and attitudinal disorders caused by chronic diseases. Objectives: Determining the effect of peer group support educational intervention on the HgA1C level and self-care behaviors of adolescents with type 1 diabetes. Methods: This quasi-experimental research was conducted on adolescents aged 11-18 years with type 1 diabetes who were referred to the Diabetes Clinic in Zahedan city, Iran, in 2019. A total of 189 samples were included in the study using the convenience sampling method and were randomly assigned to two intervention groups and one control group (63 people in each group). The researcher used two methods of educational intervention, including peer support intervention and individual training by the researcher. Individuals in the intervention groups were subjected to separate educational interventions during 4 sessions of 60 minutes, one session every week. The control group received routine care. Demographic information, self-care behaviors, and HbA1c questionnaires were completed and recorded before, immediately, and 2 months after the end of the intervention. The data were analyzed using the Shapiro-Wilk test, chi-square test, repeated measures analysis of variance, one-way analysis of variance, and Bonferroni post hoc test using the SPSS version 26 software. The significance level of the tests was considered 0.05. Results: Peer support training significantly improved self-care behavior (P < 0.001) and decreased HbA1c level (P < 0.001) in the intervention group compared to the control group. Moreover, in the intervention group, the self-care score and HbA1c level were significantly different between the pre-test, post-test, and follow-up stages (P < 0.001). The permanence of the effect of peer education in the follow-up phase was not confirmed for the variables self-care (P < 0.001) and HbA1c (P < 0.001). Conclusions: Our findings showed that using peer groups and the experiences of similar people as educators can improve self-care behaviors and also record lower average glycosylated hemoglobin in type 1 diabetic patients. Therefore, it is recommended that peer support training be used as an effective method in diabetes and other chronic diseases.

A single-subject research design evaluating a co-created yoga program for adults with gynecologic cancer: feasibility study protocol

BackgroundWorldwide, > 1.3 million adults are diagnosed with a gynecologic cancer each year, affecting their wellbeing and quality of life. This manuscript describes the protocol for a study that sought to assess the feasibility, acceptability, and fidelity of a community-based co-created yoga program and proposed evaluative methods, and estimate program effects on self-reported outcomes.MethodsUsing a multiple baseline single-subject research design with a follow-up phase (ABA), quantitative and qualitative data were collected from program participants and the instructor. Participants were randomly assigned to varying baseline lengths and completed weekly surveys for 3–5 weeks pre-program. Then, participants engaged in a bi-modal 12-week hatha yoga program consisting of 2 60-min group classes a week, with optional supplemental features (January–April, 2023). Participants completed surveys after classes 1, 12, and 24. All yoga classes were audio- and video-recorded. Post-program, participants completed surveys 1, 4, and 8 weeks after the last class and took part in a semi-structured interview 1 week after to discuss program acceptability, suitability, relevance, and potential benefits. Feasibility outcomes (i.e., recruitment, retention, and program adherence rates, engagement with optional program features) were tracked by the instructor assistant and study team during the study. The yoga instructor was interviewed about their experience delivering the program 2 weeks after the last class. Planned analysisFeasibility outcomes will be analyzed using descriptive statistics. Interview transcripts will be coded using reflexive thematic analysis. Class recordings will be coded using duration and frequency coding. Survey responses for self-reported outcomes will be analyzed visually and using multilevel modeling.Expected outcomesData will help determine refinements, if any, required to the program and instructor guidebook, implementation approach, and proposed evaluation methods before scale-up projects and definitive trials are started.Trial registrationClinicalTrials.gov NCT05610982. November 3, 2022.

A longitudinal study on artificial intelligence adoption: understanding the drivers of ChatGPT usage behavior change in higher education.

