Lower Dropout Rates Research Articles

Influence of participation in sports on academic performance among students in public secondary schools in Imenti North Sub-County, Meru County, Kenya

This study sought to examine the influence of sporting activities on academic performance among students in public secondary schools in Imenti North Sub-County, Meru County, Kenya. This study employed a descriptive research design. Fifteen schools were identified in the study using stratified sampling based on the zones. The sample size comprised 15 class teachers, 15 games masters, 15 principals and 225 from three students. Data was obtained through structured questionnaires, oral interviews, and primary and secondary sources to ensure the reliability and validity of the study. Twenty-two from three students from two public secondary schools in Buuri Sub-County were used for the pre-test, which was approximately (10%) of the sample size. After the data was collected, it was sorted, cleaned and coded. Subsequently, the data was keyed into Statistical Package for Social Sciences (Version 27) for processing. Descriptive and inferential statistics were utilised in data analysis. The study established that there was a significant influence of sporting activities on academic performance in public secondary schools. The study concluded that students' involvement in sporting activities had a positive influence on their academic performance among public secondary schools in Imenti North Sub-County, Meru County, Kenya. The study recommends that school administrators should invest in games and enlighten students on the benefits of engaging in sports. Moreover, policymakers should look for measures to encourage students to engage in sports to better attendance rates, lower dropout rates, and improve academic performance.

Randomized-controlled trial assessing a digital care program versus conventional physiotherapy for chronic low back pain

Low back pain (LBP) is the world’s leading cause of years lived with disability. Digital exercise-based interventions have shown great potential in the management of musculoskeletal conditions, promoting access and easing the economic burden. However, evidence of their effectiveness for chronic LBP (CLBP) management compared to in-person physiotherapy has yet to be unequivocally established. This randomized controlled trial (RCT) aims to compare the clinical outcomes of patients with CLBP following a digital intervention versus evidence-based in-person physiotherapy. Our results demonstrate that patient satisfaction and adherence were high and similar between groups, although a significantly lower dropout rate is observed in the digital group (11/70, 15.7% versus 24/70, 34.3% in the conventional group; P = 0.019). Both groups experience significant improvements in disability (primary outcome), with no differences between groups in change from baseline (median difference: −0.55, 95% CI: −2.42 to 5.81, P = 0.412) or program-end scores (−1.05, 95% CI: −4.14 to 6.37; P = 0.671). Likewise, no significant differences between groups are found for secondary outcomes (namely pain, anxiety, depression, and overall productivity impairment). This RCT demonstrates that a remote digital intervention for CLBP can promote the same levels of recovery as evidence-based in-person physiotherapy, being a potential avenue to ease the burden of CLBP.

Development of the NOGGO GIS v1 Assay, a Comprehensive Hybrid-Capture-Based NGS Assay for Therapeutic Stratification of Homologous Repair Deficiency Driven Tumors and Clinical Validation.

The worldwide approval of the combination maintenance therapy of olaparib and bevacizumab in advanced high-grade serous ovarian cancer requires complex molecular diagnostic assays that are sufficiently robust for the routine detection of driver mutations in homologous recombination repair (HRR) genes and genomic instability (GI), employing formalin-fixed (FFPE) paraffin-embedded tumor samples without matched normal tissue. We therefore established a DNA-based hybrid capture NGS assay and an associated bioinformatic pipeline that fulfils our institution's specific needs. The assay´s target regions cover the full exonic territory of relevant cancer-related genes and HRR genes and more than 20,000 evenly distributed single nucleotide polymorphism (SNP) loci to allow for the detection of genome-wide allele specific copy number alterations (CNA). To determine GI status, we implemented an %CNA score that is robust across a broad range of tumor cell content (25-85%) often found in routine FFPE samples. The assay was established using high-grade serous ovarian cancer samples for which BRCA1 and BRCA2 mutation status as well as Myriad MyChoice homologous repair deficiency (HRD) status was known. The NOGGO (Northeastern German Society for Gynecologic Oncology) GIS (GI-Score) v1 assay was clinically validated on more than 400 samples of the ENGOT PAOLA-1 clinical trial as part of the European Network for Gynaecological Oncological Trial groups (ENGOT) HRD European Initiative. The "NOGGO GIS v1 assay" performed using highly robust hazard ratios for progression-free survival (PFS) and overall survival (OS), as well a significantly lower dropout rate than the Myriad MyChoice clinical trial assay supporting the clinical utility of the assay. We also provide proof of a modular and scalable routine diagnostic method, that can be flexibly adapted and adjusted to meet future clinical needs, emerging biomarkers, and further tumor entities.

