Repeated Measures ANOVA Research Articles

Effect of brimonidine on visual indices in patients with acute optic neuritis: A single blind randomized clinical trial

PurposeThis study investigates brimonidine's potential effect on visual functions, particularly contrast sensitivity (CS), an indicator of retinal ganglion cell function. MethodsIn this single-blind, randomized clinical trial, 60 patients (aged 23–56) with first-episode acute optic neuritis within seven days of symptom onset were randomly assigned to brimonidine or control groups. The intervention group received brimonidine three times daily for three months, while the control group received synthetic tears with the same dosage and frequency. Primary outcomes were changes in CS, visual acuity (VA), and color vision at one and three months post-treatment. Repeated measures ANOVA was used to assess statistically significant and partial eta squared (η2) values, mean differences, and clinically significance important were reported. ResultsAll participants completed the study without complications. VA improved significantly in both groups by follow-up end (p < 0.001), with significant improvement from first to third month only in the brimonidine group (p < 0.001). The mean VA difference between groups was not statistically and clinically significant. CS showed statistically significant improvement within both groups (p < 0.001) and between groups (p < 0.001), with a large effect size (partial η2 = 0.28). The mean CS difference between groups (14.5) was clinically considerable. No significant changes in color vision were observed between groups (p = 0.96). ConclusionBrimonidine significantly improved contrast sensitivity compared to placebo and was well-tolerated. Its neuroprotective effects suggest it may be beneficial in treating optic neuritis and preserving retinal ganglion cell function. Trial registrationProspectively registered at Iranian Clinical Trial Registration; Registration date 3 December 2022; Registration number: IRCT20221127056631N1

Exploring the Relationship Between Examination-Induced Anxiety and Cardiovascular Responses Among PT Students

This study explores the relationship between examination-induced anxiety and cardiovascular responses among physical therapy (PT) students. A quasi-experimental repeated measures design was utilized to examine heart rate (HR), blood pressure (BP), and heart rate variability (HRV) at three stages: before, during, and after high-stakes Objective Structured Clinical Examinations (OSCEs). A total of 120 PT students (60 male, 60 female) were recruited using purposive sampling, with data collection extended over two academic years to ensure balanced gender representation. Anxiety was measured using the State-Trait Anxiety Inventory (STAI), while cardiovascular responses were continuously monitored using wearable devices. Results revealed significant increases in HR and BP, alongside decreases in HRV during the examination, reflecting heightened autonomic stress. Post-exam, cardiovascular markers demonstrated partial recovery but remained elevated compared to pre-exam levels, indicating lingering physiological effects of anxiety. Qualitative data from student interviews revealed cognitive impairments and lingering anxiety post-exam, corroborating the physiological findings. Repeated measures ANOVA indicated significant changes in cardiovascular responses over time, with no significant interaction effects for gender. These findings underscore the impact of examination-induced anxiety on both physiological and psychological outcomes in PT students. The persistent elevation in cardiovascular markers post-exam suggests that students may not fully recover from stress immediately, highlighting the need for targeted interventions, such as mindfulness or biofeedback, to help manage anxiety. Addressing examination stress could enhance both student well-being and academic performance, mitigating the long-term risks associated with chronic stress.

Investigation the effect of Acceptance and Commitment Therapy (ACT) training on stigma and family functioning in family members of patients with psychiatric disorders: a randomized controlled clinical trial

