Significant Within-group Effects Research Articles

When the attention control condition works: A systematic review of attention control training for posttraumatic stress disorder.

Attentional bias and deficits in attentional control are associated with posttraumatic stress disorder (PTSD) symptoms. Attention control training (ACT) may address these factors. We reviewed randomized controlled trials (RCTs) of ACT for PTSD to address unanswered questions about ACT's effectiveness, tolerability, and implementation. Studies were included if they were an RCT that used an adult sample, recruited participants with a PTSD diagnosis, and had ACT as at least one treatment arm. The PTSD Trials Standardized Data Repository (PTSD-Repository) and additional databases were searched to identify PTSD RCTs published through May 2024. Seven studies met the inclusion criteria (N = 407). The effect size for ACT versus a comparison condition on PTSD symptoms was large, but the confidence interval (CI) overlapped with 0, g = 0.75, 95% CI [-0.63, 2.12]. The same pattern was observed for attention bias variability, g = 1.04, 95% CI [-0.90, 2.98]. There was a significant within-group effect of ACT on self-reported PTSD symptoms, g = -1.43, 95% CI [-2.83, -0.03]. Risk of bias varied, with high risk of bias being primarily due to bias in the measurement of the outcome. These effects should be interpreted cautiously given the significant heterogeneity and wide confidence intervals observed. It remains unclear for whom and under what conditions ACT may be most effective. Future studies should move beyond response time measures, employ an inactive comparator, and examine the mechanism of action to determine whether ACT could be a viable intervention for PTSD.

The Impact of Caregiver Support on Symptom Improvement in Post-Stroke Patients

The Impact of Caregiver Support on Symptom Improvement in Post-Stroke Patients

Effects of Audio-visual and Contextual Conditions on Auditory Word Recognition in Patients with Normal Pressure Hydrocephalus

Objectives: In this study, we compared performance on the auditory word recognition tasks between patients with normal pressure hydrocephalus (NPH) and healthy elderly adults (HE) under different visual, auditory, and contextual conditions to determine how these variables affect auditory comprehension with cognitive decline.Methods: We conducted a standardized comprehension assessment, Paradise Korean Western Aphasia Battery Revised (PK-WAB-R) and the auditory word recognition tasks on 30 patients with NPH and 30 HE. The auditory word recognition task was divided into noisy and quiet conditions (auditory variable), blurry and clean conditions (visual variable), and low- and high-context conditions (contextual variable).Results: Patients with NPH showed relatively good comprehension on the standardized comprehension test of PK-WAB-R. For the auditory word recognition tasks, there was a significant main effect of group, a significant within-group effect of auditory and contextual conditions, and significant interaction effects between auditory condition and group, auditory condition and contextual information, and auditory condition, contextual information, and group.Conclusion: This study confirmed that patients with NPH have difficulty processing auditory comprehension at the sentence level. In addition, the auditory word recognition performance in patients with NPH was significantly lower than HE, and that their difficulties may be more pronounced under certain conditions, such as noisy conditions and low contextual information.

Muscular fitness profiles in relation to the response in body fat during school-based high-intensity intervention.

