Medium Effect Size Research Articles

Exploring the Peaks and Potholes: Understanding positive and negative effects of concentrated exposure treatment for obsessive-compulsive disorder

The Bergen 4-Day Treatment offers brief concentrated exposure with response prevention (cERP) for obsessive-compulsive disorder (OCD). To date, this intervention has primarily been studied in Norway, and no study has been done on its side effects. We tested the safety, feasibility, and effectiveness of cERP in Germany and compared cERP to a historical inpatient control group.Thirty-three patients with OCD were treated with cERP. We assessed severity of OCD (primary outcome: Y-BOCS), depression, global functioning, self-esteem, self-efficacy, experiential avoidance, and quality of life at baseline (t0), two weeks after t0 (t1), and three months after t1 (t2). Side effects were assessed at t1 and t2. The changes in OCD were compared to a matched historical inpatient control group (n = 33) treated at the same site.The cERP group improved over time, with a large effect size in OCD symptoms and other outcome measures. Improvement of OCD symptoms over treatment was superior in the cERP group compared to the historical control group, with a medium effect size for OCD symptoms. 53–56% of the participants reported at least one side effect (e.g., exhaustion). cERP is safe and effective in the treatment of OCD and can be successfully implemented in Germany.

Group cognitive remediation therapy for adolescents with anorexia nervosa: Outcomes before, after, and during follow-up in a real-world setting in Japan.

Objective: Cognitive remediation therapy (CRT) can be used as an adjunct treatment for adolescents with severe and complex anorexia nervosa (AN) requiring inpatient treatment. However, there has been only one study on CRT for adolescents with AN in Japan. This study explored group CRT as an adjunct to inpatient treatment for Japanese adolescents with severe and complex AN requiring inpatient care. Methods: Thirty-one adolescents with AN underwent group CRT. Neuropsychological (set-shifting and central coherence) and psychological assessments (motivation, self-esteem, and depressive symptoms) were measured before and after the intervention. Weight and AN symptoms were measured before and after the intervention and at follow-up, and the adolescents completed post-intervention and follow-up questionnaires. Results: Set-shifting led to medium to large effect size improvements. Medium effect size improvements in central coherence and depressive symptoms were also observed. The feedback from the adolescents was mainly positive, and the treatment completion rate was high. The patients also reported that the skills learned through group CRT could be applied in daily life. Conclusion: Group CRT may be beneficial for adolescents with severe and complex AN who require inpatient care.

Psychological Interventions for Chronic Pain: An Umbrella Review of Systematic Reviews and Meta-Analyses of Randomized Controlled Trials

Background: There is a continuous increase in the number of studies showing that psychological interventions help reduce chronic pain. Systematic review studies that analyze the effect are also increasing. The aim of this umbrella review was to synthesise the best available research evidence for the effectiveness of standardised psychological interventon for adults with chronic pain.Methods: Using MEDLINE (PubMed) and Cochrane CENTRAL search engines, four systematic reviews met the study criteria, including 60 randomized control trials and 7,025 patients with chronic pain.Results: Compared to waiting control and treatment as usual, psychological interventions displayed medium effect sizes for pain intensity (SMD −0.35, CI −0.42 to −0.29, 4 reviews, N=4,061), pain disability (SMD −0.44, CI −0.51 to −0.36, 3 reviews, N=2,609), and physical functioning (SMD 0.38, CI 0.29 to 0.48, 2 reviews, N=1,699). Additionally, psychological interventions exhibited a medium effect size in reducing pain intensity (SMD −0.34, CI −0.42 to −0.26, 2 reviews, N=2,508) and pain disability (SMD −0.43, CI −0.51 to −0.35, 2 reviews, N=2,563) in chronic low back pain.Conclusions: The results reaffirm that psychological interventions, along with drug or conventional treatments, can be helpful in managing chronic pain.