BackgroundRegarding the prevalence and pervasiveness of psychiatric disorders, which significantly affect not only the patients themselves, but also their families, family therapy has emerged as a promising intervention. This research examined the effects of Acceptance and Commitment Therapy (ACT) on stigma and family functioning in family members of patients with psychiatric illnesses, demonstrating effectiveness in improving family functioning and coping strategies in the face of mental illness.MethodsThis randomized controlled clinical trial without blinding. Forty family members of patients with psychiatric disorders were randomly assigned to an intervention group (N = 20) or a control group (N = 20). The intervention group received ACT in eight weekly sessions, each lasting 90 min, while control group remained on a waiting list. Both groups were assessed at three time points: pre-intervention, post-intervention, and at a one-month follow-up. Data collection instruments included a demographic information questionnaire, a stigma assessment, and a family functioning measure. Data were analyzed using SPSS software version 23.ResultsA statistically significant difference was observed between the mean post-test and follow-up stigma scores of the intervention and control groups (P < 0.05). The intervention group’s mean scores showed a rising trend, whereas the control group’s mean scores showed a declining trend. This was evident from within-group comparisons of the mean post-test and follow-up stigma scores. Repeated measures ANOVA indicated that the pattern of change in stigma for the intervention group was significant, in contrast to control group, suggesting a reduction in stigma (P < 0.001).ConclusionIn light of the findings presented in this study, ACT emerges as a promising intervention for mitigating stigma, and enhancing the family functioning of individuals afflicted with mental disorders. To improve the generalizability of the study results, comparable studies using this therapy method should be undertaken on family caregivers of patients with mental illnesses.Iranian Registry of Clinical TrialsIRCT registration number: IRCT20190917044802N10.Registration date14/9/2023.

Impact of blood volume, air exposure duration, transport duration, and testing delay on plasma total carbon dioxide in simulated open collections using microtainers

BackgroundExposing blood specimens to air reduces plasma total carbon dioxide (TCO2). We evaluated the degree of TCO2 reduction attributed to open collection of neonatal blood in BD microtainers® (microtainers), microtainer transport duration and delayed testing of open plasma aliquots. MethodsVenous blood was aliquoted into open microtainers in a 3x4 factorial design to simulate combined effects of blood volume (0.2–0.6 mL) and air exposure duration (0–5 min), with blood drawn in vacutainers as a control. Separate effects of in-hospital transport duration (0–120 min; whole blood), off-site transport duration (0–24 h; centrifuged whole blood), and the duration plasma aliquots remained open (0–120 min) were evaluated by repeated testing. Findings were analyzed using repeated-measures ANOVA and Student’s T-tests. ResultsIn the factorial experiment, mean plasma TCO2 in microtainers was on average 3.5 mmol/L lower than in vacutainers. Smaller blood volume but not greater air exposure duration significantly (p < 0.05) reduced TCO2. Mean TCO2 in filled (0.6 mL; 1–5 min air exposure) microtainers was on average 2.9 mmol/L lower than in vacutainers. Simulated off-site transport of microtainers containing centrifuged whole blood significantly reduced TCO2 (4 h; mean change = -1.5 mmol/L), as did delayed testing of aliquoted plasma (15 min; mean change = -1.3 mmol/L). ConclusionsPlasma TCO2 decreased with reduced microtainer blood volume, extended off-site transport duration of centrifuged whole blood and testing delay of aliquoted plasma. To minimize TCO2 reduction, microtainers should be fully filled and tested rapidly. Laboratories should also consider whether an interpretive comment, correction factor or separate reference intervals are appropriate for these tests.

Aging Processes of Working Memory in Different Modalities.

Background: Working memory (WM) involves temporarily storing and manipulating information. Research on the impact of aging on WM has shown inconsistent results regarding the decline in visual and verbal WM, with a lack of studies on tactile WM. This study aimed to assess the effects of aging on WM across verbal, visuospatial, and tactile modalities using span tasks of forward (storage) and backward (manipulation) stages. Methods: A total of 130 participants, divided into four age groups of 20-29, 60-69, 70-79, and 80-89, completed the Digit, Visuospatial, and Tactual Spans. Performance was analyzed using a 3 (Task) × 4 (Group) × 2 (Stage) mixed design repeated measures ANOVA. Results: The analysis revealed significant main effects for modality (p < 0.001, ηp2 = 0.15), age (p < 0.001, ηp2 = 0.48), and stage (p < 0.001, ηp2 = 0.30). Digit Span outperformed the other modalities, while Tactual Span showed the worst performance. Additionally, task performance declined with age, and the forward stage was superior to the backward stage. Interaction effects indicated that Digit Span was less affected by aging compared to the Visuospatial and Tactual Spans (p = 0.004, ηp2 = 0.07). Post hoc analyses further revealed that the Digit Span consistently outperformed the other modalities in both stages, with more pronounced differences observed in the forward stage. Conclusions: Verbal WM is more resilient to aging compared to the other modalities while tactile WM declines with age in a manner similar to verbal and visuospatial WM, suggesting a modality-specific impact of aging on WM.