As the field of artificial intelligence (AI) continues to progress, the use of AI-powered chatbots, such as ChatGPT, in higher education settings has gained significant attention. This paper addresses a well-defined problem pertaining to the critical need for a comprehensive examination of students' ChatGPT adoption in higher education. To examine such adoption, it is imperative to focus on measuring actual user behavior. While measuring students' ChatGPT usage behavior at a specific point in time can be valuable, a more holistic approach is necessary to understand the temporal dynamics of AI adoption. To address this need, a longitudinal survey was conducted, examining how students' ChatGPT usage behavior changes over time among students, and unveiling the drivers of such behavior change. The empirical examination of 222 Dutch higher education students revealed a significant decline in students' ChatGPT usage behavior over an 8 month period. This period was defined by two distinct data collection phases: the initial phase (T1) and a follow-up phase conducted 8 months later (T2). Furthermore, the results demonstrate that changes in trust, emotional creepiness, and Perceived Behavioral Control significantly predicted the observed change in usage behavior. The findings of this research carry significant academic and managerial implications, as they advance our comprehension of the temporal aspects of AI adoption in higher education. The findings also provide actionable guidance for AI developers and educational institutions seeking to optimize student engagement with AI technologies.

Epidemiology of soil-transmitted helminth infections and the differential effect of treatment on the distribution of helminth species in rural areas of Gabon

BackgroundSoil-transmitted helminth (STH) infections are a public health concern in endemic areas. For efficient control, the epidemiology of the disease needs to be monitored. This report assesses the prevalence, incidence, post-treatment infection (PTI) rate, and risk factors for STH infections in two rural areas of Gabon.MethodIn this longitudinal and prospective study, participants aged six to 30 years from the vicinity of Lambaréné and selected households using a simple randomization process were included and followed in two consecutive periods of six and nine months. Stool samples were obtained at the beginning and the end of each follow-up phase (FUP). The Kato-Katz technique was used for the detection of STH eggs, while the Harada-Mori technique and coproculture were used for the detection of larvae in stool processed within a maximum of four hours of collection. Prevalence was determined at the three main time points of the study, incidence was assessed during the two study phases, and PTI was defined as an infection detected nine months post-treatment.ResultsA total of 262 participants were included. The overall prevalence of STH infections was 42% (95%CI: 34–50) and 44% (95%CI: 37–51) at baseline for the six and nine month FUPs, respectively. Trichuris trichiura was the most prevalent species at each time point of assessment. The cumulative incidence of STH at the 6- and 9-month follow-ups was 18% (95%CI: 12–27) and 35% (95%CI: 27–43), respectively, while the incidence rates were 41 (95%CI: 28–55) and 56 (95%CI: 46–67) per 100 person-years, respectively. The PTI rates at the 9-month follow-up for T. trichiura, hookworm, and Ascaris lumbricoides were 58% (95%CI: 41–74), 31% (95%CI: 11–59) and 18% (95%CI: 5–40), respectively. The STH infection intensity was generally light.ConclusionThe prevalence level of STH infection is moderate in the vicinity of Lambaréné, with T. trichiura being the most prevalent species. Our results reveal a rapid spread of the disease in the population mainly following intervention, particularly for trichuriasis, and therefore call for the full implementation of the World Health Organization’s recommendations in the area.Trial registration clinicaltrials.gov Identifier NCT02769013. Registered 21 April 2016, https://clinicaltrials.gov/study/NCT02769013

Effect of Acceptance and Commitment Therapy on Emotional Regulation, Psychological Flexibility, and Stress in Children of Veterans With PTSD: A Randomized Controlled Clinical Trial