Evaluation of a male-specific psychotherapeutic program for major depressive disorder compared to cognitive behavioral therapy and waitlist: study protocol for a six-arm randomized clinical superiority trial examining depressed eugonadal and hypogonadal men receiving testosterone.

Treatment of major depressive disorder (MDD) in men is complicated by the endorsement of traditional masculinity ideologies (TMI) often leading to reluctance toward psychotherapy, therapy interfering processes, or premature termination. In addition, it has been shown that men with MDD have a significantly increased risk of being hypogonadal (e.g., total testosterone levels <12.1 nmoL/L). Therefore, it is recommended to examine depressed men with regard to their testosterone status and if hypogonadism is present to combine psychotherapy with testosterone treatment (TT). This project aims to evaluate a male-specific psychotherapeutic program (MSPP) for MDD in depressed eugonadal and hypogonadal men receiving testosterone in comparison to a standard cognitive behavioral therapy (CBT) for MDD and a Waitlist. The study presents a 2×3 factorial study design. In total, 144 men aged between 25 and 50 will be stratified by testosterone status (eugonadal/hypogonadal) and then randomized into one of the three conditions (MSPP, CBT, or Waitlist). Additionally, a healthy control group of 100 men will be recruited, which will undergo only baseline assessments. Both standardized psychotherapy programs will encompass 18 sessions delivered in a weekly manner. Aligned with the TT-related medical visits of the 72 hypogonadal men, all participants will be followed up with clinical assessments and bio sampling at weeks 0, 6, 15, 24, and 36. Compared to Waitlist control groups, treatment groups are expected to be more effective and efficacious (depression score reduction of ≥50%) at week 24 and at the follow-up at week 36. The MSPP is expected to show higher effectiveness and efficacy for depressive symptoms and higher acceptability (lower dropout rate) as compared to CBT. This study represents the first attempt to test a male-specific psychotherapy for MDD in a single-setting compared to standard CBT and a Waitlist control condition using randomized clinical trial methodology. In addition, the potential positive adjunct effect of psychotherapy to TT in reducing depressive burden and improving quality of life in hypogonadal depressed men represents a neglected research area and might introduce new hypogonadism screening procedures in depressed men and combined treatment approaches for depressed men suffering from hypogonadism. Limitations are the rigorous inclusion and exclusion criteria, which limit the generalizability of the study results to first episode treatment naïve depressed men. ClinicalTrials.gov, identifier NCT05435222.

664-P: Efficacy of a Digital Diabetes Logbook for Reducing Treatment Burden—Results of a Randomized Controlled Trial

The digital diabetes logbook mySugr is designed to help people with diabetes manage their diabetes and to reduce burden of diabetes management. To test the efficacy of the app, a randomized controlled trial (RCT) was conducted. The RCT was designed as a multi-center, open-label, parallel study with a 3-month follow-up in Germany. Participants were randomized to either using the mySugr app or to the treatment-as-usual control group in a 2:1 ratio. Primary outcome was change in diabetes distress using the Problem Areas in Diabetes (PAID) questionnaire. Based on the power analysis, the recruitment goal was 396 participants, anticipating 15% drop-out it was planned to recruit 466 participants. Robust regression was used to analyze the data with follow-up scores as dependent variable, group as independent variable and controlled for respective baseline scores. Primary analysis was based on the intention-to-treat population with jump-to-reference approach for multiple imputation of missing data. A total of 424 people with diabetes were randomized, 282 to the intervention and 142 to the control group (12.5% type 1 diabetes, 68.2% type 2 diabetes, 18.9% gestational diabetes, age: 51.7±15.2 years, 50% female, diabetes duration: 9.5±10.8 years, A1c: 7.1±1.5%, PAID: 21.6±17.4); 397 completed the 3-month follow-up. Intention-to-treat analysis revealed a significant between-group difference in the primary outcome (p = 0.0182). PAID scores at follow-up in the mySugr group were significantly lower than in the control group (Δ -2.20, 95% CI: -4.02 to -0.38). This was corroborated by the per-protocol analysis (Δ -2.43, 95% CI: -4.49 to -0.37, p = 0.0211). Recruitment was successful and could be stopped earlier due to the very low drop-out rate (6.4%). Use of mySugr led to a significant improvement in diabetes distress after 3 months compared to the treatment-as-usual control group. Thus, the efficacy of mySugr regarding the reduction of diabetes distress could be demonstrated in the RCT. Disclosure D.Ehrmann: Advisory Panel; Roche Diabetes Care, mySugr, Dexcom, Inc., Speaker's Bureau; Berlin-Chemie AG, Dexcom, Inc. N.Hermanns: Advisory Panel; Insulet Corporation, Research Support; Sanofi-Aventis Deutschland GmbH, Roche Diagnostics, Becton, Dickinson and Company, Speaker's Bureau; Dexcom, Inc., Berlin-Chemie AG. S.Silbermann: Employee; Roche Diabetes Care. J.Kober: Employee; mySugr. K.Finke-groene: None. T.Roos: None. I.Vesper: None. V.L.Schaefer: Employee; Roche Diabetes Care. B.Kulzer: Advisory Panel; Berlin-Chemie AG, Abbott Diabetes, Bayer Inc., Dexcom, Inc., Novo Nordisk, Insulet Corporation, embecta, Research Support; Sanofi, Roche Diabetes Care. Funding Roche Diabetes Care GmbH (DC000097)