“I think I speak without hesitation”: Learning-Oriented Assessment to Enhance English Oral Communication of Thai Pre-Service Teachers

Learning-oriented assessments have been implemented in the English language classroom to maximize students’ ability to acquire a language through their involvement in assessment processes. Nevertheless, empirical studies investigating the oral communication ability of students using learning-oriented assessments remain limited. This study aims to investigate the effects of a learning-oriented assessment on the English oral communication ability of Thai pre-service teachers and to explore their attitudes towards the model. Thus, the study employed a mixed-methods research design. The participants of the study were 60 first-year students divided into two groups: the control group (N = 30) and the experimental group (N = 30) were selected through convenience sampling. The data were collected for 10 weeks using an oral communication test, a questionnaire, and interview questions. The results of the test were analyzed using a paired sample t-test and an independent sample t-test. The results of the questionnaire were analyzed using descriptive statistics. In addition, the qualitative data were analyzed using content analysis. The quantitative results showed positively significant effects on the development of students’ oral communication ability in the aspects of range, accuracy, fluency, interaction, coherence, and pronunciation, with a medium effect size. Additionally, the students positively reported the benefits of learning-oriented assessments as being helpful in improving their oral communication ability. Therefore, this study shows that learning oriented assessments could serve as one of many alternative approaches to developing English oral communication ability.

Effectiveness of PEARL Mobile Application in Enhancing the Academic Performance of Students in English

This research aimed to test the effectiveness of the Packeted Electronically Assisted Reading Leaflets (PEARL) mobile application in enhancing students’ English academic performances. The researcher gained knowledge of declining reading comprehension skills, including Grade 7 reading levels, using the Philippine Informal Reading Inventory (PHIL-IRI), the official reading material from the Department of Education. However, due to the COVID-19 pandemic, the administration of this reading inventory has been put on hold due to its inapplicability. This study was conducted with Grade 7 Calamba Bayside Integrated School students from the Division of Calamba as respondents. A quasi-experimental technique, and administration of pretest, formative, and posttest, were used in this study. As for the data collection, the respondents' pretest, formative test, and post-test scores in the experimental and controlled groups were recorded weekly. There are 22 active students participated in the study through random sampling. Next, data analysis was performed using the T-test and Pearson’s formulas, respectively. Based on these findings, the researcher concluded that there was a significant difference between the pretest and posttest mean scores of the two groups, which indicates that the PEARL application is practical in enhancing English academic performance. Although there was only a medium-sized effect regarding the significant differences in the scores of the experimental group, it is concluded that several factors, like poor internet connectivity and technical difficulties, should be considered. The researcher also suggested that crafting instructional materials such as PEARL could improve students’ English proficiency.

Evaluating the effectiveness of the CAIDS-Q for screening for intellectual disability in mainstream schools

Objectives The identification of intellectual disability in children can help them access targeted support and interventions. Research suggests that current methods of identifying intellectual disability in schools in the United Kingdom need to be improved. Screening tools can play a role in this. The study examined the performance of the Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q) in mainstream schools as a means of facilitating identification of intellectual disability. Methods Parents and/or teachers of 70 children completed the CAIDS-Q and an assessment of adaptive functioning about them. Children who were indicated as having difficulties completed an intellectual assessment. The data were used to explore some psychometric properties of the CAIDS-Q. Results The CAIDS-Q had sensitivity and specificity values of 100% and 79% respectively when completed by teachers and 92% and 70% when completed by parents. CAIDS-Q scores correlated positively with intellectual and adaptive functioning scores, with large and medium effect sizes respectively. There was moderate agreement between parents and teachers on the outcome of the CAIDS-Q. Conclusions The CAIDS-Q, when used in mainstream schools, had psychometric properties consistent with those found in health service settings. It may offer a way of improving identification of intellectual disability in educational settings.

Prevention and Reduction of Anxiety in Autistic Preschoolers Through an Autism-Specific Parent-Mediated Intervention: A Pilot Randomised Controlled Trial Evaluating Short and Longer Term Outcomes.

Anxiety is a common co-occurring condition for autistic preschoolers. Whilst there has been extensive research evaluating anxiety prevention/reduction interventions for neurotypical preschoolers, such research is limited for autistic children. Fifty-seven parents of autistic 4-5-year olds, with varying levels of anxiety, participated in a randomised controlled trial of an autism-specific, parent-mediated intervention (CLK-CUES) to prevent or reduce anxiety in autistic preschoolers. Baseline, short-term (post-intervention) and longer term (12 months follow-up) assessments included child anxiety (ASC-ASD-P and PAS-R), intolerance of uncertainty, and parent well-being. (Trial registration ACTRN12620001322921). There were no reports of harmful effects of the intervention or trial. Linear mixed models show a significant group x time interaction for ASC-ASD-P Total score and the Uncertainty subscale with medium and large effect sizes. Post-hoc analyses show a significant decline for only the intervention group in anxiety (specifically, anxiety around uncertainty) from pre-post intervention, maintained at one year follow-up. There was no change on the PAS-R or other ASC-ASD-P subscales. CLK-CUES shows promise as a way to prevent and reduce anxiety in young autistic children, specifically anxiety related to uncertainty. Trials with larger samples are warranted. Findings also highlight the importance of using measures designed for autistic children.