Objectives The present study aims to investigate the effect of acceptance and commitment therapy (ACT) on emotional regulation, psychological flexibility, and symptoms of post-traumatic stress disorder (PTSD) in children of veterans with PSTD. Methods This is a randomized controlled clinical trial with a pre-test/post-test/follow-up design. Participants were 70 children of veterans with PTSD (boys and girls) aged 15-19 years, who were selected using simple random sampling method and randomly divided into two groups of 35 including ACT and control. Before, immediately after, and 12 months after the intervention, people were measured using the acceptance and action questionnaire-II, difficulty in emotional regulation scale, and the PTSD checklist for DSM-5. The intervention group received group ACT at 8 sessions of 60-90 minutes. For the control group, life skills education was presented at 7 sessions of 60-90 minutes. Finally, the data was analyzed using SPSS software, version 22. Results The results of analysis of covariance showed a significant difference in difficulty in emotional regulation, psychological flexibility and PTSD symptoms in the post-test and follow-up phases in two groups (P<0.01). Moreover, the two ACT and control groups were significantly different in the hyperarousal symptom of PTSD at follow-up phase, but there was no significant difference in two symptoms of re-experiencing trauma and negative alterations in mood/avoidance (P>0.05). Conclusion The ACT can improve emotional regulation skills and psychological flexibility and reduce PTSD symptoms in children of veterans with PTSD. Therefore, this method can be used in counseling and mental health centers to improve these children’s symptoms.

The Effectiveness of an Educational Program Based on the Threats and Opportunities of Remote Work for Dual-Career Couples During the COVID-19 Pandemic on Work-Family Conflict and Its Dimensions

Objective: The purpose of this research was to evaluate the effectiveness of an educational program based on the threats and opportunities of remote work for dual-career couples during the COVID-19 pandemic on work-family conflict and its dimensions. Method: This was a quantitative, applied research employing a quasi-experimental design, utilizing a pre-test/post-test with a control group. The sample consisted of dual-career couples from Kerman city who sought counseling for various reasons. Collaboration was negotiated with a private counseling center, and agreements were made. Couples scoring above the cutoff on the prepared questionnaires were purposively selected, resulting in 20 couples who were then randomly assigned to either the experimental group (10 couples) or the control group (10 couples). The experimental group underwent the educational program while the control group received no training. The data collection instrument was the work-family conflict questionnaire by Carlson et al. (2000). Data in the quantitative section were analyzed using repeated measures analysis of variance with the help of SPSS software. Findings: Given that the computed F-value for the effect of groups on work-family conflict and its dimensions was statistically significant at the 5% level (p < .05), it can be concluded that there was a significant difference between the experimental and control groups after the intervention, and the intervention significantly impacted work-family conflict and its dimensions. The Benferroni post-hoc test indicated that the effects of the educational program based on opportunities and threats of remote work on work-family conflict and its dimensions showed suitable stability during the follow-up phase. Conclusion: Therefore, it can be concluded that the educational package derived from the lived experiences of dual-career couples during the quarantine period of the COVID-19 outbreak was effective on the dimensions of work-family conflict among couples, and this effect was also stable in the follow-up phase.

The Effectiveness of Emotion-Focused Therapy on Emotional Suppression and Distress Tolerance in Divorced Women

Objective: The aim of the present study was to determine the effectiveness of emotion-focused therapy on emotional suppression and distress tolerance in divorced women. Methods and Materials: The current study was a quasi-experimental design with pre-test, post-test, and follow-up phases, including a control group. The statistical population consisted of all divorced women residing in Shiraz in 2021, who had been legally divorced for at least 6 months and up to 2 years. A total of 40 individuals were selected from this population based on inclusion criteria using purposive sampling from those who visited the Aban Clinic in Shiraz in 2021. These individuals were randomly assigned to two experimental groups and one control group (20 participants in each group). The experimental group underwent ten 90-minute sessions of emotion-focused therapy, while the control group did not receive any therapeutic intervention. Data were collected using the Weinberger Emotional Suppression Questionnaire (2010) and the Simons and Gaher Distress Tolerance Scale (2005) and analyzed using repeated measures ANOVA via SPSS software version 23. Findings: The results indicated the impact of emotion-focused therapy on emotional suppression (F=204.1, P=0.001) and distress tolerance (F=48.120, P=0.001), with the persistence of these effects in the follow-up phase. Conclusion: Based on the findings of this study, emotion-focused therapy can be considered a complementary treatment alongside other therapeutic methods to reduce emotional suppression and increase distress tolerance in divorced women.