The implementation and evaluation of a program for Dutch language proficiency for teacher education in Curaçao

This contribution deals with the implementation and evaluation of a program for Dutch language proficiency that was developed in a long-term educational design study in Teacher Education at the University of Curaçao. It first gives an overview of the study and describes the multilingual context of the Dutch Caribbean in which it was conducted. It then briefly goes into the large study dropout rates and low Dutch language proficiency of student teachers that led to developing design principles and a new language proficiency program. The program’s implementation was investigated in a mixed methods case study with classroom observations, interviews, and language tests, to describe and evaluate its use and effect. The case study included a formative part, investigating how the program and its implementation were perceived and evaluated by the teacher educators and student teachers and a summative part, investigating the effects of the program for the student teachers’ Dutch language proficiency and study success. The results of the case study showed that the program and its underlying design principles were positively evaluated by the student teachers and teacher educators and that it contributed to higher Dutch language proficiency scores and lower dropout rates in teacher education.

#4511 TOLVAPTAN DOSE ADJUSTMENT IN ADPKD BASED ON URINARY OSMOLALITY: SIMILAR EFFICACY AND LOW DROPOUT RATE

Abstract Background and Aims Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited renal disease. Tolvaptan is the only treatment that has been shown to slow disease progression. The current recommendation is to reach the maximum tolerated dose while controlling side effects such as hepatotoxicity. There are data suggesting a marked decrease in tolerability at high doses of the drug. We explored the possibility of an individualized tolvaptan dose adjustment, based on urinary osmolality (Uosm), as an indirect indicator of treatment efficacy. Method Single-center prospective cohort study of tolvaptan in patients with ADPKD and rapid progression, with dose adjustment according to Uosm, with dose increase if Uosm &amp;gt; 200 mOsm/kg. Glomerular filtration rate (GFR) estimated by CKD-EPI, Uosm, adverse effects and dropouts were analyzed. Results 40 patients: 35 patients with more than 2 years treatment, mean follow-up 30± 6 months. Mean age 45± 7 years, 82% hypertensive and 47% male. Evolution: mean annual fall in GFR during the previous 3 years without treatment -7.24 ± 1.5 ml/min/year. Baseline GFR 51.05±12.5 mL/min and baseline Uosm 391±87 mOsm/kg. Average annual drop in GFR over 3 years with treatment -3.18±1.3 mL/min/year. Average Uosm achieved during treatment 171 ± 47 mOsm/kg. Maximum tolvaptan dose reached 60 mg (90%) and 90 mg (10%). The adverse events recorded highlight that there were no cases of hepatotoxicity (0%). The most frequent alterations were hyperuricemia (18%) and hypernatremia (11%), but in all cases asymptomatic. Polyuria was recorded in all our patients (100%), with a median diuresis 6000 ml/day (7000-5500), but the dropout rate due to aquaretic effects was minimal, only 2 patients (5%). Conclusion In our series of patients, treatment with tolvaptan at a dose adjusted to Uosm, seems to show similar efficacy to the reference studies in the annual fall of GFR, with a low rate of adverse events and very low dropout rate.

