Repeated Measures Multivariate Analysis Research Articles

Effectiveness of Motivational Interviewing based on the Ability, Information and Motivation Model on Adherence to Treatment and Glycosylated Hemoglobin in Females with Type 2 Diabetes Mellitus

Objective: The aim of this study was to determine the effectiveness of motivational interviewing based on the ability, information, and motivation (AIM) model on adherence to treatment and glycosylated hemoglobin (HbA1c) in female patients with type 2 diabetes. Materials and Methods: In this randomized controlled clinical trial 60 women with type 2 diabetes were randomly selected from the 73 patients who referred to the endocrinology department of Imam Hossein Hospital in Tehran province from December 2018 to April 2019. The experimental group (n= 30) was treated with family empowerment therapy based on self-compassion for eight weekly 90-minute sessions while the control group (n= 30) received the usual hospital treatments. Data collection instrument was Morisky medication adherence scale and HbA1c measurements in three phases. Multivariate repeated measures analysis of variance was used to analyze the data. Data analysis was carried out using SPSS-21 software package. Results: The findings showed that the mean score of adherence to treatment in the group treated with motivational interviewing based on the AIM model was significantly higher than that of the control group (P= 0.001). In addition, women with diabetes in the experimental group had a significantly lower mean HbA1c score compared to the control group (P= 0.001). Conclusion: The results of this study showed that motivational interviewing based on the AIM model can be effective in improving adherence to treatment and reducing HbA1c in women with type 2 diabetes.

RTMS Reduces Craving and Alcohol Use in Patients with Alcohol Use Disorder: Results of a Randomized, Sham-Controlled Clinical Trial.

(1) Background: Current evidence-based treatments for alcohol use disorder (AUD) are moderately effective. Studies testing repetitive transcranial magnetic stimulation (rTMS) in AUD commonly apply a limited number of rTMS sessions with different rTMS settings, showing inconsistent effects on craving for alcohol. This study tested the efficacy of a robust rTMS protocol on craving and alcohol use. (2) Methods: In a single-blind randomized controlled trial in recently detoxified patients with AUD, ten days of high-frequency rTMS over the right dorsolateral prefrontal cortex on top of treatment as usual (n = 14) was compared with sham rTMS (n = 16). Outcome measures were alcohol craving and use over a follow-up period of one year. Analysis was performed by means of repeated measures multivariate analysis of variance. (3) Results: The results showed a main group-by-time interaction effect on craving (Wilks’ Λ = 0.348, F (12, 17) = 2.654, p = 0.032) and an effect of group on alcohol use (Wilk’s Λ = 0.44, F (6, 23) = 4.9, p = 0.002), with lower alcohol craving and use in the group with active rTMS compared to the control group. Differences in craving between groups were most prominent three months after treatment. At 12 months follow-up, there was no effect of rTMS on craving or abstinence. (4) Conclusions: This small-scale randomized controlled trial showed the efficacy of high-frequency rTMS over the right dlPFC diminished alcohol craving and use in recently detoxified patients with AUD during the first months after detoxification. These findings suggest that rTMS might be an effective add-on in treating patients with AUD and warrant replication in future large-scale studies.

Program Evaluation of Healthy Moves™: A Community-Based Trainer in Residence Professional Development Program to Support Generalist Teachers With Physical Education Instruction

Elementary school teachers are often responsible for teaching physical education to their students, with little formal training in that instruction. This study evaluates a trainer in residence professional development program designed to improve physical education instructional attitudes and practices in elementary school generalist teachers. Participants were 139 teachers and 3577 first to fifth grade students at 11 public elementary schools in Oregon. Program evaluation measures included pre- and postteacher surveys on teacher attitudes and practices toward teaching physical education for fidelity, postprogram lesson observations for sustainability, and teacher-reported program barriers to and facilitators of feasibility. A multivariate repeated-measures analysis of covariance test assessed changes in teacher attitudes and practices related to physical education instruction. There were main effects of time observed for teacher encouragement and enthusiasm and physical education teaching practices (F2,127 = 9.68, P < .001, ηp2=.132). Postprogram observations indicated sustained use of activity components and an average of 86% of physical education class time spent with students engaged in moderate to vigorous levels of physical activity. The trainer in residence community-based approach shows promise as an appropriate professional development strategy for generalist teachers responsible for physical education instruction. However, a longer duration, randomized control trial is needed to determine the efficacy of these programs in promoting student physical education outcomes.