The relationship between the Dark Triad and academic burnout mediated by perfectionistic self-presentation

Individuals with dark personality traits are more prone to burnout, but this was not yet investigated in academia. Perfectionistic self-presentation (PSPS), an interpersonal expression of perfectionism, could be an explaining factor. Therefore, we investigated the relationship between the dark triad (Machiavellianism, vulnerable and grandiose narcissism, and psychopathy) and academic burnout, and whether the PSPS total score and its dimensions (perfectionistic self-promotion, nondisplay of imperfection, and nondisclosure of imperfection) mediates this. We expected that higher dark triad traits would be associated with higher academic burnout and that this would be explained by higher PSPS. Hypotheses included expectations for each PSPS dimension as well. Questionnaires were completed by 304 bachelor/master students (Mage = 22.81 years). Mediations were performed for each dark triad trait with total PSPS and each of its dimensions separately as mediator, and academic burnout as dependent variable. Total PSPS and almost all of its dimensions positively and significantly mediated the relation between Machiavellianism as well as psychopathy and academic burnout (small effect sizes). In contrast, only the PSPS dimension nondisplay of imperfection was a significant, positive mediator of the relation between grandiose narcissism and academic burnout (medium effect size). The other mediations with grandiose or vulnerable narcissism were non-significant. Future research should investigate this further, for instance by using the standard dark triad scales. Finally, this study offers insights for interventions and prevention of academic burnout by highlighting the unique impact of each dark triad trait. For example, those high on Machiavellianism may benefit from tools to deal with cynicism and perfectionism, ultimately lowering the risk for academic burnout.

Problematic use of social media in adolescents or excessive social gratification? The mediating role of nomophobia

The term problematic social media use (PSMU) refers to the interference produced by social networks in everyday life, where online participation is perceived as rewarding and continues despite negative consequences. The constant gratification (peer connection, instant notifications, scrolling, and variable rewards) has negative consequences for the well-being of adolescents, from the fear of not being connected to developing negative moods. Recent studies of uses and gratifications theory suggest that user preferences, such as the search for friendships and maintaining social relations, are related to PSMU. Based on that theory, this study analyzes the mediating role of nomophobia in the link between social use (social gratification) and problematic social media use among adolescents in Madrid (Spain). The research was conducted in 2022 with adolescents aged 14–17 (N = 820), who self-reported the use of social media, nomophobia, and problematic social media use (Adolescent Risk of Addiction to Social Networks and the Internet Questionnaire; ERA-RSI). The data were analyzed using structural equation modeling (SEM) with partial least squares (PLS). The gratification-oriented social use offered by social networks in interactions with other people and nomophobia were explanatory variables for problematic use in adolescent participants. As predicted, nomophobia mediates the link between social use and PSMU. Social use and nomophobia were positively and significantly related, with a medium effect size. The preference for online social interaction and fear of losing this connection contribute significantly to PSMU. The results revealed the need for school-based prevention and intervention programs for digital well-being.

Virtual reality education on myalgic encephalomyelitis for medical students and healthcare professionals: a pilot study

IntroductionMyalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS) is a chronic condition which may be characterised by debilitating fatigue, post-exertional malaise, unrefreshing sleep, and cognitive difficulties. ME/CFS has significant negative impact on quality of life for those living with the condition. This may be exacerbated by a lack of knowledge within healthcare regarding the condition. Previous research has found that immersive virtual reality (VR) educational experiences within healthcare education can increase knowledge and empathy.MethodsThe present study employed a quasi-experimental pre-test-post-test design to investigate the impact of a short immersive VR educational experience on knowledge of ME/CFS and empathy for those living with the condition. The VR experience placed participants into a virtual scene which told real life stories of the experience of people living with ME/CFS and their families. 43 participants completed in this pilot study: 28 medical students and 15 primary care health professionals. Participants completed measures of knowledge of ME/CFS and empathy before and after engagement with the experience.ResultsA statistically significant increase was found for levels of knowledge (p < .001, d = 0.74) and empathy (p < .001, d = 1.56) from pre-VR experience levels to post-VR experience levels with a medium and large effect size, respectively. Further analysis revealed no statistically significant difference between baseline levels of knowledge of ME/CFS between healthcare professionals and medical students.DiscussionThe present study is the first to explore the use of this short immersive VR experience as an education tool within healthcare to increase knowledge of ME/CFS, and empathy for those living with the condition. Findings allude to the previously established lack of knowledge of ME/CFS within healthcare although promisingly the increases in knowledge and empathy found suggest that this immersive VR experience has potential to address this. Such changes found in this small-scale pilot study suggest that future research into the use of VR as an educational tool within this setting may be beneficial. Use of a control group, and larger sample size as well as investigation of retention of these changes may also enhance future research.