Nivolumab with chemotherapy in pleural mesothelioma after surgery: The NICITA trial.

TPS8601 Background: Pleural mesothelioma (PM) is a highly aggressive cancer of the pleura, predominantly caused by prior asbestos exposure. Currently, there is no approved standard therapy for the treatment of early-stage PM. In most cases a multimodal therapy is recommended consisting of locoregional treatment by surgical cytoreduction via extended pleurectomy/decortication (eP/D), which, if feasible, can be combined with hyperthermic intrathoracic chemoperfusion (HITOC), together with inductive or adjuvant chemotherapy. Considering the immunogenic effects of chemotherapy on the tumor microenvironment, synergistic effects are expected when such a treatment is combined with immune checkpoint inhibitor therapy. In addition, interactions between immune infiltrates and mesothelioma cells play a role in the advent of PM, also implying a beneficial role for immunotherapy in this entity. This is also supported by recent clinical data that demonstrated beneficial effects of immune checkpoint inhibitors in patients with advanced PM. The NICITA trial is an investigator-initiated trial, investigating the combination of adjuvant chemotherapy with immune checkpoint inhibitor compared to chemotherapy alone in radically resected patients with early stage PM. Methods: The NICITA trial is a randomized, open-label, phase II clinical trial that is conducted in 14 centers across Germany. Eligible patients have been diagnosed with PM in tumor stages I-III (UICC 8th edition) and epithelioid subtype, and must have undergone cytoreductive surgery by eP/D with or without HITOC. Patients will be randomized 1:1 to receive either a combination of 4 cycles of pemetrexed/platinum-based adjuvant chemotherapy and nivolumab (480 mg q4w) followed by nivolumab maintenance therapy (12 cycles, 480 mg q4w) or 4 cycles of adjuvant chemotherapy only. Stratification will take place according to previous HITOC treatment (yes vs. no), ECOG status (0,1 vs. 2), and achievement of macroscopic complete resection (yes vs. no). The primary endpoint of this trial is time-to-next-treatment. Secondary endpoints include additional measures of efficacy (progression-free survival, overall survival, measures of treatment-beyond-progression) and quality of life, as well as the assessment of safety. Furthermore, a comprehensive longitudinal collection of biomarker samples, including tumor tissue, blood, and stool samples, for an accompanying translational research project is implemented in this clinical trial. Sample size justification: the recruitment of 46 patients to each arm with a low drop-out rate of 13% appears feasible resulting in 40 patients to be analyzed per arm. This sample size will permit a descriptive comparison and adequately describe the tested treatment options as deduced from the precision of the median TNT confidence interval estimate. As of February 2nd 2023, 85 of planned 92 patients have been enrolled into the NICITA trial. Clinical trial information: NCT04177953 .

Online Dance Injury Monitoring: The Efficacy of Weekly Reporting and Respondent Compliance Over a 30-Week Period.

Previous injury survey recall methods often use one-off questionnaires with varying periods of recall. These methods have proven to show injury incidence inaccuracies and limited information on injury etiology. The present study aimed to examine the efficacy of a remote weekly self-report injury incidence and etiology tool. Two online questionnaires were developed based on the "Fit to Dance 2" survey and sent to volunteers. The first questionnaire was sent once and asked for complete injury history information. The second questionnaire was sent to each respondent on a weekly basis and it focused on new injuries and their causes and whether injuries that occurred in previous weeks were still affecting their dancing. The online survey was opened for full-time dance students from September 2020 to July 2021. All weekly data for each respondent were combined with a unique reference code using their account names, students' numbers, and schools' names. The proportion of participants who drop out is defined as the measurement of outcome. A total of 756 respondents engaged in the survey from 16 different Chinese dance schools; the drop-out rate was 70.1%, with student respondents under 18 years old having a slightly lower drop-out rate than adult respondents (69%vs 71%). 33 respondents (4.4%) who completed all 30 weeks survey. These data allow other researchers to examine respondent compliance rates from a weekly survey. A reminder system and teacher engagement could potentially increase the response rate. For frequent completion questionnaires the design needs to be streamlined to increase compliance. It is concluded that the researchers would need to weigh reduced completion rates (<100%) against data efficacy to achieve generalizability.