We aimed to assess the equivalence of the muscular fitness (MF) between body fat percentage (BFP) responders (Rs<inf>BFP</inf>) and non-responders (NRs<inf>BFP</inf>) to school-based high-intensity interval training (HIIT). Adolescents aged 16 (N.=73, 42.5% of males) were identified as Rs<inf>BFP</inf> (N.=45) or NRs<inf>BFP</inf> (N.=28). MF was assessed based on hand strength (HS), abdominal muscle strength (ABS), and leg power (VJ). Profile analysis showed distinct patterns of MF changes in both response categories. Despite the presence of parallelism (Wilks' Λ=0.979, Pillai's V=0.212, P=0.473), a gradient of increasing changes (HS-ABS-VJ) was found in the Rs<inf>BFP</inf>, while a gradient of decreasing changes was shown in the NRs<inf>BFP</inf>, and a significant level of inequality (F<inf>(1,71)</inf>=7.823, P=0.047, partial eta-squared [η2<inf>p</inf>] 0.041). One-way analysis showed a significant and moderate effect on VJ (F<inf>(1,71)</inf>=7.080, P=0.010, η2<inf>P</inf>=0.091), a close to significant effect on ABS (F<inf>(1,71)</inf>=3.300, P=0.074, η2<inf>P</inf>=0.044) and lack of an effect on HS (F<inf>(1,71)</inf>=0.699, P=0.406, η2<inf>P</inf>=0.010). The test of equal means across the condition categories (separately for Rs<inf>BFP</inf> and NRs<inf>BFP</inf>) indicated that there was no multivariate statistically significant within-group effect (F<inf>(2, 70)</inf>=0.517, P=0.599). The findings may help teachers assess the potential and indirect changes in muscle performance after employing a body weight intervention (based on the HIIT program). A more targeted approach to treating adolescents with excessive BF, in parallel with improving MF, can be individually tailored.

Narrative-based autobiographical memory interventions for PTSD: a meta-analysis of randomized controlled trials.

The aim of this systematic review and meta-analysis is to evaluate the efficacy of narrative-based interventions (NBIs) for individuals with post-traumatic stress disorder (PTSD). Investigating the efficacy of NBIs should yield insight on autobiographical memory (AM) phenomena implicated in PTSD onset and recovery, leading to improved intervention protocols. Furthermore, by analyzing how NBIs influence maladaptive AM distortions, we hope to shed light on the theorized narrative architecture of AM more generally. A systematic literature search was conducted according to PRISMA and Cochrane guidelines in MEDLINE, EMBASE, PsychINFO, and PubMed. Additional studies were then also identified from the reference lists of other relevant literature and considered for inclusion. Studies were then evaluated for adherence to the inclusion/exclusion criteria and assessed for risk of bias. Various meta-analyses were performed on included studies to understand how NBIs may or may not influence the overall effect size of treatment. The results of the meta-analysis of 35 studies, involving 2,596 participants, suggest that NBIs are a viable and effective treatment option for PTSD, yielding a statistically significant within-group effect size and decrease in PTSD symptomatology at both post-treatment [g = 1.73, 95% CI (1.23-2.22)] and 3-9 month follow-up assessments [g = 2.33, 95% CI (1.41-3.26)]. Furthermore, the difference in effect sizes between NBIs compared to active and waitlist controls was statistically significant, suggesting that NBIs are superior. Sub-analyses showed that NET provided a stronger effect size than FORNET, which may be due to the nature of the traumatic event itself and not the treatment protocol. While evidence of small study and publication bias was present, a weight-function model and trim-and-fill method suggested it was not influencing the overall results. This meta-analysis presents strong evidence supporting the use of NBIs in the treatment of PTSD. Clear similarities can be identified between NBIs included in this analysis that make them distinct from non-NBI interventions, which are reviewed in the discussion. Controlled comparisons between NBIs and non-NBIs would help to further understand AM mechanisms of action implicated in recovery and how various interventions facilitate them. Future research should also aim to elucidate the full range of AM impairment in individuals with PTSD to gain insight on how other memory capabilities, such as the ability to mentally simulate the future, are implicated in the pathogenesis of PTSD.