Tactical vests worn by law enforcement: is this improving stability for optimal job performance?

Objectives. The purpose of this study was to determine whether equipped tactical vests would improve postural stability of law enforcement officers (LEOs) versus a duty belt or without either condition. Methods. Volunteers were police officers (n = 25, 22 males, three females; age 42.4 ± 3.2 years; weight 101.65 ± 19.4 kg; height 178.92 ± 8.2 cm). The Institutional Review Board approved the investigation. A Bertec posturography plate (Bertec Inc., USA) determined four center of pressure (CoP) scores – eyes open stable surface (EOSS), eyes closed stable surface (ECSS), eyes open perturbed surface (EOPS), eyes closed perturbed surface (ECPS) – and four limit of stability (LoS) scores – frontal plane (LoSF), posterior plane (LoSP), left sagittal plane (LoSL), right sagittal plane (LoSR). Results. A repeated-measures multivariate analysis of variance (MANOVA) demonstrated no statistical difference within subject group CoP scores EOSS (p = 0.723), ECSS (p = 0.252), EOPS (p = 0.079) and ECPS (p = 0.137). Comparing between groups, the tactical vest demonstrated significance over the other CoP group conditions with ECPS (p = 0.001). The duty belt group showed significance with ECSS (p = 0.001). LoS variables indicated no significant results between groups. Conclusion. Tactical vests demonstrated improvements in ECPS scores (p = 0.001) compared to either group.

Sexual dysfunction is one of the complications of infertility treatment and is often overlooked in the care of women with infertility

Aim: Sexual dysfunction is one of the complications of infertility treatment and is often overlooked in the care of women with infertility. Therefore, the aim of this study was to determine the effectiveness of self-centered compassion therapy on depression, anxiety and sexual satisfaction in patients. The woman was infertile. Method: This study was a clinical trial study. Fifty-two women with infertility who had sexual dysfunction and referred to the infertility ward of Imam Hossein Hospital in Tehran province from June to September 1400 were selected by purposive sampling. Then they were randomly assigned to the experimental group (under self-centered compassion therapy) (n = 26) and the control group (n = 26). Data collection tools Standard Questionnaire of Sexual Issues (MSQ) Snell and Fisher Walters (1993) were collected in three baseline stages, after intervention and quarterly follow-up. Data analysis was performed using repeated measures multivariate repeated measures analysis of variance. Results: The results showed that in the group under self-centered compassion therapy, the mean score of sexual anxiety and depression as well as sexual satisfaction in the experimental group decreased and increased significantly compared to the control group (P &lt;0.001). Conclusion: The results of this study showed that self-centered compassion therapy can be effective in improving sexual anxiety and depression as well as sexual satisfaction in women with infertility.

Effectiveness of mindfulness-based stress reduction program on depression and adherence to treatment in female coronary heart patients

Aim: The present study was conducted with the aim of determining the effectiveness of the mindfulness-based stress reduction program on depression and adherence to treatment in coronary heart patients. Methods: The present study was conducted as a semi-experimental type of pre-test-post-test and follow-up with a control group with measurement at the baseline after the intervention and 3-month follow-up with the control group. The number of 52 female patients diagnosed with coronary artery disease from among the patients referred to Hazrat Fatemeh (S) specialized polyclinic (Social Security Organization) located in Urmia city from September to December 2019 and randomly selected to the group Experiment (mindfulness-based stress reduction program (n=26) and control (n=26) were assigned. All participants completed the demographic questionnaire, Beck et al.'s depression questionnaire (1996) and Moriski, Eng and Wood's (2008) treatment adherence questionnaire in three stages. Mindfulness-based stress reduction program was conducted in eight weekly sessions based on Mochari et al.'s training package (2014). The research was analyzed using multivariate repeated measures analysis of variance as well as Tukey's follow-up tests. Results: The results of the present study showed that the stress reduction program based on mindfulness on depression (F=561.08, P&lt;0.001) and adherence to treatment (F=373.51, P&lt;0.001) in coronary heart patients. It was effective and this effect continued until the follow-up period. Conclusion: The results of this research showed that the mentioned treatment can be used as a psychological intervention in reducing depression and improving treatment compliance in female patients with cardiovascular disease.