Ratings of perceived exertion (RPE) from a submaximal 20-m shuttle-run test accurately predict children's VO2peak, but when should we stop the test?

The purpose of the study was to explore the validity, test-retest reliability and affective responses of a submaximal 20-m shuttle-run test (20mSRT) stopped at 6 on the Eston-Parfitt (EP) scale. The secondary aim was to examine and compare two submaximal 20mSRT protocols with different RPE end points (EP6 vs. EP7) using previously published data. Twenty-five children (16 boys; 13.4 ± 1.0years; 162.1 ± 8.7cm; 49.1 ± 6.6kg) completed three exercise tests (graded exercise test [GXT], 2 submaximal 20mSRT). The EP scale and Feeling scale were used to measure RPE and affect, respectively. The two submaximal 20mSRTs were stopped after participants reported EP6. Individual speed-RPE relationships from the submaximal 20mSRTs were linearly regressed to predict peak speed and then used to estimate VO2peak. Previously published data (n = 25) used comparable methods, except that the participants stopped at EP7. In the EP6 protocol, a two-factor repeated measures ANOVA revealed non-significant Test and Sex main effects (p > 0.05). Reliability analysis revealed intraclass correlation coefficient of ~ 0.7 (95%CI [0.432,0.867], p < 0.001) between the submaximal 20mSRTs. Significant differences in end-test affect between the GXT and submaximal 20mSRTs were found (p < 0.001), with GXT more negative. ANOVA revealed no significant differences in end-test affect between EP6 and EP7 protocols; however, frequency count analysis revealed EP6 to result in more positive end-test affect. Submaximal 20mSRT utilising RPE may offer valid predictions in VO2peak while minimising negative affect. Test end points of EP6 and EP7 both offer valid predictions in VO2peak. EP6 may be more beneficial in avoiding negative affect, even though a reduction in test-retest reliability was observed.

The Role of Gender in Cognitive Processing of Affective Linguistic Stimuli in Bilinguals

This study aims to compare the emotional reactions of bilingual men and women to affective valence by manipulating positive and negative linguistic stimuli. To achieve this aim, the semantic decision task was used. 56 Persian-English bilinguals, who were divided into two equal groups considering their gender (28 female and 28 male), were asked to decide whether the adjectives loaded with positive or negative valence (i.e., target words) were related in meaning to the preceding nouns (i.e., prime words). In order to find out whether there is any potential interaction between the valence of primes and targets, mixed factorial repeated measure ANOVA was run on reaction time and error rate data. The results of the present study on cognitive gender differences show that males and females, despite some few differences, generally follow a similar pattern in processing affective meaning of words in their second language.

Effects of repetitive transcranial magnetic stimulation at different targets on brain function in stroke patients: a randomized controlled trial.