Effects of Early Aquatic Experience on Motor and Physiological Outcomes in Infants and Children Under 36 Months: A Systematic Review and Meta-analysis

Background and Purpose: Early aquatic experiences may benefit infants and young children with and without developmental delays, but research is limited. Our purpose was to review aquatic experience effects on motor skill, heart rate, and weight gain for participants younger than 3 years of age. Methods: PubMed, Science Direct, and CINAHL were searched from inception through February 2022. Included studies examined infants and children younger than 36 months having aquatic experiences, compared with not having or prior to aquatic experiences, and reported outcomes that included motor skills, heart rate, or infant weight gain. Studies were assessed for quality and potential bias using the PEDro or STROBE checklists. Effect sizes were calculated as the standardized mean difference (Cohen's d; 95% confidence interval) within and between groups in individual studies and combined across studies using random-effects models. Results: Twelve of 16 articles met the criteria, with 110 participants in studies assessing motor skills, 58 participants in studies assessing heart rate, and 421 newborns in studies assessing infant weight gain. Significant within-group effects were found in motor skills (d = 1.16; 0.09, 2.23), heart rate (d = −0.93; −1.54, −0.31), and weight gain (d = 1.01; 0.09, 1.92). Between-group effects were not significant in motor skills (d = 0.48; −0.49, 1.44), but were significant in newborn weight gain (d = 0.63; 0.43, 0.83). No articles reported between-group data for heart rate. Discussion and Conclusions: Moderately strong evidence supports the beneficial effects aquatic experiences have in infants and young children. Limitations include heterogeneity across aquatic experience protocols and measures, retrospective study design for one study, and lack of recommendations for optimal timing and duration for protocols. Additional research is needed to determine effectiveness in subpopulations at developmental risk.

Comparison of an exergame and a moderate-intensity endurance training intervention on physiological parameters

Background&#x0D; Exergames are interactive video games that stimulate an active, whole-body gaming experience (Best, 2013). By combining electronic entertainment with physical exercise, exergames offer novel opportunities to expand physical activity in different age groups and settings. Even though studies have found a significant increase in energy expenditure when playing exergames compared to normal video games, most games only induce low to moderate-intensity activity which is too low to result in relevant physical adjustments (Biddiss &amp; Irwin, 2010). This study assessed the effects of an 8-week exergame-training (EXT) in an innovative exergame called the ExerCube and compared it with a typical moderate-intensity endurance training (ET) intervention.&#x0D; Methods&#x0D; In total, 19 individuals (10 female; age 26.9 ±8.7 years; body mass index (BMI) 23.6 ±3.1 kg/m2) participated and were block randomized into an EXT group (n = 9) and an ET group (n = 10). Throughout the 8-week intervention period, the EXT group attended 20-30-minutes of EXT three times a week while the ET group completed 15-45-minutes of ET (jogging/cycling at 65-75% of maximal heart rate) three times a week. Before and after the intervention BMI, systolic and diastolic blood pressure, and VO2max (spiroergometry; start: 50 or 75 W; increment: 25 W/min) were assessed and compared (paired-samples t-test, ANOVA).&#x0D; Results&#x0D; Significant time × group interaction effects were found for VO2max (F(1,17) = 11.345; p = .004, ηp2 = .400). The EXT group revealed significant within-group effects in VO2max from pre (43.2 ±10.6 ml/kg*min) to post (46.9 ±10.9 ml/kg*min; p = .004, d = 1.308) while the ET group revealed no significant changes (pre: 39.4 ±5.4 ml/kg*min; post: 39.7 ±4.9 ml/kg*min; p = .466, d = .241). No significant time × group interaction effects were detected in systolic blood pressure (F(1,17) = .050; p = .825, ηp2 = .003) or diastolic blood pressure (F(1,17) = .005; p = .943, ηp2 = .000). However, there was a significant decrease in the peripheral systolic blood pressure from pre (122 ±10 mmHg) to post (117 ±12 mmHg; p = .034, d = .792) in the ET group but not in the EXT group (pre: 118 ±8; post: 114 ±7; p = .156, d = .523). Concerning BMI, no significant interaction effects (F(1,17) = 2.818; p = .111, ηp2 = .142) were detected.&#x0D; Conclusions&#x0D; The EXT seems to be more effective as conventional ET exercise approach to improve endurance performance. This is promising as exergame may develop intrinsic motivation/enjoyment for physical activity. Further studies confirming these findings and extending to psychological variables are needed.&#x0D; References&#x0D; Best, J. R. (2013). Exergaming in youth: Effects on physical and cognitive health. Zeitschrift für Psychologie, 221(2), 72-78. https://doi.org/10.1027/2151-2604/a000137&#x0D; Biddiss, E., &amp; Irwin, J. (2010). Active video games to promote physical activity in children and youth: A systematic review. Archives of Pediatrics &amp; Adolescent Medicine, 164(7), 664-672. https://doi.org/10.1001/archpediatrics.2010.104