Effectiveness of Recovery-Oriented Cognitive Therapy on Depression Symptoms and Interpersonal Relationships in Patients with Schizophrenia

Background and Objective: The aim of this study was to examine the effectiveness of recovery-oriented cognitive therapy on depression symptoms and interpersonal relationships in patients with schizophrenia. Methods and Materials: The research method was quasi-experimental with a pre-test, post-test, and follow-up design with a control group. The statistical population of the present study included all schizophrenic patients admitted to psychiatric residential centers in Tehran in 2023. The sample size consisted of 30 individuals (15 in the experimental group and 15 in the control group) selected by convenience sampling and assigned to two groups. For the experimental group, recovery-oriented cognitive therapy was administered, while the control group remained on the waiting list. Research instruments included the Beck Depression Inventory (Beck, 1987) and the Interpersonal Skills Questionnaire (Manjamizadeh, 2012). Findings: The results showed that recovery-oriented cognitive therapy had a significant impact on depression symptoms and interpersonal relationships in the post-test and follow-up phases. Conclusion: The findings of this study provide useful information regarding recovery-oriented cognitive therapy, and psychologists and psychiatrists can use this intervention to improve depression symptoms and interpersonal relationships in patients with schizophrenia.

Comparison of the Effectiveness of the Successful Intelligence Training Package Focused on Risky Behaviors with the Executive Functioning Improvement Package on the Inclination to Risky Behavior and Family Affinity among Female Middle School Students Engaged in Risky Behaviors

The present study aimed to compare the effectiveness of the Successful Intelligence Training Package focused on risky behaviors (Baramkeh et al., 2024) with the Executive Functioning Improvement Package (Karimi et al., 2023) on the inclination to risky behavior and family affinity among female middle school students engaged in risky behaviors. The research method was a quasi-experimental design with pre-test, post-test, and follow-up phases, involving two experimental groups and one control group. The population consisted of all middle school students engaged in risky behaviors, from which 60 students were purposively selected based on inclusion and exclusion criteria and randomly assigned to two experimental groups and one control group. All subjects were assessed at three stages of the research using research instruments. These tools included the Inclination to Risky Behavior scale (Paki et al., 2020) and Family Affinity (Yousefi, 2022, cited from Karimi et al., 2023). While the control group was on a waiting list, the experimental groups received eight 120-minute sessions of Executive Functioning training and the Successful Intelligence Training Package focused on risky behaviors. Data were analyzed using descriptive statistics (mean and standard deviation) and analysis of variance with repeated measures. The results indicated that both methods were effective on the dependent variables, and except for self-management, there was no significant difference in effectiveness between the two methods, with executive functioning having more effectiveness on the mentioned variable. Based on the findings, it can be said that both training packages are suitable for improving the dependent variables of this research.

Comparison of the Effectiveness of Schema Therapy and Narrative Therapy on the Psychological Well-being of Women Affected by Infidelity

Objective: The present study aimed to compare the effectiveness of schema therapy and narrative therapy on the psychological well-being of women affected by infidelity. Methods and Materials: The research method was quasi-experimental with a pre-test, post-test, and control group design with a follow-up period. The statistical population of the present study included all women affected by infidelity who sought counseling services at centers located in District 1 of Tehran in 2024. A total of 45 individuals were purposefully selected and randomly assigned to two experimental groups and one control group. The instrument used in this research was the Psychological Well-Being Questionnaire (Ryff, 2002). The schema therapy intervention and White's (2017) narrative therapy protocol were implemented in 12 group sessions, each lasting 120 minutes, conducted twice a week for the first and second experimental groups. Data were analyzed using mixed ANOVA. Findings: The results of the ANOVA indicated a significant difference in psychological well-being between the groups in the post-test and follow-up phases (P<0.05). The results showed that schema therapy was significantly more effective than narrative therapy in improving the psychological well-being of women affected by infidelity, and a significant difference was observed between the two treatments (P<0.05). Conclusion: It can be concluded that there is a significant difference between schema therapy and narrative therapy.