Safety and efficacy of aggressive exercise therapy for patients with unilateral early-stage spondylolysis: A retrospective comparative cohort study

IntroductionBony union in patients with early-stage spondylolysis can be achieved using a rigid corset and avoiding sports activities. However, prolonged absence from sports activities may decrease physical fitness. This study aimed to investigate the safety and efficacy of aggressive exercise therapy for patients with early-stage spondylolysis (ESS). MethodsThirty-one patients (aged <19 years; 26 males) diagnosed with unilateral ESS were divided into light intensity (L group; n = 16) and aggressive (A group; n = 15) exercise groups. All patients wore a hard corset and received light intensity (L group) or aggressive (A group) exercise therapy for 2–3 months. After treatment, the bony union was assessed using magnetic resonance imaging and computed tomography. The mean interval between the initial and second computed tomography examinations, including treatment drop-out rates, was determined. Results: Second computed tomography examination results showed that bony union was either improved or achieved in both groups. The mean interval between the initial and second computed tomography examinations was 78.1 ± 19.7 and 78.1 ± 17.4 days in the L and A groups, respectively, with no significant difference. The L group had a higher drop-out rate (n = 5; 31.3%) than the A group (n = 1; 6.7%), albeit not significant. DiscussionBoth groups showed bony union after treatment, suggesting that aggressive exercise therapy was safe and effective for patients with unilateral ESS. Moreover, the lower drop-out rate in group A suggests that aggressive exercise therapy maintained the patients’ adherence to long-term treatment. ConclusionsAggressive exercise therapy was effective-to-safe and maintained good motivation in patients with ESS.

Antenatal mobile-delivered mindfulness-based intervention to reduce perinatal depression risk and improve obstetric and neonatal outcomes: A randomized controlled trial

ObjectivesOne in five mothers will experience perinatal depression (PND) during pregnancy and within their first year following childbirth. Current evidence suggests the short-term efficacy of Mindfulness-based interventions (MBI) for perinatal women, but the extent to which this positive impact remains the early postpartum period is unclear. This study investigated the short- and maintenance efficacy of a mobile-delivered four-immeasurable MBI on PND, and obstetric and neonatal outcomes. MethodsSeventy-five adult pregnant women suffering from heightened distress were randomized to receive a mobile-delivered four-immeasurable MBI (n = 38) or a web-based perinatal education program (n = 37). PND was measured by Edinburgh Postnatal Depression Scale at baseline, post-intervention, 37th-week gestation, and 4–6 weeks postpartum. Outcomes also included obstetric and neonatal outcomes, trait mindfulness, self-compassion, and positive affect. ResultsParticipants reported an average age of 30.6 (SD = 3.1) years with a mean gestational age of 18.8 (SD = 4.6) weeks. In intention-to-treat analyses, women in the mindfulness group showed a significantly greater reduction in depression from baseline to post-intervention (adjusted mean change difference [β] = −3.9; 95%CI = [−6.05, −1.81]; d = −0.6), and the reduction sustained until 4–6 weeks postpartum (β = −6.3; 95%CI = [−8.43, −4.12]; d = −1.0), compared with control. They had a significantly reduced risk of emergent cesarean section (relative risk = 0.5) and gave birth to infants with higher Apgar scores (β = 0.6;p = .03; d = 0.7). Depression reduction before giving birth significantly mediated the intervention effect on lowering the emergency cesarean risk. ConclusionsWith a reasonably low dropout rate (13.2 %), the mobile-delivered MBI can be an acceptable and effective intervention for reducing depression throughout pregnancy and postpartum. Our study also suggests the potential benefits of early prevention for mitigating emergent cesarean section risk and enhancing neonatal health.

Process-outcome relations in music therapy versus music listening for people with schizophrenia viewed through a mediational model: the role of the therapeutic alliance.