Self-Reported Perceptions of Patients and Staff on Participation and Verbal and Social Interactions in High-Security Forensic Psychiatric Care in Sweden.

Studies suggest that experiences of patient participation, as described by both patients and staff, are associated with a significant caring relationship of high quality. This study aimed to investigate staffs' and patients' self-reported perceptions on participation and the frequency and importance of verbal and social interactions in high-security forensic psychiatry. The questionnaire Verbal and Social Interactions (VSI) was used together with the subscale Participation from Quality in Psychiatric Care (QPC). The study was conducted at a large forensic psychiatric clinic in Sweden. Staff and patients rated the frequency of VSI differently while reporting the same perceived degree of patient participation. All categories of VSI were significantly correlated with perceived level of participation with medium or small effect size for the patients. Patients' perceived participation seems to depend on verbal and social interaction within the specific categories 'Showing interest in the patients' feelings, experiences, and behavior' and 'Helping the patients establish structure and routines in their everyday life'. There was, however, a negative association for the latter. The results give a better understanding of what kind of interactions that affect patients' perceived level of participation. Patient participant is a prioritised area for development in forensic psychiatry. The study contributes to a better understanding of what types of interactions that affect the perceived level of participation, while at the same time, it shows important similarities and differences between patient and staff perspectives.

Why Students Cannot Easily Integrate Component Skills: An Investigation of the Composition Effect in Programming

Programming skills are increasingly important to the current digital economy, yet these skills have long been regarded as challenging to acquire. A central challenge in learning programming skills involves the simultaneous use of multiple component skills. This article investigates why students struggle with integrating component skills—a challenge called the composition effect. This effect was first studied in learning mathematics, and findings in that area have led to more effective instruction in mathematics. In the current work, we systematically investigate the nature of the composition effect in novice code tracing through a classroom study in a university-level introductory programming course. We designed a set of problems that require integrating component skills, along with matched problems that use the same component skills separately. The composition effect was defined as the performance difference between these two types of problems. We further singled out errors that were committed in integration problems but not in the matched problems and conducted qualitative coding to categorize these errors. Statistical analyses produced three main findings. First, we found a robust composition effect across problems and students, mostly with small or medium effect sizes. Second, we identified two potential sources of errors for this composition effect: conceptual misunderstandings of how to integrate component skills and process errors resulting from slips related to cognitive load challenges. In particular, additional conceptual knowledge often appears to be needed when component skills are integrated in specific ways. Moreover, the primary source appears to be misunderstandings of how skills integrate. Composition effects may not generalize across topics, which suggests that domain topics may serve as the conceptual basis for the composition effect. Third, we found stable individual differences in susceptibility to the composition effect in both overall and finer-grained levels. Our findings provide implications for building theories that may generally explain challenges in learning complex skills and may result in practical designs for skill integration enhanced curricula and instruction to foster student mastery in computing education.