The effectiveness instructional games based on social constructivism approach in interaction with learning styles on improvement emational outcomes and the amount of learning in the mathematic lesson of girl students

Background and Aim: Student-centered learning is a major driver behind educational policy and practice in the modern era, and with the move toward adopting learner-centered learning in the classroom, especially in mathematics learning, understanding where such games are offered and the potential They have not yet been discovered, it is vital. The purpose of this research was to investigate the effectiveness of educational games based on social constructivism in interaction with learning styles on improving the emotional efficiency and learning rate of secondary school girl students in mathematics. Research method: The research method was semi-experimental with a pre-test, post-test with a control group and a 2-month follow-up phase. The statistical population was all secondary school female students studying in public schools in Hamadan city in 1402-1401. In the first stage, using a simple random sampling method, a school was selected from the 1st district of Hamedan city and 100 people who met the conditions to enter the research were selected, and then by a simple random method, they were divided into 2 experimental groups (25 people in the deep learning group and 25 people in the deep learning group). surface learning) and 2 control groups (25 deep learning group and 25 surface learning group) were replaced. The groups of the first experiment underwent 6 90-minute sessions of educational games based on the social constructivism approach; But the control groups did not receive any intervention and remained on the waiting list. Biggs et al.'s (2001) two-factor learning process questionnaire, McCutch and Sikel's (2003) school attitude questionnaire, and a researcher-made questionnaire on the learning rate of mathematics lessons were used to collect information. The analysis of the information obtained from the implementation of the questionnaires was carried out through SPSS software version 24 in two descriptive and inferential sections (mixed variance analysis and Benferroni's post hoc test). Risult: The results showed that educational games based on the social constructivism approach in the post-test and follow-up phase had a significant effect on emotional efficiency and the amount of mathematical learning compared to the control groups (P<0.05). Also, the results showed that educational games based on the social constructivism approach in the group of students with a deep learning style had more effectiveness than students with a superficial learning style on emotional efficiency and the amount of mathematical learning (P<0.05). ). Conclusion: Based on the results of the present research, it can be said that educational games based on the social constructivism approach can be used as a suitable educational method to improve the emotional efficiency and learning rate, especially in secondary school students with Deep learning style should be used in secondary schools.

Development of digital health management systems in longitudinal study: The Malaysian cohort experience.

The management of extensive longitudinal data in cohort studies presents significant challenges, particularly in middle-income countries like Malaysia where technological resources may be limited. These challenges include ensuring data integrity, security, and scalability of storage solutions over extended periods. This article outlines innovative methods developed and implemented by The Malaysian Cohort project to effectively manage and maintain large-scale databases from project inception through the follow-up phase, ensuring robust data privacy and security. We describe the comprehensive strategies employed to develop and sustain the database infrastructure necessary for handling large volumes of data collected during the study. This includes the integration of advanced information management systems and adherence to stringent data security protocols. Key achievements include the establishment of a scalable database architecture and an effective data privacy framework that together support the dynamic requirements of longitudinal healthcare research. The solutions implemented serve as a model for similar cohort studies in resource-limited settings. The article also explores the broader implications of these methodologies for public health and personalized medicine, addressing both the challenges posed by big data in healthcare and the opportunities it offers for enhancing disease prevention and management strategies. By sharing these insights, we aim to contribute to the global discourse on improving data management practices in cohort studies and to assist other researchers in overcoming the complexities associated with longitudinal health data.