Examine whether change in clinical outcomes for patients with schizophrenia and negative symptoms randomized to either Music Therapy (MT) or Music Listening (ML) is associated to moderators and mediators, with focus on alliance, attendance and dropout. An exploratory post-hoc analysis of data from an original randomized controlled trial (RCT) investigating the effect of MT vs. ML for people with schizophrenia and negative symptoms. Inclusion to the study was implemented through screening of referred patients for symptoms of schizophrenia and negative symptoms. A total of 57 patients were randomly assigned, 28 to MT and 29 to ML. Session logs and notes were included in this study. Statistical analysis investigated moderator and mediator relation to outcome variables: Negative symptoms, functioning, quality of life, and retention to treatment. On average, participants in MT attended 18.86 sessions (SD = 7.17), whereas those in ML attended 12.26 (SD = 9.52), a statistically significant difference (p = 0.0078). Dropout at 25 weeks was predicted by intervention, with dropout being 2.65 (SE = 1.01) times more likely in ML than in music therapy (p = 0.009). Helping alliance score at weeks was explained by intervention, with mean score being 0.68 (SE = 0.32) points lower in ML than in MT (p = 0.042). The number of sessions attended was also explained by intervention, with participants in ML attending on average 6.17 (SE = 2.24) fewer sessions than those randomized to MT (p = 0.008). Though both groups improved significantly, improvements in negative symptoms, depression, and functioning tended to be higher in ML, whereas improvements in alliance and quality of life tended to be higher in MT. The analysis could not detect a direct link between helping alliance score and outcome variables. However, the analysis documented a stronger alliance developed in the MT group, a lower dropout rate, as well as higher attendance in treatment.Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT02942459.

Effectiveness of a projection-based augmented reality exposure system in treating cockroach phobia: study protocol of a randomised controlled trial

BackgroundDespite being the treatment of choice for phobic disorders, in vivo exposure treatment (IVET) presents some important limitations related mainly to low acceptance and high drop-out rates. Augmented reality (AR)...

Comparing mixed oil to soybean oil lipid emulsion in patients on home parenteral nutrition: a pilot prospective double-blind, crossover, randomized trial

BackgroundHome parenteral nutrition (HPN) can be associated with increased liver enzymes, catheter-related bloodstream infections (CRBSI), and hospitalizations. Mixed oil (MO) versus soybean oil (SO) lipid emulsion reduces risks in hospitalized patients, but there are no randomized double-blinded controlled trials in HPN. Therefore, the primary objective was to test the study’s feasibility such as recruitment and retention in the HPN population and the secondary objective was to assess changes in liver enzymes between MO and SO as well as other clinical and biochemical outcomes.MethodsThis 13-month prospective double-blind crossover randomized pilot trial took place in Toronto, Canada. Participants were HPN patients who were a part of the HPN program at Toronto General Hospital. We recruited patients from the HPN program. HPN patients receiving SO were randomized to either MO or SO, and the study duration was 6 months in each arm (MO or SO) with a 1-month washout period resuming SO. As this is a crossover trial design, the patient is his/her own control. The main outcome measures were descriptions of study feasibility, namely the study recruitment and retention. We also collected biochemical parameters, CRSBI, hospitalization rate, antibiotic use, and mortality. Demographic, nutritional, clinical, and laboratory data were collected at baseline, 3 and 6 months of each arm. The primary analysis population was defined as the per-protocol population who completed the trial including all lipid measurements.ResultsA total of 65 HPN patients were assessed, and 60 met the inclusion criteria for the study. Thirty-five percent (21/60) were randomized using a computer-generated random number sequence generator: 10 participants were randomized to receive SO first while 11 were randomized to receive MO first. At 13 months, 3/10 who received SO first completed the study, whereas 9/11 who received MO first completed the study. This did not meet our a priori criteria for success in recruitment and retention. Between types of lipid emulsions, there were no significant differences in changes in liver enzymes or biochemical and clinical outcomes, despite significant changes in plasma free fatty acid composition reflecting MO or SO.ConclusionsOverall, this pilot trial demonstrated that the use of a prospective double-blind, crossover, randomized trial design was not feasible to conduct in the HPN population because of difficulties in recruiting and retaining patients. In addition, there was no significant impact of MO versus SO lipid emulsion on liver enzymes or most parameters. The lack of significance may be attributed to low sample size from low recruitment and high drop-out rate, short study duration (6 months/arm), and complex care. In a future definitive trial, a multicenter study of longer duration and a larger sample size is recommended, and drop-outs may be reduced by using a parallel study design.Trial registrationClinicalTrials.gov, NCT02796833. Registered on 13 June 2016—retrospectively registered.