Repetitive transcranial magnetic stimulation (rTMS) can improve post stroke motor function. However, there is little research on targets. The purpose of this study is to investigate the effects of rTMS therapy with different targets on post stroke motor function and neural plasticity. Fifty-four subjects were randomly divided into M1 (Primary motor area) group, SMA (supplementary motor area) group and Sham group, and were given 10 Hz on the affected M1 area, SMA area and sham stimulation rTMS. The primary outcomes included Fugl-Meyer Assessment Upper Extremity Scale (FMA-UE), Fugl-Meyer Assessment Lower Extremity Scale (FMA-LE) and Berg balance scale (BBS). Secondary outcomes: amplitude of low frequency fluctuation (ALFF), regional homogeneity (ReHo) and functional connectivity (FC) were analyzed by functional magnetic resonance imaging (fMRI) to evaluate brain functional activation and functional connectivity changes. The 2-way repeated-measures ANOVA revealed a significant group × time interaction (F = 23.494, p < 0.001; F = 10.801, p < 0.001; F = 17.812, p < 0.001) in the FMA-UE, FMA-LE and BBS scores. Post hoc analysis indicated that 4 weeks of SMA rTMS resulted in an increase in FMA-UE, FMA-LE and BBS scores compared with Sham group (p = 0.006; p = 0.033; p = 0.012), SMA group was significantly increased in BBS compared with M1 group (p = 0.034). Moreover, there were significant effects of time in all 3 groups in the FMA-UE, FMA-LE and BBS scores (p < 0.001). In addition, the increase of ALFF in the supramarginal gyrus on the affected side was correlated with better FMA-UE recovery, the increase of ALFF in the middle temporal gyrus and the middle frontal gyrus on the affected side was positively correlated with the improvement of BBS, and the ALFF in the cerebellum on the healthy side was negatively correlated with the improvement of BBS. There was a positive correlation between FC (SMA - ipsilateral cerebellum) changes and BBS changes in SMA group. In conclusion, SMA-rTMS intervention has a better recovery effect on motor dysfunction after stroke than Sham-rTMS. SMA-rTMS led to similar improvement on motor function but significantly greater improvement on balance compared to M1-rTMS, and this may pave a new way for stroke rehabilitation. Registration number: ChiCTR2200060955, https://www.chictr.org.cn/.

Effectiveness of TheraPEP Versus Conventional Breathing Techniques in Managing Acute COPD Exacerbations

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, often complicated by acute exacerbations that impair lung function and quality of life. Effective airway clearance techniques are essential in managing exacerbations, but the comparative effectiveness of different methods remains unclear. This study aimed to evaluate the short-term effectiveness of TheraPEP, a positive expiratory pressure (PEP) device, versus the Active Cycle of Breathing Technique (ACBT) in managing acute COPD exacerbations. Methods: A randomized controlled trial (RCT) was conducted with 60 patients (≥40 years) admitted with acute exacerbations of COPD. Participants were randomly assigned to either the TheraPEP group (n=30) or the ACBT group (n=30). Each group received three daily sessions of their assigned therapy throughout their hospital stay. Primary outcomes included dyspnea, measured by the modified Borg Dyspnea Scale, and secondary outcomes included sputum clearance, lung function (FEV1, FVC, and FEV1/FVC ratio), oxygen saturation (SpO₂), and quality of life, measured by the Breathlessness, Cough, and Sputum Scale (BCSS). Data were collected at baseline, discharge, and 14-day follow-up. A two-way repeated-measures ANOVA was used to examine changes in dyspnea, lung function, sputum clearance, SpO₂, and BCSS scores over time (baseline, discharge, and 14-day follow-up) within and between groups. The main effects of time (within-subject factor) and group (between-subject factor) were assessed, along with the interaction effects (time × group). Results: Both groups demonstrated significant improvements in dyspnea, lung function, and quality of life from baseline to discharge and follow-up. However, the TheraPEP group showed significantly greater improvements in sputum clearance (p=0.01), oxygen saturation (p=0.03), and BCSS scores (p=0.03) compared to the ACBT group. No significant between-group differences were found for FEV1, FVC, or FEV1/FVC ratio (p &gt; 0.05). Conclusions: Both TheraPEP and ACBT are effective in managing acute COPD exacerbations, but TheraPEP offers additional benefits in terms of sputum clearance and oxygenation. These findings suggest that TheraPEP may be more suitable for patients with severe mucus hypersecretion. Further research is warranted to assess the long-term effects of these therapies on COPD progression and patient outcomes.