Resilience-based Integrated IBD Care Is Associated With Reductions in Health Care Use and Opioids

Integrated inflammatory bowel disease (IBD) care is effective but not routinely implemented. Validated methods that simultaneously address mind and body targets such as resilience may improve access and outcomes. We describe the development and implementation of the GRITT method and its impact on resilience, health care utilization (HCU), and opioid use in IBD. Consecutive patients from an academic IBD center were evaluated for low resilience on the basis of provider referral. Low resilience patients were invited to participate in the GRITT program. Primary outcome was % reduction in HCU. Secondary outcomes were change in resilience and corticosteroid and opioid use. Patients were allocated into 2 groups for analysis: GRITT participants (GP) and non-participants (NP). Clinical data and HCU in the year before enrollment were collected at baseline and 12 months. One-way repeated measures multivariate analysis of covariance evaluated group× time interactions for the primary outcome. Effect size was calculated for changes in resilience over time. Of 456 screened IBD patients 394 were eligible, 184 GP and 210 NP. GP had greater reduction in HCU than NP: 71% reduction in emergency department visits, 94% reduction in unplanned hospitalizations. There was 49% reduction in opioid use and 73% reduction in corticosteroid use in GP. Resilience increased by 27.3 points (59%), yielding a large effect size (d= 2.4). Mind-body care that focuses on building resilience in the context of IBD care may be a novel approach to reduce unplanned HCU and opioid use, but large, multicenter, randomized controlled trials are needed.

Verbal and Visual Feedback Immediately Affect the Electromyographic Activity of Female Pelvic Floor Muscles

ObjectiveThe purpose of this study was to assess the immediate effect of verbal and visual feedback on pelvic floor muscles (PFM) in nulliparous women without pelvic floor dysfunction. MethodsIn this observational, single-assessor, cross-sectional study, 45 female university students were evaluated using bidigital vaginal palpation and vaginal surface electromyography (EMG). EMG assessments were performed at 2 time points (T1 and T2). According to the protocol, participants performed 5 maximal voluntary contractions (MVC) with 10-second intervals, 5 sustained voluntary contractions (SVC) for 10 seconds, and a 60-second voluntary contraction until fatigue (CUF) before (T1) and after (T2) receiving verbal instructions and visual feedback on PFM contractions. At T2, women received visual feedback on their PFM contraction. Root mean square (RMS) for each repetition (MVC and VCF) was recorded, and mean value was calculated. Compensatory mechanisms during contraction were recorded visually. The difference in mean RMS (mV) for MVC, SVC, and CUF; curve integral for MVC, SVC, and CUF; median frequency (Hz) for CUF between T1 and T2 were analyzed with repeated measures multivariate analysis of variance. ResultsBefore the instructions, most participants (95.6%) performed PFM MVC using at least 1 compensatory mechanism. PFM EMG outcomes changed at T2: RMS and curve integral were reduced in T2 (P < .05) for MVC, SVC, and CUF. The median frequency increased from T1 to T2 in the CUF group (P = .01). ConclusionVerbal and visual feedback had an immediate impact on the EMG activity of PFM in nulliparous continent women.

Clubhouses as Essential Communities During the COVID-19 Pandemic.

Intentional recovery communities, such as Clubhouses, exist as physical spaces for individuals living with Serious and Persistent Mental Illness. Due to the COVID-19 pandemic, it was necessary for these facilities to rapidly convert to virtual platforms. The aim of this study was to assess the extent to which virtual Clubhouse communities impacted the well-being of their members during the initial weeks of pandemic-related closures. Two hundred and eighty nine Clubhouse members across 19 countries responded to weekly measures of Clubhouse engagement, contact with other members, and well-being. A repeated measures multivariate analysis of covariance indicated that members with high levels of Clubhouse engagement reported higher mental and physical health ratings over time than those with low levels of engagement. These findings support the virtual Clubhouse model and highlight the efficacy of Clubhouses’ rapid adaptations to the pandemic.