The effect of daily peanut consumption on cognitive function and indicators of mental health among healthy young women

Background: Peanuts and tree nuts contain many bioactive compounds that may provide health benefits. There is some evidence to suggest that regular consumption of peanuts and peanut butter may improve cognitive function and mood, however, there are no prior studies examining whether daily intake of dry roasted, skinless peanuts improves cognition. Objective:The objective of this study was to determine the effect of consuming 49 g/day of peanuts for 12 weeks on cognitive function and mental health, compared to consuming a peanut-free diet, among healthy young women. Methods:This was a pre-post test study of 65 women (n = 32 in peanut group, n = 29 in control group). Participants in the peanut group consumed an individually portioned pack of peanuts each day for 12 weeks. Cognitive function was assessed using the CNS Vital Signs computerized neurocognitive test battery. Mental health was assessed using the Depression, Anxiety, and Stress Scale (DASS-42). Differences in endpoints between groups were assessed using ANCOVA tests. Results:There was a significant difference between the two groups in reaction time (6.9 points; p = 0.029), with the control group having a greater increase in scores. There was a significant within-group effect of peanuts on processing speed, with the peanut group increasing scores by 6.3 points (95% CI: 2.7, 9.8). There was no effect of peanut consumption on depression, anxiety, or stress scores. Conclusion:Further research is needed to fully understand the effect of different types of peanut products on cognition. Keywords: cognition, mental health, peanuts, nuts

A self-administered moxibustion-cum-massage intervention for older adults with chronic pain in the community: A randomized controlled trial

ObjectivesTo determine the effectiveness of a simple, self-administrable moxibustion-cum-massage intervention for relieving chronic pain and improving psychological well-being for older adults in the community. DesignA randomized controlled trial. SettingSeventy-eight participants with chronic pain were randomly assigned to the intervention and waitlist control groups. InterventionsParticipants received two moxa sticks a day to use the moxibustion-cum-massage procedure with the help of trained volunteers or caregivers for five consecutive days. Main outcome measuresParticipates’ pain level, sleep quality, depression and subjective well-being were measured before the intervention (T0), immediately after the intervention (T1), and one week after the intervention (T2). ResultsRepeated measures ANOVA revealed a significant group × time interaction effect in subjective well-being with a medium effect size. Regarding within-group effects in the intervention group at post-intervention (T1), the subjective pain level was significantly reduced with a small effect size, while sleep quality and depression significantly improved with large effect sizes. The control group showed no significant within-group effects in these variables. Maintenance effects at follow-up (T2) were not significant. ConclusionDespite the short intervention timeframe of five days, the study revealed preliminary evidence that the moxibustion-cum-massage intervention can be an effective, self-administrable pain relief regime for older adults. A longer period of intervention time is suggested for future studies.

The Influence of Kinesiology Tape on Breathing Mechanics in College-Aged Individuals–A Randomized Trial

