Intervention Research Research Articles

Telomere Length and Cognitive Function Among Middle-Aged and Older Participants From Communities Underrepresented in Aging Research: A Preliminary Study.

ObjectiveAccelerated biological aging is a plausible and modifiable determinant of dementia burden facing minoritized communities but is not well-studied in these historically underrepresented populations. Our objective was to preliminarily characterize relationships between telomere length and cognitive health among American Indian/Alaska Native (AI/AN) and Black/African American (B/AA) middle-aged and older adults.MethodsThis study included data on telomere length and neuropsychological test performance from 187 participants, enrolled in one of two community-based cognitive aging cohorts and who identified their primary race as AI/AN or B/AA.ResultsNested multivariable regression models revealed preliminary evidence for associations between telomere length and cognitive performance, and these associations were partially independent of chronological age.DiscussionSmall sample size limited estimate precision; however, findings suggest future work on telomere length and cognitive health in underrepresented populations at high risk for dementia is feasible and valuable as a foundation for social and behavioral intervention research.

To Intervene or Not to Intervene: An Experimental Methodology Measuring Actual Bystander Behaviour

Bystander intervention and sexual assault research typically rely on self-reported intent to intervene. However, predicted behaviour can be considerably different from actual behaviour. Hypothetical scenarios are often utilised to remove extenuating circumstances, limiting insight into actual behaviour where those circumstances impact intervention. This paper discusses the development and evaluation of an innovative methodology to measure actual bystander behaviour when witnessing signs of an impending sexual assault. With careful attention paid to ethical considerations and participant safety, 13 participants were directly deceived about the true aim of the research. Utilising observational data and a funnelling debrief, the findings demonstrated varied reactions to sexual assault cues, from not noticing and therefore not intervening, to noticing and (in)directly intervening. Participants’ responses indicated they remained unaware of the deception until it was formally revealed, suggesting the methodology effectively realised the study’s aims. The funnelling debrief mitigated the adverse effects of the deception, with some participants reporting more confidence and motivation to intervene in the future. Further development of this methodology could create more interactive bystander intervention programmes that teach people to identify signs of a sexual assault, develop skills to safely intervene, and raise awareness about sexual violence.

Interpretation bias and its relationship with pain: a systematic review and meta-analysis.

The aim of this review was to systematically review and meta-analyse evidence for the presence of interpretation bias in pain and to establish the likely role of interpretation bias in chronic pain. The primary questions were whether people experiencing pain showed a greater interpretation bias than people without pain and whether interpretation bias was associated with pain outcomes. We were also interested in evaluating existing longitudinal and intervention research, which could inform interpretation bias as a causal mechanism and/or treatment target in pain. A total of 33 studies across 31 articles were identified (combined n = 4842). People with chronic pain showed a greater interpretation bias than people without pain, with a moderate effect (g = 0.602). This effect was even more pronounced when interpretation bias was measured with the word association task, reaching a large effect size (g = 0.899). Interpretation bias was associated with degree of pain interference, pain catastrophising, and less reliably with pain severity, but not with experimental pain outcomes. Longitudinal studies (k = 3) were mixed as to whether interpretation bias predicted subsequent pain. Whereas, intervention studies (k = 3) showed that interpretation bias could be modified and, for chronic pain, led to improved pain outcomes. Overall, data show that interpretation biases are robust among those with chronic pain compared with those without and are associated with pain interference. There is emerging evidence that interpretation biases are a treatment target that can be modified for improved pain outcomes.

Negotiating healthy food retail initiatives in the research project Healthier Choices in Supermarkets: an ethnographic study of a partnership between health intervention researchers, food retailers, and public health advocates