Association between sleep bruxism and snoring in adults: An observational study

ObjectiveThis study evaluated the association between sleep bruxism and snoring. Additionally, the associations between sleep bruxism and age, sex, body mass index, sleep structure, sleep quality, and sleepiness were evaluated. MethodsAdults suspected of having sleep disorders (n = 61) underwent single-night video polysomnography according to the American Academy of Sleep Medicine criteria. Validated questionnaires were used to assess sleepiness and sleep quality, and clinical examinations were performed to document weight and height. Jamovi software was used for statistical analysis. Logistic regression analyses of the different sleep stages—REM sleep, NREM sleep, and total sleep time—were conducted. ResultsNo association was found between sleep bruxism and snoring (P > 0.31), with a small effect size (V = 0.171). However, the snore index was found to influence the rhythmic masticatory muscle activity index during REM sleep, with an odds ratio of 1.018 (95 % CI: 1.005 to 1.03; P = 0.05). Moreover, logistic regression showed that the desaturation index presented an odds ratio of 5.01 (95 % CI: 0.96 to 26.13; p = 0.056), with a medium effect size (>3.5). Sleep bruxism was not associated with age, sex, body mass index, or other sleep variables. ConclusionSnoring appears to be associated with bruxism during REM sleep. No associations were found between sleep bruxism and sex, age, or body mass index. This lack of association underscores the complexity of sleep bruxism and snoring and highlights the need for further research. Concerning sleep architecture, only desaturation episodes were associated with bruxism during REM sleep. Neither sleep quality nor sleepiness was associated with sleep bruxism.

B - 43 Utility of the Activity Measure for Post-Acute Care (AM-PAC) as a Measure of Functional Recovery across the TBI Rehabilitation Continuum

Abstract Objective To evaluate the utility of the AM-PAC (Activity Measure for Post-Acute Care) for functional assessment of patients with Traumatic Brain Injury (TBI) across inpatient and outpatient rehabilitation settings. We evaluated (1) Longitudinal changes (1-year) in cognitive and physical recovery patterns across the rehabilitation continuum (2) Concurrent validity of AM-PAC as compared to traditional measures. Method A prospective repeated measures cohort study of adults with TBI (n = 186), where 87 participants received inpatient rehabilitation (IR), and 99 participants received outpatient cognitive rehabilitation (CR). Functional recovery was assessed at IR admission, discharge, 6 months and 1 year, and at admission/discharge from CR for post-acute participants. Functional measures included AM-PAC-Basic Mobility (BM), Daily Activities (DA), and Applied Cognitive (AC) domains, Neuropsychological Assessment Battery (NAB), Texas Functional Living Scale (TFLS), Functional Independence Measure (FIM), Participation Assessment with Recombined Tools-Objective (PART-O), and Mayo-Portland Adaptability Inventory (MPAI-4: self-awareness). Results The AMPAC was sensitive to changes throughout the care continuum, demonstrating medium effect sizes across all three functional domains. Notably, AMPAC scores showed greater change compared to traditional tools (90% and 68% confidence levels). Additionally, analysis of Minimum Detectable Change thresholds demonstrated significant improvements, across settings and within moderate/severe TBI (p &amp;lt; 0.05), followed by predictably smaller gains in the mild TBI population (p &amp;lt; 0.05), underscoring the clinical relevance of these findings. Conclusions Results demonstrate that the AM-PAC is a practical, valid and sensitive scale responsive to longitudinal ecological and functional change in TBI. Analysis confirms the effectiveness of functional assessments, particularly emphasizing strengths of the AMPAC.

Mobile multitasking in learning: A meta-analysis of effects of mobilephone distraction on young adults’ immediate recall

Mobilephone distraction in learning is a widely observed phenomenon due to dividing and switching attention between learning activities (e.g., attending lectures and reading textbooks) and off-task activities (e.g., texting and chatting). In the past 30 years, hundreds of empirical studies have examined this distraction and generated abundant but inconclusive findings. Built on two influential meta-analyses (Liu et al., 2017; Kates et al., 2018), this meta-analysis aimed to systematically synthesize evidence from 27 randomized controlled experiments, with a total of 55 effect sizes and 2245 participants, and precisely estimate the effect of mobilephone distraction on students' immediate recall scores for the first time. It is concluded that mobilephone distraction (1) causes an overall negative medium-sized effect on immediate recall (Hedges'g = −0.65, 95% CI [-0.81, −0.49]), (2) has a negative nearly-large-sized effect on lecture recall (Hedges's g = −0.70, 95% CI [-.86, -.54]), (3) is significantly moderated by gender but not by the 10 other moderators related to study features and demographical variables, and (4) is not distorted by publication bias, outlier studies, and missing data. These findings and future studies are discussed.

Metaanalysis of Repetitive Transcranial Magnetic Stimulation (rTMS) Efficacy for OCD Treatment: The Impact of Stimulation Parameters, Symptom Subtype and rTMS-Induced Electrical Field.