Purpose: Kinesiology Tape (KT) has been used to improve mobility and muscle activation. Limited research has studied its effect on respiratory function. The purpose of this study was to investigate the influence of KT on chest wall excursion (CWE) and magnitude of respiratory muscle activation. Methods: Ninety subjects were randomly assigned to receive KT, sham tape, or no tape around the lower thoracic region. Measures, including CWE, maximal inspiratory pressure (MIP), and surface electromyography (sEMG) of intercostal and scalene muscles, were taken during a maximal inspiratory effort before (T-B) and after (T-1) tape application. Subjects continued to wear the tape and returned 48 hours later for another set of measurements (T-2). Repeated measures Analysis of Variance and post-hoc paired t-tests were used to determine the influence of tape. Results: No significant differences were identified for sEMG amplitude or CWE. Maximal inspiratory pressure scores showed no significant between-group effect; however, a significant within-group effect was found. Post-hoc analyses revealed significant differences between T-B and T-2 and T-1 and T-2 for all groups. Conclusion: Kinesiology Tape application did not show increased muscle activation, CWE, or MIP compared with sham and control scenarios. A significant training effect for MIP was identified. Future research should investigate KT effects in other age groups or with the presence of pulmonary pathology.

A randomized controlled trial of an mHealth application with nursing interaction to promote quality of life among community-dwelling older adults.

Using mHealth apps alone at home without the support of healthcare experts could mean that older adults might not fully utilize the functions of the apps, recognize their benefits, and sustain their use. Incorporating an integrated health-social partnership model to support the app usage when further help is needed by the older adults might maximize the apps' benefits in the long term. This study aimed to examine the benefits of adding nursing interaction supported by a health-social partnership model in the use of mHealth, and the sustained beneficial effects on psychological outcomes, including quality of life, self-efficacy, and depression, among older adults after the completion of the program. A three-arm, randomized controlled trial design was adopted. Community-dwelling older adults with chronic pain, hypertension, or diabetes, were randomly assigned to either the mHealth, mHealth with interactivity, or control group. Subjects in both the mHealth and the mHealth with interactivity groups received the mHealth application. In addition, the mHealth with interactivity group received support from a nurse case manager, who was supported by a health-social partnership team. mHealth apps and services from a nurse case manager were not provided to the control group. The primary outcome measure was quality of life, and secondary outcomes were self-efficacy and depression. Data were collected at pre-intervention (T1), post-intervention (T2), and at 3 months post-intervention to measure the sustained effect of the program. There were 74 mHealth+I, 71 mHealth, and 76 control group subjects enrolled in the program. No statistically significant between-group, within-group, and interaction effects between group and time in both physical component summary (PCS) and mental component summary (MCS) scores were found among the three groups. The mHealth group showed an improvement in PCS and depression scores from T1 to T2, sustained at T3; while the mHealth+I group demonstrated improved self-efficacy from T1 to T2, with a decrease at T3. Adding nurse-directed telephone calls may be of little to no benefit at all in the long term. Future studies may consider a longer intervention period to build and sustain quality of life and self-efficacy levels among community-dwelling older adults. www.ClinicalTrials.gov, identifier: NCT03878212.

Long-Term Effect of Exercise on Irisin Blood Levels-Systematic Review and Meta-Analysis.

Physical exercise may activate a number of important biochemical processes in the human body. The aim of this systematic review and meta-analysis was to identify the long-term effect of physical activity on irisin blood levels. We searched PubMed, Scopus, and Web of Science for articles addressing the long-term effect of physical exercise on irisin blood levels. Fifty-nine articles were included in the final qualitative and quantitative syntheses. A statistically significant within-group effect of exercise on irisin blood levels was in 33 studies; out of them, the irisin level increased 23× and decreased 10×. The significant positive between-groups effect was found 11×. Furthermore, the meta-analysis indicated that physical exercise had a significant positive effect on irisin blood levels (SMD = 0.39 (95% CI 0.27–0.52)). Nevertheless, considerably high heterogeneity was found in all the analyses. This systematic review and meta-analysis indicate that physical exercise might increase irisin blood levels; however, the results of individual studies were considerably inconsistent, which questions the methodological detection of irisin by ELISA kits.