Development of a mobile application to monitor the effectiveness of a hydrolyzed cartilage matrix supplement on joint discomfort: a real-life study.

Joint discomfort is a widespread and growing problem in active adults. The rising interest in preventative nutrition has increased the demand for supplements reducing joint discomfort. Protocols assessing the effect of a nutritional intervention on health commonly involve a series of face-to-face meetings between participants and study staff that can weigh on resources, participant availabilities and even increase drop-out rates. Digital tools are increasingly added to protocols to facilitate study conduct but fully digitally run studies are still scarce. With the increasing interest in real-life studies, the development of health applications for mobile devices to monitor study outcomes could be of great importance. The purpose of the current real-life study was to develop a specific mobile application, Ingredients for LifeTM, to conduct a 100% digital study testing the effectiveness of a hydrolyzed cartilage matrix (HCM) supplement on joint discomfort in a heterogeneous group of healthy, active consumers. The 'Ingredients for LifeTM ' mobile app using Visual Analog Scale (VAS) was specifically developed to monitor the variation in joint pain after exercise by the study participants. A total of 201 healthy and physically active, adult women and men (18 to 72 years old) with joint pain completed the study over a period of 16 weeks. Participants were randomly allocated to the study groups and did not receive any dietary or lifestyle advice. Each participant indicated one area of joint pain and logged the type and duration of their weekly activities. They received blinded study supplements and took a daily regimen of 1 g of hydrolyzed cartilage matrix (HCM-G) or 1g of maltodextrin (placebo group; P-G) for 12 weeks while weekly logging joint pain scores in the app. This was followed by a 4-week wash out period during which participants continued reporting their joint pain scores (until the end of week 16). Joint pain was reduced within 3 weeks of taking a low dosage of HCM (1g/day), regardless of gender, age group and activity intensity when compared to the placebo-group. After stopping supplementation, joint pain scores gradually increased but still remained significantly lower than placebo after 4 weeks of washout. The low dropout rate (< 6% of participants, mainly in the P-G) demonstrates the digital study was well received by the study population. The digital tool allowed to measure a heterogeneous group of active adults in a real-life setting (without any lifestyle intervention), thus promoting inclusivity and diversity. With low dropout rates, it demonstrates that mobile applications can generate qualitative, quantifiable, real-world data showcasing supplement effectiveness. The study confirmed that the oral intake of a low dose (1g/day) of HCM led to a significant reduction of joint pain from 3 weeks after starting supplementation.

Self-regulation as a resource for coping with developmental challenges during middle childhood and adolescence: the prospective longitudinal PIERYOUTH-study

BackgroundSelf-regulation (SR) as the ability to regulate one’s own physical state, emotions, cognitions, and behavior, is considered to play a pivotal role in the concurrent and subsequent mental and physical health of an individual. Although SR skills encompass numerous sub-facets, previous research has often focused on only one or a few of these sub-facets, and only rarely on adolescence. Therefore, little is known about the development of the sub-facets, their interplay, and their specific contributions to future developmental outcomes, particularly in adolescence. To fill these research gaps, this study aims to prospectively examine (1) the development of SR and (2) their influence on adolescent-specific developmental outcomes in a large community sample.Methods/designBased on previously collected data from the Potsdam Intrapersonal Developmental Risk (PIER) study with three measurement points, the present prospective, longitudinal study aims to add a fourth measurement point (PIERYOUTH). We aim to retain at least 1074 participants now between 16 and 23 years of the initially 1657 participants (6–11 years of age at the first measurement point in 2012/2013; 52.2% female). The study will continue to follow a multi-method (questionnaires, physiological assessments, performance-based computer tasks), multi-facet (assessing various domains of SR), and multi-rater (self-, parent-, and teacher-report) approach. In addition, a broad range of adolescent-specific developmental outcomes is considered. In doing so, we will cover the development of SR and relevant outcomes over the period of 10 years. In addition, we intend to conduct a fifth measurement point (given prolonged funding) to investigate development up to young adulthood.DiscussionWith its broad and multimethodological approach, PIERYOUTH aims to contribute to a deeper understanding of the development and role of various SR sub-facets from middle childhood to adolescence. The large sample size and low drop-out rates in the first three measurements points form a sound database for our present prospective research.Trial registration German Clinical Trials Register, registration number DRKS00030847.