BackgroundPartnerships between researchers and food retailers are advocated as necessary for developing sustainable and effective health-promotion initiatives in supermarkets. However, little is known about how such partnerships evolve and influence different phases of intervention research. This study explores how partnerships between researchers and food retailers develop during the pre-intervention phase and examines the factors that influence both the partnerships and the initiatives they produce.MethodsThe empirical case used in the study is a partnership between intervention researchers, food retailers, and public health advocates that aimed to develop and test healthy food retail initiatives to make healthy food choices easy for customers. We conducted an ethnographic study covering the pre-intervention phase from the establishment of the partnership in 2019 to the feasibility test of the initiatives in 2021. We used participant observation of meetings and intervention development activities, qualitative interviews with partners, and document analysis of email correspondence and project materials. We analysed the data abductively, drawing on a narrative analytical approach and theoretical concepts of institutional logics and negotiation.FindingsWe present a narrative in six chapters illustrating how market logic dominated the selection and development of healthy food retail initiatives, ultimately compromising the researchers’ original research interests. Furthermore, the pre-intervention phase was challenged by an unclear division of roles and responsibilities, misaligned expectations, high staff turnover in the retail organisation, and the Covid-19 pandemic. These challenges resulted in growing mistrust and an asymmetric partnership that undermined the progress and potential of the project.ConclusionsUsing the lens of institutional logics, we show how differing interests and perspectives between partners – for example regarding health and consumer behaviour – can make it difficult to realize the original research ideas and build a trusting relationship. Overall, this study illustrates the complexity of research partnerships with commercial actors such as food retailers. To develop and implement effective health-promotion initiatives in a food retail setting, researchers must stay mindful of their initial research interest, integrity, and study design, ensuring they are not compromised in the collaboration.

Obstacles and Aspirations for Improving Delivery of Cardiopulmonary Resuscitation to Wheelchair Users: A Qualitative Study.

To describe obstacles and ideas for improvement for the delivery of cardiopulmonary resuscitation and basic life support to wheelchair users. A descriptive qualitative study underpinned by constructivism was conducted. Semi structured interviews were completed with 26 participants from three cohorts: formal and informal carers, wheelchair users and healthcare professionals. Data were collected via online and in person interviews between February and June 2024. All participants were located in Australia, with the exception of one who was located in the United Kingdom. Data were analysed using thematic analysis. Two major themes were identified: (1) obstacles to providing cardiopulmonary resuscitation and basic life support to a wheelchair user and (2) aspirations for improving cardiopulmonary resuscitation and basic life support for wheelchair users. Participants shared ideas for how to improve emergency care for wheelchair users, highlighting a need for further research, testing and development of an education intervention. Improving knowledge about providing emergency care to a wheelchair user could improve outcomes, save lives and reduce the life expectancy gap experienced by people with disability. Approximately 2% of the global population use a wheelchair. Wheelchair use complicates the delivery of cardiopulmonary resuscitation and basic life support. There are currently no guidelines informing emergency care for wheelchair users available globally. Recognition of common symptoms of distress exhibited by wheelchair users, and options for the delivery of practical emergency care are required for wheelchair users. The paper adheres to the EQUATOR reporting guidelines utilising the SRQR checklist. Patients and the public were the driving force in recognising the gap in knowledge regarding the delivery of CPR to wheelchair users. Questions from patients and the public shaped the aims and methodological choices for this study.

Evaluating representativeness: recruitment for a virtual family-based intervention focused on the transition from pediatric to adult diabetes care†.

Recruiting representative samples of youth for behavioral health interventions is challenging yet necessary to translate research into practice and eliminate health disparities. Transition-aged youth with type 1 diabetes (T1D) represent a vulnerable population; not enough attention is given to their inclusion in behavioral health interventions. Behavioral Family Systems Therapy for Diabetes Transition (BFST-DT) is an intervention aimed at improving transition readiness and is currently being pilot tested. The objectives of this study are to (1) evaluate the representativeness of the enrolled sample based on demographic and medical characteristics and (2) evaluate recruitment communication preferences. Thirty adolescents (Mage = 16.57 years) with T1D and their caregiver(s) were recruited from a large urban hospital. Demographic and medical variables were collected via electronic medical record. Research staff recorded recruitment details about communication attempts and methods and reasons for participation decline. Those who enrolled in the intervention had more insulin pump usage than the recruitment population. Those who enrolled communicated primarily over email, while those who declined preferred phone. The length of time before a participation decision was communicated was similar between the enrolled and declined groups at about 6 weeks. The main reason for declining to participate was lack of interest. Recruitment strategies were mostly effective in recruiting a representative sample of adolescents with T1D. Findings have implications for recruiting populations that are challenging to engage in intervention research. Future research should prioritize the stratification of historically underrepresented groups during recruitment.

Intervention Research on Attachment Behavior in Children with Autism

The positive behavior support strategy was used to intervene in the attachment behavior of a 4-year-old autistic child. During the intervention, the ABC behavior observation form and the children's attachment behavior classification cards were used to observe the child and implement the intervention. The intervention lasted for 6 weeks, with 5 sessions per week and 30 minutes per session, and the intervention effect was monitored in a timely manner. The intervention results showed that the case's attachment behavior was significantly reduced, and the positive behavior support strategy could effectively improve the case's attachment behavior. In future attachment behavior interventions, designs with multiple samples and multiple scenarios need to be considered.