Effect of prewarming on body temperature in short-term bladder or prostatic transurethral resection under general anesthesia: A randomized, double-blind, controlled trial

Perioperative hypothermia causes postoperative complications. Prewarming reduces body temperature decrease in long-term surgeries. We aimed to assess the effect of different time-periods of prewarming on perioperative temperature in short-term transurethral resection under general anesthesia. Randomized, double-blind, controlled trial in patients scheduled for bladder or prostatic transurethral resection under general anesthesia. Eligible patients were randomly assigned to receive no-prewarming or prewarming during 15, 30, or 45 min using a forced-air blanket in the pre-anesthesia period. Tympanic temperature was used prior to induction of anesthesia and esophageal temperature intraoperatively. Primary outcome was the difference in core temperature among groups from the induction of general anesthesia until the end of surgery. Repeated measures multivariate analysis of covariance modeled the temperature response at each observation time according to prewarming. We examined modeled contrasts between temperature variables in subjects according to prophylaxis. We enrolled 297 patients and randomly assigned 76 patients to control group, 74 patients to 15-min group, 73 patients to 30-min group, and 74 patients to the 45-min group. Temperature in the control group before induction was 36.5 ± 0.5 °C. After prewarming, core temperature was significantly higher in 15- and 30-min groups (36.8 ± 0.5 °C, p = 0.004; 36.7 ± 0.5 °C, p = 0.041, respectively). Body temperature at the end of surgery was significantly lower in the control group (35.8 ± 0.6 °C) than in the three prewarmed groups (36.3 ± 0.6 °C in 15-min, 36.3 ± 0.5 °C in 30-min, and 36.3 ± 0.6 °C in 45-min group) (p < 0.001). Prewarming prior to short-term transurethral resection under general anesthesia reduced the body temperature drop during the perioperative period. These time-periods of prewarming also reduced the rate of postoperative complications.Study Registration Registered at ClinicalTrials.gov (Identifier: NCT03630887).

Changing misconceptions of abilities: The impact of a brief mindset refutation text intervention

AbstractThe current study investigated whether a brief refutation text intervention could change college students’ misconceptions about the malleability of their intelligence and abilities. Students from a 2‐year college and a 4‐year university in a large urban city in the Northeastern United States participated in experimental and control conditions. A repeated measures multivariate analysis of variance demonstrated a significant overall model with a medium effect size (ηp2 = 0.11) for increased growth mindset and decreased fixed mindset for students in the experimental condition. A follow‐up χ2 analysis for a dichotomous variable of fixed/growth mindset demonstrated a 3% increase from pre‐ to posttest (from 229 students to 236) of students believing in growth mindset. The results demonstrate that a refutation text intervention is effective in promoting growth mindset in undergraduate college students during a brief mindset intervention. This study extends research from a European secondary school context to a US college context.

Recovery Following Peer and Text Messaging Support After Discharge From Acute Psychiatric Care in Edmonton, Alberta: Controlled Observational Study.

BackgroundPeer support is an emotional, social, and practical help provided by nonprofessionals to assist others in sustaining health behaviors. Peer support is valued in recovery-oriented models of mental health and is becoming increasingly implemented at the organizational level. Text messaging is a relatively low-cost, high-impact, and easily scalable program that uses existing technology, is devoid of geographic barriers, and is easily accessible to end users.ObjectiveThis study aims to evaluate the effectiveness of an innovative peer support system plus a supportive text messaging program on the recovery of discharged patients from acute psychiatric care.MethodsThis prospective, rater blinded, controlled observational study included 181 patients who were discharged from acute psychiatric care. Patients were randomized to one of four conditions: treatment as usual (follow-up care), daily supportive text messages only, peer support only, or peer support plus daily supportive text messages. A standardized self-report measure of recovery (Recovery Assessment Scale [RAS]) was completed at baseline, 6 weeks, 3 months, and 6 months. Descriptive analysis, one-way analysis of variance, and repeated measures multivariate analysis of covariance were used to examine the changes in the RAS among the study groups and over the follow-up time points.ResultsA total of 65 patients completed the assessments at each time point. For the overall sample, higher scores were found for the peer support plus text message condition compared with the text message only and treatment as usual condition on several scales (ie, willingness to ask for help and personal confidence and hope) and total score on the RAS, after 6 months of intervention.ConclusionsPeer support plus supportive text messaging seems to result in improved recovery compared with other interventions. It may be advisable to incorporate the two interventions as part of routine practice for patients with psychiatric disorders upon hospital discharge.

Primary School Physical Education at the Time of the COVID-19 Pandemic: Could Online Teaching Undermine Teachers’ Self-Efficacy and Work Engagement?