Individually tailored Internet-delivered cognitive-behavioral therapy for survivors of intimate partner violence: A randomized controlled pilot trial

Intimate partner violence (IPV) is a serious public health concern worldwide and defined as behavior performed by spouses or other intimate partners that causes physical, sexual, or psychological harm. Internet-delivered cognitive-behavioral therapy (ICBT) may be particularly useful for survivors of IPV for several reasons, including barriers pertaining to limited community recourses and treatment availability, safety concerns, and issues of stigma, guilt and shame, which may prevent members of this population from seeking help via face-to-face interactions. However, Internet interventions are lacking. The primary aim of the present randomized controlled pilot trial was to explore the feasibility of ICBT as guided self-help individually tailored to the predominant symptomatology of PTSD or depression in survivors of IPV. A second aim was to conduct a preliminary evaluation exploring the short- and long-term effects of the treatment in comparison to a waitlist control condition. Results showed that the treatment was feasible. Attrition rate was low (9.4%), and participants were satisfied with treatment. However, treatment adherence was moderate in terms of completed modules (62.5%). Results of the preliminary evaluation of treatment effects showed large and statistically significant between-group effect sizes (Cohen's d = 0.86–1.08) on some measures of PTSD and depression at post assessment, favoring the treatment condition. However, there were no effects on other measures. At follow-up assessment, when the control condition had received delayed treatment, there were large and statistically significant within-group effect sizes (d = 0.96–1.48) on measures of PTSD, depression and anxiety, and small effects (d = 0.48) on a measure of quality of life. The results of the present pilot study are promising and warrant further research on ICBT for this population.

The Comparative Effects of Cooperative and Competitive Learning on Speaking Ability and Self-Confidence of EFL Learners (Research Article)

This study aimed at investigating the comparative effects of cooperative and competitive learning on English as Foreign Language (EFL) learners’ speaking ability and self-confidence. Moreover, EFL learners’ attitude towards cooperative and competitive learning procedures were explored. To these ends 90 learners were selected on the basis of a sample PET results and were assigned into three 30-learner cooperative, competitive and control groups. The speaking section of a sample PET test and Academic Confidence Scale were administered to the three groups before the treatment. As the treatment, the first experimental group members were engaged in cooperative learning, the second experimental group members were engaged in competitive learning, and the control group received regular teacher-fronted instruction. At the end of the treatment, the speaking section of another sample PET and Academic Confidence Scale were re-administered as the posttests.10 EFL learners were randomly selected from each experimental group and seated for a semi-structured interview. The analyses revealed that while both cooperative and competitive learning procedures had significant within-group effects on the learners' speaking ability, the impact on academic self-confidence was significant only for cooperative learning procedure. Moreover, analyses verified that the impact of cooperative learning on speaking ability and self-confidence of EFL learners was statistically superior to the other procedures. Content analysis of the interview data showed that the majority of EFL learners believed that cooperative learning helps them develop their own ideas in greater depth, enhance their participation and creativity in speaking, improve self-confidence and reduce anxiety.

A clinical significance analysis of manualised psychological interventions for obsessive-compulsive disorder

AimsTo conduct an individual patient data meta-analysis of randomised controlled trials (RCTs) of manualised psychological treatments for obsessive-compulsive disorder (OCD), and examine the differential efficacy of psychological treatments by treatment type and format.BackgroundPrevious meta-analyses conclude that efficacious psychological treatments for OCD exist. However, determining the efficacy of psychological treatments requires multiple forms of assessment across a range of indexes, yet most previous meta-analyses in OCD are based solely on effect sizes.MethodWe evaluated treatment efficacy across 24 RCTs (n = 1,667) by conducting clinical significance analyses (using standardised Jacobson methodology) and standardised mean difference within-group effect-size analyses. Outcomes were Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores, evaluated at post-treatment and follow-up (3-6 months post-treatment).ResultPost-treatment, there was a large significant within-group effect size for treated patients (g = 1.28) and a small significant effect size for controls (g = 0.30). At follow-up, large within-group effect sizes were found for both treated patients (g = 1.45) and controls (g = 0.90). Clinical significance analyses indicated that treated patients were significantly more likely than controls to recover following an intervention, but recovery rates were low; post-intervention, only 32% of treated patients and 3% of controls recovered; rising to 38% and 21% respectively at follow-up. Regardless of allocation, only approximately 20% of patients were asymptomatic at follow-up. Across the different analysis methods, individual cognitive therapy (CT) was the most effective intervention, followed by group CT plus exposure and response prevention. Self-help interventions were generally less effective.ConclusionReliance on aggregated within-group effect sizes may lead to overestimation of the efficacy of psychological treatments for OCD. More research is needed to determine the most effective treatment type and format for patients with OCD.