Efficacy of an internet-based, therapist-guided cognitive behavioral therapy intervention for adolescents and young adults with body dysmorphic disorder: a randomized controlled trial

BackgroundBody dysmorphic disorder (BDD) is particularly prevalent yet highly understudied and undertreated in adolescence. This study evaluates the efficacy of an internet-based, therapist-guided cognitive behavioral therapy (CBT) for adolescents and young adults with BDD compared to supportive online therapy as an active control condition.MethodsIn a single-blind, randomized controlled trial, N = 45 adolescents (aged 15–21 years) of all genders from German-speaking countries were assigned to 12 sessions of internet-based CBT (iCBT) or 12 weeks of supportive online therapy. The primary outcome was change in expert-rated BDD symptom severity from pre- to post-intervention (Yale-Brown Obsessive-Compulsive Scale Modified for Body Dysmorphic Disorder, BDD-YBOCS). Secondary outcomes included the remission and responder rate, changes in delusionality of appearance beliefs (BABS), self-rated BDD symptom severity (FKS), BDD cognitions (FKDK), quality of life (KINDL-R), and depressive symptoms (PHQ-9) from pre to post and to a 4-week follow-up.ResultsiCBT was more efficient than supportive online therapy on the BDD-YBOCS (p =.002), with a large between-group effect size at post-intervention (Hedges’ g (SE) = 0.93 (0.42)), and on all secondary measures (p <.05), except for depressive symptoms (p =.068). All secondary outcome measures also showed significant improvements from pre to post iCBT, with moderate to large effect sizes, and gains were stable until the 4-week follow-up period. iCBT participants showed higher remission (61.5%) and responder rates (66.7%), compared to controls (0% and 26.7%), but only the difference in remission reached significance.ConclusionThe results indicate the efficacy of internet-based CBT in comparison to an active control condition, thus contributing to the limited intervention research in adolescent BDD and adding a much-needed treatment option. Trial registration: The trial was pre-registered on 2020/06/08 at the German Clinical Trials Register, DRKS00022055.

The invisibility of anxiety in young, traumatised South African children

The high prevalence of anxiety in young traumatised children has been well established in literature. However, the body of literature that explores how anxiety manifests in classroom settings in the South African context is still growing. The ways in which it presents at the personal level for individual children, in particular, need to be examined in greater depth. The current study posed the question, ‘How does anxiety manifest in young, traumatised South African children in classroom settings?’ The researchers adopted an interpretive phenomenological approach and used a combination of intervention and vignette research. Data were collected from individualised, intuitive, and integrative psychotherapeutic processes. Primary participants ( n = 5) ranged in ages from 8 to 14 years, while secondary participants included parents and teachers. An analysis of parental and teacher interviews as well as vignettes for each participant revealed high levels of anxiety invisibility in classroom settings for all the study participants. This finding was triangulated from the teacher interviews, parental interviews, therapeutic engagement, and vignettes. The study identified the need for capacity development in teachers in terms of mental health and wellbeing, and recommended that additional support mechanisms be provided for young, traumatised children suffering from anxiety.

Long-term clinical efficacy of radioplaque gelified ethanol for lumbar disc herniation: a multicenter study.

Degenerative and/or herniated discs are a global cause of chronic lower back and neck pain. While multiple treatments exist, the research for long-term effective interventions with minimal side effects continues. The radioplaque gelified ethanol (RGE) (DiscoGel®, Hérouville-Saint-Clair, France), is an addition to the armamentarium of potential treatments. This study aimed to evaluate the long-term efficacy of this device in treating lumbar disc herniation through a 10-year follow-up period. In this bi-centric observational study, patients treated with RGE in the lumbar spine between 2009 and 2011 were evaluated based on specific inclusion and exclusion criteria. Collected data encompassed preoperative imaging, VAS pain scores, ODI functional scores, were recorded through 10-year follow-up. Fifty-two participants (26 males and 26 females) with an average age of 51.7 years were enrolled in the study. Ten years after treatment, there was a statistically significant improvement in VAS pain scores and ODI percentages (p < 0.01). Additionally, significant changes in anterior, medial, and posterior disc dimensions were observed, suggesting structural adaptations due to RGE treatment. A statistically significant difference in the anterior dimension of the treated disc was found 10 years postoperatively compared to preoperative measurements (p = 0.0011). RGE is a promising therapeutic choice for lumbar symptomatic herniation resistant to conservative treatments, offering both immediate relief and enduring benefits. Although our findings are promising, additional randomized controlled trials are essential to compare DiscoGel® with established treatments and substantiate its efficacy.