Background: Repetitive transcranial magnetic stimulation (rTMS) has recently demonstrated significant potential in treating obsessive-compulsive disorder (OCD). However, its effectiveness depends on various parameters, including stimulation parameters, OCD subtypes and electrical fields (EFs) induced by rTMS in targeted brain regions that are less studied. Methods: Using the PRISMA approach, we examined 27 randomized control trials (RCTs) conducted from 1985 to 2024 using rTMS for the treatment of OCD and conducted several meta-analyses to investigate the role of rTMS parameters, including the EFs induced by each rTMS protocol, and OCD subtypes on treatment efficacy. Results: A significant, medium effect size was found, favoring active rTMS (gPPC = 0.59, p < 0.0001), which was larger for the obsession subscale. Both supplementary motor area (SMA) rTMS (gPPC = 0.82, p = 0.048) and bilateral dorsolateral prefrontal cortex (DLPFC) rTMS (gPPC = 1.14, p = 0.04) demonstrated large effect sizes, while the right DLPFC showed a significant moderate effect size for reducing OCD severity (gPPC = 0.63, p = 0.012). These protocols induced the largest EFs in dorsal cognitive, ventral cognitive and sensorimotor circuits. rTMS protocols targeting DLPFC produced the strongest electrical fields in cognitive circuits, while pre-supplementary motor area (pre-SMA) and orbitofrontal cortex (OFC) rTMS protocols induced larger fields in regions linked to emotional and affective processing in addition to cognitive circuits. The pre-SMA rTMS modulated more circuits involved in OCD pathophysiology-sensorimotor, cognitive, affective, and frontolimbic-with larger electrical fields than the other protocols. Conclusions: While rTMS shows moderate overall clinical efficacy, protocols targeting ventral and dorsal cognitive and sensorimotor circuits demonstrate the highest potential. The pre-SMA rTMS appears to induce electrical fields in more circuits relevant to OCD pathophysiology.

Preworkout dietary nitrate magnifies training-induced benefits to physical function in late postmenopausal women: a randomized pilot study.

To inform end points for future work, we explored the utility of preworkout (i.e., an acute dose before training) beetroot juice (BRJ) combined with exercise (BRJ + EX) to augment indices of physical function in postmenopausal women compared with exercise only (EX). A two-arm pilot study was used to compare 24 postmenopausal women following an 8-wk, circuit-based exercise intervention. Participants were randomized to BRJ + EX (n = 12) or EX (n = 12). BRJ + EX participants consumed 140 mL of BRJ 120-180 min (only) before training for 7 wk, then discontinued during the final week to mitigate carryover effects. Physical function indices were 6-min walk test (6MWT), estimated V̇o2peak, heart rate recovery (HRR), and maximal knee extensor power (Pmax). A treadmill task was used to measure V̇o2 on-kinetics wherein mean response time (MRT) coincided with the duration to reach 63% of steady-state V̇o2. Results showed greater changes (Δ) among BRJ + EX participants for 6MWT distance (40 ± 23 m vs. 8 ± 25 m; P = 0.003, d = 1.35), ΔV̇o2peak (1.5 ± 0.9 mL·kg-1·min-1 vs. 0.3 ± 1.0 mL·kg-1·min-1; P = 0.008, d = 1.20), and ΔHRR (-10 ± 6 beats/min vs. -1 ± 9 beats/min; P = 0.017, d = 1.05). Large and medium effect sizes favoring BRJ + EX were detected for ΔPmax (P = 0.07, d = 0.83) and ΔMRT (P = 0.257, d = 0.50), respectively. In postmenopausal women, BRJ + EX appears to magnify some adaptive benefits to physical function including aerobic capacity and recovery beyond that of training without BRJ. Investigation into contributing mechanisms is needed.NEW & NOTEWORTHY Though exercise training represents the principal strategy to combat age-related decline, the attendant effects of menopause weaken aspects of exercise adaptation compared with premenopausal women and age-matched men. Here we provide important initial evidence that preworkout (i.e., an acute dose before training) beetroot juice coupled with an 8-wk, circuit-based exercise training intervention may uniquely benefit late postmenopausal women by enhancing indices of physical function including aerobic capacity and recovery.

Does practice make perfect? Functional connectivity of the salience network and somatosensory network predicts response to mind-body treatments for fibromyalgia.