Effectiveness of a Communication Skills Training Protocol on Improving Marital Burnout

Objective: The aim of this research was to investigate marital burnout and to determine the effectiveness of a communication skills training protocol. Methods: The experimental method employed was a single-subject design with multiple baselines, involving couples seeking counseling at the Raz City Clinic in Shiraz and the Clinic of the General Directorate of Exceptional Education in Fars Province, during the autumn of 2021. Among these couples, three pairs exhibiting the highest levels of marital burnout were selected using a purposive sampling method. The therapeutic program of the communication skills training protocol was conducted by the researcher over 10 sessions, followed by a follow-up in two stages, one month apart. The participants responded to the Marital Burnout Scale at the baseline, post-treatment, and follow-up stages. Data were analyzed using visual analysis methods, the recovery percentage formula, and the reliable change index. Findings: Findings indicated that the communication skills training protocol enhanced marital quality and reduced marital burnout, with these effects being maintained during the follow-up phase. Conclusion: The treatment protocol proved to be effective, and couple therapists can utilize these communication skills in their work with couples to reduce marital burnout and enhance marital quality, particularly during the early years of marriage, where it can have a significant impact.

Effect of Life Review Therapy on self-actualization and Happiness of the Elderly in Iran

Objectives Older people experience physical and psychological changes that can negatively affect their life satisfaction and result in unhappiness. Life review therapy can be an effective intervention in increasing the positive feelings and happiness of the elderly. This study aims to determine the effects of a life review therapy program on self-actualization and happiness among older adults. Methods & Materials This is a quasi-experimental study with a pre-test/post-test/follow-up design. Participants were 22 elderly people aged ≥60 years referred to a daycare center in Tehran, Iran. They were randomly divided into two intervention (n=11) and control (n=11) groups. The perma flourishing scale and the Oxford happiness questionnaire were used to collect data before, immediately after, and one month after the intervention. The life review therapy was performed according to Haight and Webester’s protocol. The collected data were analyzed in SPSS software, version 26. Results There was a significant increase in the total mean scores of happiness and flourishing scores in the intervention group immediately and one month after the intervention (P<0.001), but no significant change was reported in the control group. The mean scores of happiness and flourishing in the intervention group in the pre-test phase were 50.27 and 98.63, respectively. In the post-test and follow-up phases, these scores reached 58.27 and 57.09 for happiness and 111.63 and 104.81 for flourishing, respectively. Conclusion The present study shows that life review intervention in can provide an opportunity for flourishing and psychological development and also an increase in the level of happiness among older adults.

Effectiveness of Acceptance and Commitment Therapy on Emotional Eating Behavior, Emotion dysregulation, Perceived Stress, and Rumination in Women with Chronic Obesity

Objective: The present research aimed to determine the effectiveness of Acceptance and Commitment Therapy (ACT) on emotional eating behavior, emotion dysregulation, perceived stress, and rumination in women suffering from chronic obesity. Methods and Materials: This study was a quasi-experimental design with pre-test, post-test, and follow-up phases, including a control group. The research population consisted of all women suffering from chronic obesity and body mass index, visiting the Kian City Nutrition Counseling Clinic in Tehran between May and July 2022. For forming two groups, 30 women with chronic obesity and body mass index were initially selected through screening, and then randomly divided into 15 patients in the experimental group and 15 in the control group. The ACT treatment program was conducted over 8 sessions of 90 minutes each, based on the protocol by Neff and Germer (2013). The instruments included the Eating Behavior Questionnaire by van Strien et al. (1986), the Emotion dysregulation Questionnaire by Gratz and Roemer (2004), the Perceived Stress Questionnaire by Cohen et al. (1983), and the Rumination Questionnaire by Nolen-Hoeksema and Morrow (1991). Data were analyzed using repeated measures ANOVA. Findings: The results showed that ACT had a significant effect on improving emotional eating behavior (F=115.83, P<0.001), emotion dysregulation (F=98.10, P<0.001), perceived stress (F=101.53, P<0.001), and rumination (F=74.52, P<0.001) in women with chronic obesity and body mass index (P>0.05). Conclusion: Therefore, it can be concluded that Acceptance and Commitment Therapy contributes to the improvement of emotional eating behavior, emotion dysregulation, perceived stress, and rumination in women with chronic obesity.