Automated Data Extraction Using Large Language Models in Vascular and Interventional Neurology Research: Towards an AI Fully Assistant Automated Research (P9-14.007)

Automated Data Extraction Using Large Language Models in Vascular and Interventional Neurology Research: Towards an AI Fully Assistant Automated Research (P9-14.007)

Pilot Study on the Effects of Aerobic and Resistance Exercise on Glucose Metabolism and Gut Microbiota in Older Adults with Type 2 Diabetes Mellitus

BACKGROUND: Physical exercise has a regulatory effect on intestinal flora and glucose metabolism, but the effect of aerobic combined resistance exercise on intestinal flora and glucose metabolism in patients with T2DM is unclear, so this paper will investigate the effect of aerobic combined resistance exercise on glucose metabolism and intestinal flora in patients with T2DM. METHODS: Twelve patients with T2DM were recruited, 4 were shed, and 8 were finally available, and aerobic combined Resistance exercise intervention was carried out on the patients for a period of 6 weeks, 3 times per week, and fasting blood and fecal samples were collected from the subjects before and after the intervention, and glucose metabolism indexes were detected on the blood samples, and intestinal flora was detected on the fecal samples, and the changes in glucose metabolism indexes and intestinal flora indexes of the patients with type 2 diabetes mellitus were compared before and after the intervention Results. RESULTS: (1) GSP in blood indexes was significantly reduced (t=9.07, P&lt;0.05); (2) Alpha diversity analysis showed that the diversity of intestinal flora communities community coverage decreased significantly (P &lt; 0.05). (3)The Venn diagram shows an increase in the number of intestinal flora species by 58, with a significant increase in the abundance of Agathobacter in the thick-walled portal (P&lt;0.05). Conclusion: Aerobic combined with Resistance exercise intervention significantly improved GSP levels and increased beneficial intestinal flora and bacterial stability in T2DM patients. The study also found that Agathobacter increased with the decrease of FINS, and the genus showed a significant negative correlation with glucose metabolism indexes, which provides an important reference for the research of T2DM exercise intervention.

The gut–brain axis: Collective impact of psychosomatic conditions and gut microbiota on health and disease

The gut&amp;ndash;brain axis represents a dynamic, bidirectional communication system linking the central nervous system and the gastrointestinal (GI) tract through neural, hormonal, and immune pathways. A growing body of research highlights the role of gut microbiota in modulating neuroinflammatory responses, neurotransmitter production, and vagal nerve signaling. However, while numerous reviews have addressed gut microbiota&amp;rsquo;s impact on health and disease, few have systematically compared findings across different study models or emphasized recent advances in therapeutic interventions. Hence, this review consolidates present research on the interplay between gut microbiota, psychological conditions (stress, anxiety, and depression), and GI disorders (irritable bowel syndrome and inflammatory bowel disease). This review explores the latest methodologies, including genomic approaches and metabolomics, to understand microbial signatures in health and disease. Furthermore, it examines therapeutic interventions, including probiotics, pre-biotics, dietary modifications, and fecal microbiota transplantation, and their efficacy across different studies. The gut&amp;ndash;brain axis plays a crucial role in health and disease through complex interactions between gut microbiota, psychological conditions, and GI disorders. By consolidating recent research and advancements in therapeutic interventions, this review provides a comprehensive perspective on emerging methodologies and potential treatments. A deeper understanding of these mechanisms may pave the way for more effective, personalized therapeutic strategies.

Shaping adolescent lives: The influence of personality traits on mental health and behavioral outcomes

Adolescence is a pivotal developmental period during which personality traits begin to crystallize and significantly impact mental health and behavioral outcomes. This review synthesizes existing literature on the role of personality traits in adolescence, with a particular focus on longitudinal studies and dimensional assessments. Key personality traits, such as conscientiousness, emotional stability, and extraversion, are associated with positive outcomes, including mental well-being and pro-social behavior. In contrast, traits such as neuroticism and impulsivity, as well as callous-unemotional traits, are linked to internalizing disorders, substance use, and antisocial behavior. Longitudinal research demonstrates that personality traits exhibit both stability and malleability during adolescence, offering critical insights into how these traits predict long-term outcomes, such as academic achievement, mental health disorders, and criminal behavior. The review identifies several research gaps, including the need for more cross-cultural studies and investigations into under-researched traits like openness to experience. Policy implications include the integration of personality assessments into mental health screening programs and the development of tailored interventions that focus on emotional regulation, self-control, and pro-social behaviors. By addressing these gaps and advancing intervention strategies, researchers and clinicians can better support adolescents in developing healthy personality traits that foster long-term mental well-being and positive behavioral outcomes.