Validity Study of an Emotional Face-Database in Iranian Community

Objective: To investigate the accuracy of facial emotion recognition in the Iranian community, a face database validated in this community is required. To do this, we conducted a validation study on the Radboud face database. The primary objective of this study was to evaluate the accuracy of recognizing emotions through faces in an Iranian sample and then to choose the pictures with high agreement in terms of detecting emotions. Method: This is a cross sectional study recruiting a total number of 142 males and females aged between 20 and 50 years old (Mean ± SD of age 31.7 ± 7.07). The participants were instructed to detect the type of emotion of each face as well as its valence and arousal. The percentage of participants’ agreement on evaluating each picture was assessed. To evaluate the effect of different variables on participants’ accuracy, one way and repeated measure ANOVA analyses were also used. Results: Emotional faces were recognized by around 84% of the participants. The highest accuracy belongs to happy (Mean ± SD of 98 ± 6.1%) and the lowest one to neutral (75 ± 18.06%) faces. The accuracy for detecting other emotions were as follows: sad (91 ± 8.7%), surprised (87 ± 10.64%), angry (77 ± 15.6%), and fearful (76 ± 15.26%). Additionally, we found no differences between male and female participants in terms of recognizing emotions. Then we selected the pictures with high agreement (above 85 percent) in labeling emotions among the participants. Conclusion: The current study provided a valid emotional face database based on Iranian participants’ responses in terms of recognizing basic emotions. The selected pictures can be used in designing tasks to evaluate emotion recognition ability in clinical and nonclinical populations. It can also be used in designing applications to improve detecting emotion in clinical samples such as individuals with autism spectrum disorder.

IMPROVEMENT IN LV END-DIASTOLIC PRESSURE AFTER PRIMARY PCI AND ITS IMPACT ON PATIENTS’ RECOVERY

Left ventricular end-diastolic pressure (LVEDP) is a crucial indicator of cardiac function, particularly in patients with acute ST-segment elevation myocardial infarction (STEMI). Primary percutaneous coronary intervention (PCI) is the standard of care for STEMI, but its impact on LVEDP and patient recovery remains to be thoroughly studied. Objective: This study aimed to evaluate the improvement in LVEDP following primary PCI in patients with acute STEMI and to assess its impact on recovery and clinical outcomes. Methods: This prospective study included 100 patients with acute STEMI treated by primary PCI. LVEDP was recorded at four-time points: before PCI, and at one week, one month, and three months post-PCI. Demographic and clinical characteristics were also collected. Statistical analysis was performed to compare LVEDP values at different time intervals using paired t-tests and repeated measures ANOVA to assess significant changes over time. Results: The mean LVEDP significantly decreased from 18 ± 4 mmHg before PCI to 12 ± 3 mmHg at one week, 10 ± 2 mmHg at one month, and 9 ± 2 mmHg at three months post-PCI (p &lt; 0.001). This demonstrated a consistent improvement in left ventricular function and hemodynamic status, suggesting favorable patient recovery post-intervention. Conclusion: Primary PCI significantly reduces LVEDP in patients with acute STEMI, leading to improved cardiac function and patient recovery. Monitoring LVEDP post-PCI can serve as a valuable predictor of patient prognosis and long-term outcomes. Further studies are warranted to explore additional therapies that may further enhance recovery and improve the quality of life in STEMI patients.

A proximal external focus does not benefit skilled skiers

The potential performance benefit of an external focus of attention remains unexamined for skilled junior performers, especially those executing ballistic, whole-body continuous movements. Skilled junior skiers (M age = 14.09) completed slalom runs under external focus, internal focus, and control focus conditions. Repeated measures ANOVA revealed no significant difference between attentional foci on performance times. Our data challenges the commonly held belief regarding the superiority of an external focus. Instead, we offer researchers and practitioners a more nuanced discussion concerning possible distance effects (proximal vs. distal) associated with external foci in skilled junior performers executing ballistic, whole-body movements.