The Effectiveness of Integrated Gross Motor Skill Program on The Symptoms of Cerebal Palsy among Children

he primary aim of this study was to assess the effectiveness of an integrated gross motor skills program intervention on improving motor functions compared to a control group, with evaluations conducted at three time points: pre-test, post-test, and follow-up. This study involved 40 participants, divided equally into experimental and control groups (N=20 for each group). Both groups were assessed for motor functions at three different times: before the intervention (pre-test), immediately after the intervention (post-test), and a follow-up phase. The experimental group received a specific intervention aimed at improving motor functions, whereas the control group did not receive this intervention. Statistical analyses included descriptive statistics, analysis of variance with repeated measurements, and Bonferroni post-hoc tests to evaluate the differences between and within the groups over time. The experimental group showed significant improvement in motor functions from pre-test to post-test (mean increase of 11.99, p=0.001) and maintained these improvements at follow-up (mean increase from pre-test of 12.40, p=0.001). The control group's scores remained stable across all time points, indicating no significant change. The analysis of variance confirmed significant effects for time, group, and the interaction between time and group, suggesting that the intervention was effective in enhancing motor functions. The study concluded that the experimental intervention significantly improved motor functions in the participants compared to the control group. These improvements were evident immediately after the intervention and were maintained at the follow-up, highlighting the long-term benefits of the intervention on motor function recovery.

Determining the Incidental Pathologic Findings (IPFs) on panoramic radiographs before orthodontic treatments: A retrospective study

Background/Aim: Panoramic radiography is an imaging method that displays teeth, jaws and surrounding structures in two dimensions and is frequently used in the follow-up and treatment phase of patients. This study aims to determine the frequency of incidental findings (IPFs) in panoramic radiographs taken before orthodontic treatment. Material and Methods: In this retrospective study; A total of 330 patients (170 women, 160 men) aged between 7 and 49 years were included. IPFs were grouped into dental anomalies, radiopacities and radiolucent areas in the jaws, impacted teeth, and other anomalies in the jaws. Data were compared according to gender and age groups (6-12 years, 13-49 years). Results: Dental anomalies were detected in 90.6% of the panoramic radiographs examined. No statistically significant relationships were found between gender and dental abnormalities (p>0.05). The incidence of idiopathic osteosclerosis is 3.6%, and all of these people are men; It has been determined that people with sclerosing osteitis are mostly men and alveolar radiopacities are mostly not seen in women. It has been observed that patients are mostly between the ages of 6-12 in the absence of any dental anomalies. It has been determined that people with sclerosing osteitis are mostly between the ages of 13-49 and patients aged 13-49 mostly have alveolar radiopacities. It has been determined that patients with possible periapical or residual cyst and possible dentigerous cyst are mostly between the ages of 13-49, and patients aged 13-49 are mostly seen in radiolucent areas in the jaw bones. As a result of the analysis, a statistically significant relationship was found between age groups and IPFs (p<0.05). Conclusions: According to the results of this study, a high rate of dental anomalies were detected by evaluating panoramic radiographs before orthodontic treatment. Age and gender changes play a role in the presence of Incidental Pathologic Findings.

A follow-up study of post-COVID-19 syndrome in hospitalized children with Omicron variant infection in Wuhan.