Mind-body treatments can improve coping mechanisms to deal with pain, improve the quality of life of patients with fibromyalgia syndrome (FMS), and reduce perceived pain in some cases. However, responses to these treatments are highly variable, the mechanisms underpinning them remain unclear, and reliable predictors of treatment response are lacking. We employed resting-state blood oxygen level-dependent (rsBOLD) functional magnetic resonance imaging (fMRI) to examine changes in brain functional connectivity (FC) following mind-body treatment that may relate to and predict pain relief. We recruited patients with FMS who underwent either mindfulness-based stress reduction (MBSR; n = 18) or a psychoeducational program (FibroQoL; n = 22) and a treatment-as-usual FMS group (TAU; n = 18). We collected rsBOLD data, alongside subjective pain, anxiety, depression, and catastrophizing measures prior to and following treatments. We examined behavioral changes and FC changes in the salience network (SN) and sensorimotor network (SMN) and performed regression analyses to identify predictors for treatment response. The MBSR and FibroQoL groups experienced significant reductions in pain catastrophizing. After treatment, the FC of the sensorimotor cortex with the rest of the SMN became significantly reduced in the MBSR group compared to the TAU group. The FC between the SN and the SMN at baseline was negatively correlated with pain reductions following MBSR but positively correlated with pain reductions in the FibroQoL group. These results yielded large to very large effect sizes. Following MBSR, only for those patients with lower baseline SMN-SN FC, minutes of mindfulness practice were positively associated with clinical improvement (small to medium effect size). Different mind-body treatments are underpinned by discrete brain networks. Measures of the functional interplay between SN and SMN have the potential as predictors of mind-body treatment response in patients with FMS.

Long-term effects of dialectical behaviour therapy for posttraumatic stress disorder and cognitive processing therapy 9 months after treatment termination

ABSTRACT Background: The complexity of posttraumatic stress disorder (PTSD) symptoms related to childhood abuse (CA) present challenges for effective psychotherapeutic treatment. Consequently, there is great interest in the long-term effectiveness of psychological treatments for this population. Objective: This study aims to investigate the long-term outcomes of Dialectical Behaviour Therapy for PTSD (DBT-PTSD) and Cognitive Processing Therapy (CPT) 9 months after treatment termination. Method: This is a long-term analysis from a randomised-controlled trial of DBT-PTSD versus CPT (registration number DRKS00005578). Initially, 193 individuals with CA-related PTSD were randomly allocated to receive either DBT-PTSD (n = 98) or CPT (n = 95). The primary outcome the Clinician-administered PTSD-Scale for DSM-5 (CAPS-5) was administred at baseline, treatment completion (15 months post-randomization) and at the 9-month follow-up. Secondary outcomes included self-reported PTSD severity (PCL-5), dissociation (DSS), severity of borderline symptoms (BSL-23), and psychosocial functioning (GAF). Results: No significant changes were observed in the primary (CAPS) and all other outcomes from post-intervention to 9-months follow-up in both the DBT-PTSD (CAPS: Mpost = 15.60, M follow-up = 14.93) and CPT group (CAPS: Mpost = 18.80, Mfollow-up = 17.41). Between-group analyses at 9-months follow-up were significantly in favour of DBT-PTSD compared to CPT with small to medium effect sizes on all outcomes ranging from d = 0.35 on the CAPS to d = 0.57 on the BSL-23 and GAF. Conclusions: Our results indicate that treatment effects of psychotherapy addressing complex presentations of PTSD persist 9 months after treatment termination. In addition, the superiority of DBT-PTSD as compared to CPT found at treatment termination, was confirmed at 9-months follow-up. Trial registration: German Clinical Trials Register identifier: DRKS00005578..

Penerapan model pembelajaran problem-based learning dalam meningkatkan kemampuan pemahaman konsep matematika siswa

This study investigated the effectiveness of problem-based learning (PBL) model in improving seventh-grade students’ conceptual understanding of mathematics at SMP Negeri 13, Ternate City, Indonesia. This study used a quantitative approach using a pre-experimental design, specifically a one-group pretest-posttest design. The sample consisted of 34 seventh-grade students at one of the public junior high schools in Ternate City. Data were collected using a written test, and analysis was conducted using inferential statistics, specifically the Paired Sample T-Test. The findings showed that the implementation of the PBL model significantly improved students’ ability to understand mathematical concepts, with the results showing a medium effect size. In addition, the effect size test classified the impact of PBL on students’ mathematical understanding in the high category.