An intervention to determine the effectiveness of the Sanubari optimal health program (OHP) in improving mental well-being among junior doctors in Malaysia: a quasi-experimental study

BackgroundMental health problems among junior doctors in Malaysia pose a significant concern, as they not only adversely affect their overall well-being but also impact the quality of health services they provide. Therefore, it is important to implement interventions aimed at preserving their mental health. This study aimed to evaluate the effectiveness of the Sanubari Optimal Health Program (OHP) intervention in enhancing the mental well-being of junior doctors in Malaysia.MethodsThe study utilised a quasi-experimental design involving 204 junior doctors who participated in the intervention. The Sanubari OHP Intervention Package was employed alongside self-administered questionnaires for mental health and well-being assessment. To evaluate the effects over time, repeated measures ANOVA was employed to analyse within-group and between-group changes in various endpoints, as measured at different assessment time points.ResultsThe study revealed that self-efficacy and adaptive coping behaviours scores increased over time among the intervention group and decreased among the control group. Yet, depression and anxiety scores decreased significantly over time among the intervention group but not in the control group. No significant differences were observed in well-being and maladaptive coping strategies among the groups.ConclusionsThis study showed promising results regarding the effectiveness of Sanubari OHP in improving mental well-being among junior doctors.

A mixed methods, cluster randomized control trial to examine assistive technology use to support early literacy in preschool children with disabilities

This mixed methods study examined the impact of a multi-faceted professional development (PD) program for preschool teachers and classroom assistants on teacher-supported assistive technology (AT) use and early literacy development of children with disabilities. Four special education preschools were randomized into intervention (2 schools, 9 teachers, 50 children) and waitlist control (2 schools, 17 teachers, 42 children) groups. The 24-week PD included online modules, coaching, and AT device kits. Pre-post gains in children’s AT use and early literacy skills were analyzed using χ2 and repeated measures ANOVA. Teacher interviews and reflective commentaries were analyzed using Framework Analysis methodology. From pre- to post-test, the percent of children in the intervention group using some form of AT rose from 36 to 80%. The percent of children using AT in the control group went from 45 to 62%. The difference in change between the two groups was statistically significant, χ 2 = 13.93, p=.001. Gains in early literacy skills were not significantly different across groups, F(1,90)=0.010, p=.922. Analysis of the qualitative data revealed three themes: the positive impact of AT on child engagement and participation, the importance of individualizing AT for each student, and barriers teachers faced in AT implementation. The PD program had a positive effect on children’s AT use but not on gains in early literacy. Teachers’ comments highlighted the nuanced relationship between AT use and literacy outcomes, suggesting the need for more targeted implementation of AT during literacy activities.

Distortion Assessment of Different Materials in Full-Arch Dentate Impressions in Relation to Operator Experience: A Comparative In Vivo Study.

To evaluate the distortion probability in impressions of completely dentate arches when different impression materials are used in relation to operator experience. A total of 28 students (Group A) and 7 dentists (Group B) performed three maxillary impressions on 28 participants, each using vinyl siloxane ether (VSE), polyether (PE), and irreversible hydrocolloid (IHC). Gypsum master casts were fabricated and subsequently digitized. Intraoral scans were taken as a control. Differences between master casts and intraoral scans were visualized with heatmaps, and planar deviations were investigated. If planar deviations > 120 μm were found, the impression was rated as 'distorted.' An additional superimposition using the casts from VSE or PE was performed to confirm the presence of distortions. The relative number of surfaces with distortions in each impression was calculated. The procedure was repeated for a distortion threshold of 500 μm. The statistical analyses included repeated measures ANOVA (RMA) and post hoc tests (α < .05). When 120 μm was considered as the threshold for distortions, IHC impressions showed higher distortion probability than PE impressions in Group A (P &#61; .003) and Group B (P < .0001). In Group B, PE showed a lower distortion probability than VSE (P &#61; .02). There was no significant difference between the study groups (P &#61; .42). Considering 500 μm as a threshold for distortions, there was no difference between impression materials (P &#61; .17) or study groups (P &#61; .53). There were no statistically significant differences in relation to operator experience. Different impression materials had a significant impact on distortion probability. PE impressions showed the lowest distortion probability.