Since the Chinese government changed its COVID-19 prevention and control policies, the rapid spread of the omicron variant resulted in a pervasive surge of infections throughout the nation, particularly affecting children. Although the acute symptoms of children infected with COVID-19 are milder compared to adults, the impact of post-COVID-19 syndromes (PCS) on the growth and development of children should not be ignored. The clinical manifestations, treatment methods, and long-term effects of children are significantly different from those of adults, making it necessary to understand the phenotype of children with PCS in order to effectively manage their health. The study focuses on hospitalized children infected with omicron variant in Zhongnan Hospital of Wuhan University from December 7, 2022, to January 5, 2023. Three telephone follow-ups with the guardians was conducted at 4-5 weeks, 12-13 weeks, and 24-25 weeks after the patients' discharge to understand their prevalence, clinical characteristics, and risk factors of PCS. The age range of the 112 hospitalized pediatric patients was 0-13 years, with a median age of 19 months. After three follow-ups, 49.1% patients had PCS, while the incidence of PCS persisting 3 month was 21.4%, with a prevalence of PCS persisting 6 month of 10.7%. From the first follow-up phase to the third phase, there was a significant decrease in the incidence of PCS. In infants, the most common persistent symptom was sleep disorder (19.2%), followed by respiratory symptoms, diarrhea (8.2%), and decreased appetite (6.8%). In children and adolescents, decreased appetite was the most common persistent symptom (30.8%), followed by respiratory symptoms, fatigue (15.4%), and mood changes (15.4%). Decreased appetite was more common in the children and adolescents, while diarrhea and sleep disorders were more common in the infants. Binary logistic regression analysis and ordered logistic regression analysis showed that times of illness (OR = 1.671, 95% CI: 1.339-2.086) were positively correlated with the duration of symptoms. Times of illness was positively correlated with cough/expectoration (OR = 1.491, 95% CI: 1.039-2.138). Age (OR = 0.844, 95% CI: 0.755-0.944) and re-hospitalization (OR = 0.146, 95% CI: 0.022-0.969) were positively correlated with sleep disorders. Children with Omicron variant may still experience PCS, but the incidence is lower compared to adults and compared to other variants and the incidence of PCS will gradually decrease over time. The symptoms of PCS differ between older children and infants and it is necessary to prevent recurrent illness for at least half a year after COVID-19 recovery. In order to further understand and ameliorate the impact of PCS on the health of children infected with COVID-19, subsequent follow-up studies will expand the scope, combine with objective follow-up contents, and establish an assessment and management system especially for children of different ages.

The Effectiveness of the Narrative-Based Acceptance and Commitment Counseling Package on Experiential Avoidance, Affective Capital and Desire to Divorce in Women on the Verge of Divorce

Objective: Divorce is the primary factor in the disintegration of the most fundamental social foundation, namely the family, which has detrimental effects on both spouses, especially women. Therefore, this study aimed to investigate the effectiveness of a narrative-focused Acceptance and Commitment Therapy (ACT) counseling package on experiential avoidance, affective capital, and the inclination towards divorce among women on the verge of divorce in Isfahan. Methods and Materials: The research method was a quasi-experimental design with a pre-test, post-test, control group, and a two-month follow-up phase, and the sampling method was voluntary. Accordingly, with coordination with counseling centers affiliated with the judiciary, among the volunteers who were willing to participate in the study and considering the inclusion and exclusion criteria, 30 individuals were randomly selected and then randomly assigned to three groups: experimental and control (each group consisting of 15 individuals). The experimental group received the treatment in eight 75-minute group sessions based on the package developed by the researcher. The control group, however, did not undergo any intervention. The research instruments at the pre-test, post-test, and follow-up stages included the Golparvar Affective Capital Questionnaire (2016), Acceptance and Action Questionnaire (Bond, 2011), and the Roosevelt et al.'s (1986) Divorce Proneness Scale. Findings: The results of the repeated measures ANOVA indicated that the narrative-focused ACT counseling package had a significant effect on experiential avoidance, affective capital, and the inclination towards divorce among women on the verge of divorce at the post-test stage (p < 0.05), and the effects of the counseling package were sustained at the follow-up stage (p < 0.05). Conclusion: Based on these findings, the narrative-focused ACT counseling package can be used as one of the treatments for improving psychological variables in women on the verge of divorce.