This study aimed to evaluate whether primary school classroom teachers reported changes in physical education teaching self-efficacy (SE-PE) and work engagement (WE) during the first COVID-19 wave. A total of 622 classroom teachers filled in an online questionnaire on SE-PE and WE, referring to before and during the lockdown, and on perceived digital competence. While controlling for perceived digital competence, a mixed between-within Repeated Measures Multivariate Analysis of Covariance (RM-MANCOVA) was performed, using a factorial design with two time categories (before vs. during the lockdown) and three age categories (≤40 vs. 41–50 vs. ≥51 years). The RM-MANCOVA revealed that perceived digital competence significantly adjusted teachers’ SE-PE and WE values (p &lt; 0.001). The analysis yielded a significant multivariate main effect by time (p &lt; 0.001) and by time × age categories (p = 0.001). Follow-up univariate ANCOVA showed significant differences by time in teachers’ SE-PE (p &lt; 0.001) and WE (p &lt; 0.001), with a reduction in both values from before to during the lockdown. A Bonferroni post hoc pairwise comparison showed teachers’ SE-PE significantly decreased in all age categories (p &lt; 0.001). The present findings confirm the importance of promoting SE-PE among primary school teachers, regardless of the crisis due to the COVID-19 pandemic. Teachers’ self-efficacy and WE are essential to master the challenges of PE teaching.

Promoting Wellness in Counselors‐in‐Training: Impact of a Wellness Experiential Group

We investigated the effectiveness of a 5‐week wellness group curriculum for counselors‐in‐training (N = 60). A repeated measures multivariate analysis of variance was conducted to evaluate whether the curriculum positively affected perceived wellness among participants. The results showed statistically significant differences in scores, indicating a higher level of wellness after the intervention.

Effects of Brain Breaks Video Intervention of Decisional Balance among Malaysians with Type 2 Diabetes Mellitus: A Randomised Controlled Trial.

Brain Breaks® are structured physical activity (PA) web-based videos designed to promote an interest in learning and health promotion. The objective of this study was to examine its effects on decision balance (DB) which consists of the perceived benefits (Pros) and perceived barriers (Cons) of exercise in people with type 2 diabetes mellitus (T2DM). A randomised controlled trial was conducted among people with T2DM at Hospital Universiti Sains Malaysia. The intervention group received Brain Breaks videos for a period of four months. The intervention and control groups completed the validated Malay version of DB questionnaire for five times, at pre-intervention, the first month, the second month, the third month, and post-intervention. Multivariate Repeated Measures Analysis of Variance was performed for data analysis. A total of 70 participants were included (male = 39; female = 31) with a mean age of 57.6 years (SD = 8.5). The intervention group showed a significant change in the Pros and Cons factors of DB scores over time. The intervention group showed significantly higher scores for the Pros (p-value < 0.001) and lower scores for the Cons (p-value = 0.008) factors than the control group. In conclusion, the Brain Breaks video is an effective intervention to improve decisional balance in patients with T2DM to help them in deciding on behaviour change to be more physically active.

The Protective Impacts of α-tocopherol Supplementation on the Semen Quality of Sapera Goat Preserved at 4oC

Supplementation of vitamin E (α-tocopherol) as an antioxidant into an extender is useful to maintain sperm quality during the process of cryopreservation by protecting the sperms from reactive oxygen species (ROS). This study aims to evaluate the protective impacts of vitamin E supplementation on the motility, viability, and reducing the abnormality of sperms in Sapera goats. The sample of semen used in the present study was obtained from fresh semen and good-quality ejaculates of the Sapera goats collected by an artificial vagina. The groups involve one controlled treatment group, which contains semen and tris egg yolk (TEY) extender without vitamin E (P0), and three treatment groups that contain semen, TEY extender, and different doses of vitamin E, i.e., 1 mg/mL (P1), 2 mg/mL (P2), and 3 mg/mL (P3), respectively. Data obtained from the experiments were analyzed using Repeated Measures Multivariate Analysis (MANOVA). The results showed that TEY extenders added with vitamin E at a dose of 1 mg/mL of vitamin E (P1) produced the highest motility and viability with the lowest abnormalities of sperm after 24th hour of cryopreservation. The lowest sperm motility and viability among the treatment groups was observed in the TEY extender added with vitamin E at a dose of 3 mg/mL (P3) at 96th hour after cryopreservation, which was almost the same as the control group without vitamin E (P0) that had the lowest motility and viability. In conclusion, the current study found that supplementation of vitamin E as an antioxidant at a dose of 1 mg/mL in TEY extender can preserve semen of the Sapera goats in refrigerator up to 96 h at 4°C and provides higher sperm motility and viability percentage, with a lower percentage of sperm abnormality.