Effectiveness of electrocardiogram interpretation education program using mixed learning methods and webpage

AimThis study was conducted to develop an electrocardiogram education program that incorporates an HTML webpage and blended learning methods to enhance electrocardiogram interpretation skills. Through continual and efficient education, the program aims to assist nurses in providing appropriate care and treatment to patients.DesignPre-post design study.MethodsWe developed an electrocardiogram interpretation HTML webpage based on an electrocardiogram interpretation algorithm and implemented an 18-week (2023.5.15 ~ 2023.9.22) electrocardiogram education program, which included daily 5-minute training sessions. Twenty-seven ward nurses were provided with the URL (https://ecgweb.github.io/ECGwebEN) to the electrocardiogram interpretation HTML webpage and shared one electrocardiogram case daily for self-interpretation. Electrocardiogram interpretation performance and confidence were evaluated through questionnaires at three phases: before the program, after 6 weeks of basic electrocardiogram and arrhythmia education, and after 12 weeks of application of the electrocardiogram interpretation HTML webpage and case-based lecture education. The statistical tests used were repeated-measures ANOVA or the Wilcoxon signed-rank test.ResultsThe average score for electrocardiogram interpretation performance before the electrocardiogram education program was 11.89(SD = 3.50), after 6 weeks of basic electrocardiogram and arrhythmia education it was 14.15(SD = 3.68), and after 12 weeks of application of the electrocardiogram interpretation HTML webpage and case-based lecture education, it was 15.56(SD = 3.04). This shows that electrocardiogram interpretation performance significantly improved over time (p < .001). Additionally, post-hoc analysis revealed significant differences in electrocardiogram interpretation performance at each stage, i.e., before, during, and after the application of an electrocardiogram education program. Furthermore, the electrocardiogram interpretation confidence questionnaire score (pre-Median 18, IQR = 5; post-Median 23, IQR = 3) was improved significantly after the completion of the 18-week education program (p < .001).ConclusionsBased on the results of this study, we believe that an electrocardiogram education program using HTML webpage, and a blended teaching method would be very beneficial for maintaining and improving electrocardiogram interpretation skills of clinical nurses. Such a program can help nurses interpret electrocardiograms more effectively and assist them in making important decisions in patient care.

Effect of the PROFIT-BR exercise program on physical fitness of children: a protocol study

BackgroundConsidering that school environments are important and have the potential to promote an active lifestyle with direct impacts on physical, motor, cognitive, affective, and psychological aspects, the objective of this study was to evaluate the effect of a physical exercise program in the school context.MethodsA parallel, two-arm experimental research project carried out over 19 weeks, with two non-consecutive weekly classes of 60 min, with the inclusion of PROFIT-BR in the initial 15 min of the class followed by 40 min based on specific physical education skills on indicators of physical fitness in children. Estimates of excess weight and visceral fat will be measured and assessed by body mass index and waist-to-height ratio, respectively, and cardiorespiratory fitness by performance in the six-minute run/walk test. Flexibility will be assessed by the sit and reach test; and muscle strength measured by the number of sit-ups in one minute. The 2 kg medicine ball throw and the horizontal jump will be used to measure upper and lower limb power, respectively, the square test used as a measure of agility, and the 20-meter run test used to measure speed. To analyze the differences between baseline and post-intervention values, repeated measures ANOVA adjusted for somatic maturation will be used. The magnitude of the effect size will be estimated by “partial eta squared”. Statistical analyses will be carried out using SPSS version 24.0 software and a 5% probability of error in the analyses will be accepted.DiscussionThe main theoretical assumption of the proposal is the cause-and-effect relationship between the regular practice of physical exercise in childhood and adolescence and several parameters of health and motor performance. The elaborated program has a lot of applicability because it was wondering from the perspective of the school, in terms of materials, space, and objectives of physical education.