Are psychological interventions for adult PTSD more efficacious and acceptable when treatment is delivered in higher frequency? A meta-analysis of randomized controlled trials.

Two systematic reviews indicated that higher treatment frequency of psychological interventions for adult PTSD may lead to higher efficacy and less dropout. Yet, a quantitative review is missing. We conducted a thorough systematic literature search and included trials meeting the following criteria: a) random allocation, 2) PTSD was primary treatment focus, 3) ≥70% interview-based PTSD rate 4) mean age ≥18 years, and 5) N≥20. Treatment session frequency was analyzed dichotomously (< 1.5 vs. ≥ 1.5 sessions/week) and continuously (sessions per week & minutes per week). A total of 160 RCTs with data from 10,556 patients were included. Analyses yielded similar treatment efficacy irrespective of treatment frequency definitions and whether differential efficacy was estimated directly via head-to-head trials or indirectly via comparisons to the same comparison group. Intense (≥ 1.5 sessions/week) vs. standard (< 1.5 sessions/week) delivery was, however, associated with significantly lower dropout rates (as a proxy for acceptability) for trauma-focused interventions (18.64% vs 11.54%, respectively, p=.024), but not for non-trauma-focused interventions. We found no evidence for differential treatment efficacy of intense vs. standard psychotherapies for adult PTSD. Evidence for increased acceptability was found for intense vs. standard trauma-focused interventions.

Exploring the Influence of Teacher Qualifications, Classroom Size, Student Age, and Parental Involvement on High School Drop Out Rates in Sukabumi Regency

The purpose of this study was to explore the influence of teacher qualifications, classroom size, student age, and parental involvement on high school dropout rates in Sukabumi Regency. Using data from a survey of high school students in the region, multiple regression analysis was used to examine the relationships between these predictor variables and dropout rates. The results showed that all four predictor variables were significant predictors of dropout rates, with teacher qualifications and student age having the strongest influence. Specifically, having a teaching degree and license, having less than five years of teaching experience, being between the ages of 18 and 20, and larger class sizes were associated with higher dropout rates, while regular communication with teachers was associated with lower dropout rates. These findings suggest that efforts to improve teacher qualifications, reduce class sizes, and increase parental engagement and communication could help reduce high school dropout rates in Sukabumi Regency.

Glaucoma and aging: therapeutic difficulties experienced by the elderly

Introduction: Glaucoma is a public health problem among chronic-degenerative visual diseases due to its high incidence and for causing disability. Thus, the Glaucoma Patient Assistance Program was created to improve follow-up and avoid bleak prognoses. Objectives: to analyze the difficulties of the elderly in the use of eye drops for the treatment of glaucoma.Methods: an exploratory research was carried out where the population was composed of elderly patients with glaucoma treated at the Integrated Unit of Ipiranga linked to Basic Care in District III of João Pessoa-PB, a questionnaire was the instrument for data collection for the 61 participants. Results: it was found that 38 (62.3%) %) of the participants , 53 (87%) received 1-2 minimum wages, and 23 (37.7%) studied only until primary school. As for administration, 37 (60.7%) had no problems remembering if they had already used the eye drops, 39 (63.9%) had no difficulty using it, and 34 (55.7%) were unable to follow its use in the basic assistance. Conclusion: respondents have their obstacles to medication adherence regardless of the disease, the lack of follow-up in basic care only adds another one, so that’s why educating them would enable lower dropout rates and better prognoses.

Calidad del servicio asistencial de la Facultad de Odontología de la Universidad de la República. Encuesta de satisfacción a usuarios asistidos durante 2019

The School of Dentistry of the University of the Republic of Uruguay provides oral health care within the school’s student learning program. The quality of care provided is not evaluated.Objective: to know the quality of care of the School of Dentistry of the University of the Republic of Uruguay by evaluating the satisfaction of the users seen during 2019.Methodology: user satisfaction was studied through the dimensions of structure, process, and results of care. A telephone survey was conducted on a sample of 500 adult users seen during 2019.Results: 303 users answered the survey. 72.6% reported being very satisfied with the care received, 94.1% would attend the service again and only 14.2% dropped out of care.Conclusions: The quality of care at the School of Dentistry of the University of the Republic of Uruguay is very satisfactory for users. We found excellent ratings in all the dimensions studied and a lower dropout rate than that reported in other studies.