Decrements in Adolescent Cardiac Complexity During Mother-Adolescent Conflicts.

The present study aimed to provide further evidence on the usefulness of non-linear cardiac measures when examining the output of the cardiac system. Scale-invariant self-similarity and entropy, in addition to heart rate variability (HRV) given by time- and frequency-domain measures were calculated in a sample of N = 55 healthy adolescents (Mage = 14.122, SDage = 0.698) during 10-min positive (non-stressful) and negative (stressful) interactions with their mothers. We also explored sex influence in adolescents' cardiac output using both HRV measures and non-linear cardiac measures. Repeated measures MANOVA revealed a marginal within-group effect for HRV measures, F(3,51) = 2.438, p = 0.075, η2p = 0.125), and a significant within-group effect for non-linear cardiac measures, F(6, 48) = 3.296, p = 0.009, η2p = 0.292, showing a significant decrement in adolescents' cardiac complexity during the negative interaction. No significant effect for sex was found in either non-linear cardiac measures or HRV measures, but results suggest lower cardiac scaling in females than in males. These findings suggest a real-time scale predominance in heart rate output when adolescents face an aversive situation and support the importance of non-linear cardiac measures to gain insight into the cardiac system and its regulatory mechanisms. Further research is needed to examine sex-differences in cardiac complexity during aversive situations.

Vocal Fold Steroid Injection for Benign Vocal Lesions in Professional Voice Users

Current treatments for benign vocal lesions consist mainly voice therapy and phonomicrosurgery. However, these options are not always suitable for professional voice users because of their tight performance schedule and limited time for voice rest. This study investigated vocal fold steroid injection (VFSI) as an alternative treatment. Matched case series. We retrospectively enrolled 28 professional voice users (i.e., singers, actors and news anchors) who received VFSI for vocal nodules and polyps in an office setting of a tertiary teaching hospital. Outcomes were evaluated using videolaryngostroboscopy (VLS), the 10-item Voice Handicap Index (VHI-10), maximum phonation time, and acoustic and perceptual analyses before and 1 month after VFSI. Study results were compared with 56 patients of nonprofessional voice users (i.e., routine or high occupational vocal demands), matched in a 1:2 ratio by age, sex, and treatment date. After VFSI, VLS revealed substantial lesion resolution in 82% professional voice users. One professional voice user developed a self-limited vocal fold hematoma after VFSI. VHI-10 scores in the professional group decreased from 21 to 14 points, compared with 23 to 16 points in the non-professional group, demonstrating a significant within-group effect (P < 0.01, GEE) and a nonsignificant between-group effect (P=0.86). Other outcomes also improved significantly after VFSI (P < 0.05), without significant differences between the two groups. VFSI can be an effective and safe alternative treatment for professional voice users with benign vocal lesions.

Reducing Risky Alcohol Use via Smartphone App Skills Training Among Adult Internet Help-Seekers: A Randomized Pilot Trial.