Self-Assessment Video: An Effective Supplementary Learning Tool in the Development of Cardiovascular Examination Skills of Medical Students

Background: Self-evaluation can augment the facilitation of acquiring knowledge, skills and attitude through a reflective method. Self-assessment video (SAV) can be a very useful reflective method tool that is student-centered and self-directed. Objective: This study aimed to identify if SAV is an effective supplementary learning tool in improving cardiovascular examination knowledge, skills and attitude of second year medical students. Methodology: A quasi-experimental two-group design with pre- and post-test was used. The study population by convenience sampling involved second year medical students of the University of Santo Tomas Faculty of Medicine and Surgery. A structured direct observation checklist on cardiovascular precordial examination was used, done on two occasions in a week interval period. The said examinations were recorded in a video and evaluated and scored by two independent facilitators on these two occasions. The experimental group had the opportunity to review their videos immediately after the two examinations and accomplished self-assessment form. One-Way Repeated Measures Multivariate Analysis of Variance (One-Way RM-MANOVA), a parametric multivariate test for between- and within-group comparison of multiple dependent variables was used. Results: It showed that there was a significant improvement in all parameters measured after the intervention (SAV in the experimental group compared to the control group). Conclusion: The study showed that SAV is an effective supplementary learning tool in cardiovascular examination attitude, knowledge, and skills, and can be a very useful teaching and learning self-evaluation tool. Key words: Self-Assessment Video, Reflective Learning, Self-Directed Learning, Learning Tools, Evaluation Tools.

The Neurocognitive Study for the Aging: Longitudinal Analysis on the Contribution of Sex, Age, Education and APOE ɛ4 on Cognitive Performance.

Objective: The effects of normal cognitive aging on executive functions (EF), Verbal Episodic Memory (VEM) and the contribution of age, sex, education, and APOΕ ε4 in a group of old Greek Cypriots across a five-year period were investigated.Design: NEUROAGE, the first project on cognitive aging in Cyprus, is a prospective longitudinal study with a rolling admission process. Participants are assessed at baseline and retested every 24–30 months.Subjects: 170 participants completed all three testing cycles; 86 men and 84 women with ages ranging between 60 and 88 years (mean = 73.21, SD = 5.84); education, 2–20 years (mean = 9.07, SD = 4.27).Results: Α Repeated Measures Multivariate Analysis of Covariance was conducted with one between-subject factor: sex; two covariates: age and education, while Time (time 1, time 2, time 3) served as a within – subject factor. Time did not have an effect on mini mental status examination in Greek (MMSE), EF or VEM. Also, sex had no effect on MMSE, EF and VEM. There was no time by sex interaction. Age and Education significantly predicted the EF performance, F(1, 168) = 11.23, p < 0.05; F(1, 158) = 90.03, p < 0.001 and VEM performance, F(1, 171) = 17.22, p < 0.001; F(1, 171) = 61.25, p < 0.001. Furthermore, there was a significant interaction effect between time and education, for EF, F(2, 167) = 7.02, p < 0.001. Performance of the APOE ε4 carriers did not differ on any of the above measures as compared to performance of non-carriers in this older adult group.Conclusion: Cognitively healthy adults maintained overall cognitive performance across the five-year period. Male and female participants performed similarly and the pattern of change over time was similar across the two sexes. Education was predictive of VEM and EF performance across time. Furthermore, those with higher education maintained higher levels of EF performance. APOE results did not differentiate performance at baseline. Implications of findings are discussed.

Cognitive Load Impairs Time to Initiate and Complete Shooting Tasks in ROTC Members.