Efficacy of pulmonary rehabilitation on health-related quality of life in patients with interstitial lung disease as assessed by SF-36: a systematic review and meta-analysis.

The efficacy of pulmonary rehabilitation (PR) in improving health-related quality of life (HRQoL) in patients with interstitial lung disease (ILD) still have some unresolved issues. This study aimed to identify this gap by using the 36-Item Short Form Survey (SF-36) to assess the advantages and disadvantages of PR in improving the HRQoL of patients with ILD. Self-controlled before-and-after interventional design research related to PR and ILD published in English were retrieved from PubMed, Embase, Web of Science, Scopus, Ovid, and Cochrane Library from inception to May 19, 2024. Data collected from the included studies were general clinical characteristics, study sample size, SF-36 physical component summary (PCS) score, SF-36 mental component summary (MCS) score, scores of the eight domains (physical function, role physical, bodily pain, general health, vitality, social function, role emotional, and mental health), PR time, and main elements of PR. Subgroup analysis was performed based on the PR time and ILD type. Sensitivity analysis was conducted by excluding one study at a time. Publication bias was assessed using Egger's Test, and the reliability of the studies was determined using the funnel plot and trim-and-fill method. Changes in SF-36 domain scores after PR were presented in a radar chart. Pooled analysis of 15 studies involving 1289 patients with ILD who underwent PR showed that the patients had significantly higher PCS scores (weighted mean difference [WMD]=2.07, 95% CI: 1.06, 3.09) and MCS scores (WMD=4.48, 95% CI: 3.21, 5.76) after PR. According to disease types, subgroup analyses showed that patients with idiopathic pulmonary fibrosis had significantly higher PCS scores (WMD=3.15, 95% CI: 0.05, 6.24) but no change in MCS scores after PR (WMD=1.97, 95% CI: -1.91, 5.85). Additionally, subgroup analysis based on PR time revealed that the PCS scores of patients with ILD were significantly increased after <8 weeks of PR (WMD=2.09, 95% CI: 1.02, 3.17) but not after ≥8 weeks of PR (WMD=1.94, 95% CI: -1.05, 4.93, P=0.204). All included studies were of good quality, and the pooled and subgroup results were robust without publication bias. In patients with ILD, PR less than 8 weeks effectively improved the physical and mental HRQoL, but not the social function. Future studies should focus on determining the optimal PR time for enhancing HRQoL in patients with ILD and evaluating the efficacy of PR in different ILD types and other HRQoL domains.

Creation and validation of a roadside rescue skills scale for training pre-hospital medical teams: the RoadRes-Q scale

BackgroundRoad traffic injuries are the leading cause of death among young people worldwide. While advances in vehicle safety have reduced some of the risks, the speed and quality of pre-hospital care are critical to prevent fatalities. In France, patients are cared for by medical teams and firefighters who must work together as closely as possible to ensure the best possible survival rate. However, there is a lack of standardised scales to assess the performance of these multidisciplinary teams. This study aimed to create and validate a roadside rescue skills assessment scale, the RoadRes-Q scale, for healthcare teams.MethodsWe used a two-round Delphi method to develop the RoadRes-Q scale. A panel of 9 international roadside rescue experts, including 7 firefighters and 2 engineers in road rescue equipment, agreed to participate. The scale covers five key areas: healthcare provider protection, site securing, vehicle securing, first aid delivery, and patient extrication. The final version was tested during two one-day simulation-based training sessions, each involving 22 participants: 6 healthcare staff, 14 firefighters, and 2 simulated victims. Assessors completed the scale during and after each scenario, focusing on internal consistency and inter-observer reliability.ResultsThe RoadRes-Q scale consists of 60 items. Internal consistency was excellent (Cronbach’s alpha of 0.86), indicating that items were non-redundant and consistently measured the required competencies. However, inter-observer reliability was low (intra-class correlation coefficient of 0.48), suggesting variability between assessors. Satisfaction among participants to the simulation-based training courses was high, and their knowledge increased.ConclusionsThe RoadRes-Q scale proved to be a valid and reliable scale for evaluating both technical and non-technical skills. While internal consistency was strong, improvements are needed in inter-observer reliability. Structured training for assessors and video-based assessments could enhance reproducibility. The RoadRes-Q scale has the potential for assessing the quality and safety of care provided by healthcare teams in roadside rescue situations.RegistrationAs the study did not involve interventional research or patient participation, ethics committee approval was not required, but it received approval from the scientific referents of the Faculty of Medicine of Poitiers, and participants provided informed consent for using their anonymised data.