Assessing the Impact of Visual Arts Teaching on Critical Thinking and Behavior Regulation

Background: Visual arts education has been suggested to influence cognitive and behavioral outcomes, yet its specific effects on critical thinking and behavior regulation remain underexplored. The effect of visual arts education on these domains forms the topic of the present study, which employs a mixed approach research design. Aim: To assess the impact of visual arts education on the improvement of critical thinking and self-regulation in students. Methodology: A quasi-experimental approach was employed with 80 individuals, with 40 in the experimental group Report Phrase receiving education in visual arts and 40 in the control group receiving non-visual arts education. CTST and BRI assessment tools were used to acquire quantitative data about the participants, utilizing the independent and paired sample T-tests. Data collected from participants include interviews, focus group discussions, self-administered, and thematic analysis. A repeated measures ANOVA was used to analyse the data. Result: Statistical findings depicted improvements in the quantitative aspect; critical thinking skills improved from 70.0 to 75.3 with p&lt;0.001 and behavior regulation improved from 65.0 to 69.2 with p&lt;0.001 in the experimental-group in contrast to the control-group. The thematic analysis found striking increases in attention, impulse control, task completion, creativity, collaboration, affect expression, and self-esteem of experimental-group participants. Based on the findings of the Repeated Measures ANOVA, significant enhancements were observed in both domains for critical thinking and behavior regulation with effect size estimates of 0.40 and 0.30, respectively. Conclusion: The development of critical thinking and behavior control in students is greatly impacted by art instruction. Quantitative and qualitative data both support the utility of using visual arts interventions for cognitive and behavioral development and inform practice in art education.

Trajectory and predictors of adherence to Nucleos(t)ide analogues medication among patients with chronic hepatitis B

ObjectivesTo investigate the developmental trajectory of medication adherence and its predictors in chronic hepatitis B (CHB) patients taking nucleos(t)ide analogues. MethodsA longitudinal study was conducted. Patients with CHB who met the inclusion criteria were selected using convenience sampling. Follow-ups were conducted at baseline, 3 months, 6 months, 9 months, and 12 months. Medication adherence was assessed using a medication adherence scale. Group-based trajectory modeling (GBTM) was used to explore medication adherence trajectories, and repeated measures ANOVA was used to describe changes in each trajectory. Unordered multinomial logistic regression analysis was used to explore predictive factors. ResultsA total of 305 patients completed all follow-ups. Medication adherence was categorized into four trajectory groups: low adherence (4.9 %), decreasing adherence (24.3 %), increasing adherence (48.2 %), and high adherence (22.6 %). Multinomial logistic regression results showed that HBV-infected discrimination, depression, self-efficacy, and social support were significantly different among different medication adherence levels (p < 0.05). ConclusionsMedication adherence trajectories in patients with CHB exhibit heterogeneity. Healthcare professionals can develop personalized treatment plans based on patients' social and psychological characteristics to improve medication adherence.

Oral Mucositis in Adult Cancer Patients Undergoing Chemotherapy: Six-Month On-Treatment Follow-Up.

Objectives. Oral mucositis (OM) is a common adverse reaction associated with chemotherapy. We conducted a six-month longitudinal study to estimate the cumulative incidence of OM during the first six months of chemotherapy in adult patients with cancer other than head and neck cancer. Secondary objectives were as follows: (a) to scrutinize the oral health status of these patients and its evolution during chemotherapy, as assessed by oral health indices; (b) to estimate adherence to prescribed oral hygiene protocol during chemotherapy; and (c) to analyze ulceration-free survival in these patients. Methods. Sixty-four patients participated. Dental health and oral hygiene were assessed at baseline and at the end. Every month, blood tests were performed and oral lesions were recorded. This study was observational, with the only intervention being instruction in the hygiene protocol. The cumulative incidence of OM was estimated with the patient as the unit of analysis. A repeated measures ANOVA was applied to analyze the monthly blood test results. Ulceration-free survival analysis was conducted with adherence to the oral hygiene protocol as a grouping factor, followed by Cox proportional-hazards regression. Results. The six-month cumulative incidence rate was 43.75%, 95%CI (31.58-56.67%) for OM grade 2 or higher. The hazard ratio of ulceration associated with adherence to the hygiene protocol was 0.154, 95%CI (0.049-0.483), adjusted for age, sex, baseline hygiene index, and class of treatment. Conclusions. Compliance with hygiene recommendations would decrease the OM risk by more than six times, compared to non-compliance.