Multitasking typically requires an individual to simultaneously process cognitive information while performing a motor task. Cognitive motor interference (CMi) is encountered when cognitive challenges negatively impact motor task performance. Military personnel encounter cognitively taxing situations, especially during combat or other tactical performance scenarios, which may lead to injury or motor performance deficits (i.e., shooting inaccuracy, delayed stimulus-response time, and slowed movement speed). The purpose of the current study was to develop four cognitive motor shooting paradigms to determine the effects of cognitive load on shooting performance in healthy Reserve Officers' Training Corps (ROTC) cadets. Thirty-two healthy collegiate ROTC members (24 male and 8 female; 20.47 ± 1.24 years, 174.95 ± 10.58 cm, and 77.99 ± 13.90 kg) were recruited to complete four simulated shooting tasks with additional "motor" challenge (180° turn, gait, weighted, and unweighted landing) and with and without a "cognitive" decision-making challenge requiring response selection and inhibition to both auditory and visual stimuli, totaling eight multi-task cognitive motor shooting conditions. The current study was approved by the university's Institutional Review Board. Task initiation (seconds), task completion (seconds), and number of misses were calculated to determine marksmanship efficiency and accuracy. For each task, a multivariate repeated-measures analysis of variance (ANOVA) was conducted for the combined dependent variables. If the overall multivariate repeated-measures ANOVA was significant, follow-up univariate ANOVAs were conducted for each dependent variable. Alpha was set at α = 0.05 for all analyses. Task initiation increased for the cognitive condition for the 180° turn (4.29 ± 1.22 seconds baseline, 5.09 ± 1.39 seconds cognitive; P < .05), gait (2.76 ± .60 seconds baseline, 3.93 ± .62 seconds cognitive; P < .05), unweighted (1.27 ± .57 seconds baseline, 3.39 ± .63 seconds cognitive; P < .05), and weighted landing (1.46 ± .72 seconds baseline, 3.35 ± .60 seconds cognitive; P < .05). Task completion time increased for the cognitive condition for the 180° turn (3.48 ± 1.53 seconds baseline, 4.85 ± 1.24 seconds cognitive; P < .05), gait (7.84 ± 2.07 seconds baseline, 9.23 ± 1.76 seconds cognitive; P < .05), unweighted (5.98 ± 1.55 seconds baseline, 7.45 ± 1.51 seconds cognitive; P < .05), and weighted landing (6.09 ± 1.42 seconds baseline, 7.25 ± 1.79 seconds cognitive; P < .05). There were no statistically significant differences in the number of misses for any of the tasks between conditions (P > .05). The addition of a cognitive load increased both task initiation and task completion times during cognitive motor simulated shooting. Adding cognitive loads to tactical performance tasks can result in CMi and negatively impact tactical performance. Thus, consideration for additional cognitive challenges into training may be warranted to reduce the potential CMi effect on tactical performance.

Sustained, Multifaceted Improvements in Mental Well-Being Following Psychedelic Experiences in a Prospective Opportunity Sample.

In the last 15 years, psychedelic substances, such as LSD and psilocybin, have regained legitimacy in clinical research. In the general population as well as across various psychiatric populations, mental well-being has been found to significantly improve after a psychedelic experience. Mental well-being has large socioeconomic relevance, but it is a complex, multifaceted construct. In this naturalistic observational study, a comprehensive approach was taken to assessing well-being before and after a taking a psychedelic compound to induce a “psychedelic experience.” Fourteen measures of well-being related constructs were included in order to examine the breadth and specificity of change in well-being. This change was then analysed to examine clusters of measures changing together. Survey data was collected from volunteers that intended to take a psychedelic. Four key time points were analysed: 1 week before and 2 weeks, 4 weeks, and 2 years after the experience (N = 654, N = 315, N = 212, and N = 64, respectively). Change on the included measures was found to cluster into three factors which we labelled: 1) “Being well”, 2) “Staying well,” and 3) “Spirituality.” Repeated Measures Multivariate Analysis of Variance revealed all but the spirituality factor to be improved in the weeks following the psychedelic experience. Additional Mixed model analyses revealed selective increases in Being Well and Staying Well (but not Spirituality) that remained statistically significant up to 2 years post-experience, albeit with high attrition rates. Post-hoc examination suggested that attrition was not due to differential acute experiences or mental-health changes in those who dropped out vs. those who did not. These findings suggest that psychedelics can have a broad, robust and sustained positive impact on mental well-being in those that have a prior intention to use a psychedelic compound. Public policy implications are discussed.