Recruiting Spousal Caregivers of People Living With Alzheimer's or a Related Dementia for Caregiver Intervention Research: Lessons Learned From a Feasibility Study.

Improving caregivers' quality of life begins with conducting research that aims to understand caregiver's needs. However, caregivers may be reluctant to participate in research studies, adding to the importance of developing, tracking, and evaluating recruitment strategies. Here, we review the nationwide community outreach practices we implemented as our lab embarked on a program of research to develop an online intervention tailored for those caring for a spouse with Alzheimer's Disease or a Related Dementia (ADRD). We made hundreds of "cold" calls and e-mails to organizations across the US who may have access to caregivers, but whom we had no prior relationship with. It took 36.5 contact attempts to possible recruitment sites for every 1 enrolled caregiver. While time consuming, this low-cost recruitment method may offer a route for research teams to recruit caregivers into research studies without access to a medical center or collaborating physician(s).

Autism Early Intervention Providers: Their Priorities, Use of Empirically Supported Practices, and Professional Development Needs.

Autism early intervention research has indicated a research-to-practice gap, including continued use of practices with inadequate research support, and insufficient use of empirically supported practices. The present study explored the processes and mechanisms through which providers working with young children on the autism spectrum learn, select, and implement the various practices in their clinical repertoires. We addressed the role of providers' priorities, competence, and experience with (and needs for) professional development (PD), as well as whether, in clinical practice, a provider selects for implementation interventions based on domains. Providers (n = 136) responded to an online survey to report the interventions they used, their outcome domain priorities, confidence, and their desire for PD. The most commonly used interventions were reinforcement, modeling, prompting, and visual supports, which are all supported by research evidence and classified as empirically supported practices. While most providers reported using empirically supported practices, many also used unsupported practices, especially in the sensory domain. Providers' top priority domains for intervention were communication, challenging behavior, adaptive behavior, and social skills. Provider confidence regarding the evidence-base of the practices they used was domain-specific and related to provider priorities. Providers reported interest in PD in all empirically supported practices and in all domains. Results may inform the delivery of PD in early intervention services for providers working with children on the autism spectrum, to support the best possible outcomes for this population and mitigate the research-to-practice gap.

The Effect of Reciting the Quran on the Anxiety of Neurosurgery Muslim Candidates.

Anxiety is very common among patients undergoing surgery. Like other forms of surgery, neurosurgery can affect patients both physically and emotionally. One of the ways to control and reduce anxiety is to pay attention to spiritual interventions and spiritual health. The present study aimed to investigate the effect of the Qur'an on the anxiety of neurosurgery Muslim candidates. This study is interventional research with a pretest and posttest design with a control group. The research population included all patients who were candidates for brain and nerve surgery in the teaching-treatment hospitals in 2019. The samples were selected by probability and simple random sampling methods. The data collection tool included the Spielberger questionnaire and demographics (age, gender, marital status, education degree, job, etc.) and the vital signs checklist (blood pressure, heart rate, and respiration). The results of this study showed that the sound of the Quran leads to a decrease in the level of anxiety in the experimental group. The effect size of the group for overt anxiety and anxiety subscales is 53.5% and 40%, respectively; blood pressure is 4.3%, breathing is 20.9%, and heart rate is 21.5%. Anxiety is an unpleasant complication that many people suffer from before various surgeries. The results of this study indicated that the sound of the Quran is a positive and effective factor in reducing anxiety before neurosurgery in Muslim patients who are candidates for this surgery, so health policymakers can use the results of this study as a research priority to reduce anxiety before surgery.

Ten years of Women's Wellness research: Key lessons from conducting randomised controlled trials of a whole-of-lifestyle behavioural intervention.

Ten years of Women's Wellness research: Key lessons from conducting randomised controlled trials of a whole-of-lifestyle behavioural intervention.