Alcohol is one of the leading risk factors for global disease burden and overconsumption leads to a wide variety of negative consequences in everyday life. Digital interventions have shown small positive effects in contributing to reductions in problematic use. Specific research on smartphone apps is sparse and the few studies published indicate effects ranging from negative or null to small or moderate. TeleCoach™, a web-based skills training smartphone app, has shown positive effects in non-treatment-seeking university students with excessive drinking. This pilot trial aimed to evaluate app effects in a sample of internet help-seekers from the general population in Sweden. A total of 89 participants were recruited via online advertisement. Following baseline assessment for hazardous use, they were randomized to TeleCoach or a web-based control app offering brief information and advice regarding problematic alcohol use. The primary outcome was number of standard drinks per week; secondary outcomes included drinking quantity and frequency, binge drinking and blood alcohol count measures as well as app user data and comorbidity related to depression, anxiety, and drug use. Analysis of baseline and 6-week follow-up outcomes showed significant within-group effects on alcohol consumption but no significant between-group differences. Effect sizes for the within-group changes in the primary outcome over time were significant [F(1, 55)=43.98; p < 0.001], with a Cohen's d of 1.37 for the intervention group and 0.92 for the control group. This difference in effect sizes indicated that continuation of the study as a large randomized, controlled trial with up to 1,000 participants could be worthwhile.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NCT03696888.

Internet-based self-help using automatic messages and support on demand for generalized anxiety disorder: an open pilot study

Generalized anxiety disorder (GAD) is a disabling and often chronic condition. Internet-based treatments for GAD have been shown to be effective, but many studies include weekly contact with a therapist with the aim to increase adherence and clinical outcomes. The current study evaluated a less therapist-intensive alternative: support on demand and automatic messages. Thirty-three participants with GAD went through a self-help program targeting excessive worry. Treatment lasted 9 weeks and consisted of seven modules. Participants received short messages with reminders and encouragement. Therapist support was given when asked for. The intervention led to significant and large within-group effects on the primary outcome, Penn State Worry Questionnaire (PSWQ; Cohen’s d = 1.17), as well as on secondary outcomes such as Generalized Anxiety Disorder Questionnaire-IV (GAD-Q-IV; Cohen’s d = 2.71) and Patient Health Questionaire-9 (PHQ-9; Cohen’s d = 1.05). The exception was a small effect on quality of life (d = −0.34). Twenty-four (74.9%) were satisfied with the treatment and one dropped out. Therapist support was used by 65.6%. Limitations include lack of control condition and a small sample. While preliminary, the findings suggest that self-guided internet interventions can work and be acceptable when automated messages and support on demand is provided.

Contribution of Berry Polyphenols to the Human Metabolome.

Diets rich in berries provide health benefits, however, the contribution of berry phytochemicals to the human metabolome is largely unknown. The present study aimed to establish the impact of berry phytochemicals on the human metabolome. A “systematic review strategy” was utilized to characterize the phytochemical composition of the berries most commonly consumed in the USA; (poly)phenols, primarily anthocyanins, comprised the majority of reported plant secondary metabolites. A reference standard library and tandem mass spectrometry (MS/MS) quantitative metabolomics methodology were developed and applied to serum/plasma samples from a blueberry and a strawberry intervention, revealing a diversity of benzoic, cinnamic, phenylacetic, 3-(phenyl)propanoic and hippuric acids, and benzyldehydes. 3-Phenylpropanoic, 2-hydroxybenzoic, and hippuric acid were highly abundant (mean > 1 µM). Few metabolites at concentrations above 100 nM changed significantly in either intervention. Significant intervention effects (p < 0.05) were observed for plasma/serum 2-hydroxybenzoic acid and hippuric acid in the blueberry intervention, and for 3-methoxyphenylacetic acid and 4-hydroxyphenylacetic acid in the strawberry intervention. However, significant within-group effects for change from baseline were prevalent, suggesting that high inter-individual variability precluded significant treatment effects. Berry consumption in general appears to cause a fluctuation in the pools of small molecule metabolites already present at baseline, rather than the appearance of unique berry-derived metabolites, which likely reflects the ubiquitous nature of (poly)phenols in the background diet.