Strong Effect Sizes Research Articles

Relationship between physical activity levels and body composition of candidates for bariatric surgery: a pilot study

Obesity is a public health issue that is associated with the development of cardiometabolic and musculoskeletal multimorbidities, such as sarcopenia. Furthermore, the population with severe obesity confronts various barriers that hinder the practice of physical exercise, which exposes them to greater risk and fragility. In light of this, a pilot study was conducted to characterize the population eligible for bariatric surgery regarding body composition and physical activity levels and verify the relationship between the degrees of the degrees of obesity and sarcopenia. In total, a sample of 41 individuals were included in the analysis, all of whom were female, with an average age of 45 years and weighing 108 kilos, mostly with sarcopenia (28 individuals). It was possible to observe a significant difference in the fat mass of the population with Obesity in Class 2 and 3 (p> 0.001), Class 2 and 4 (p> 0.001), Class 3 and 4 (p > 0.002), and in the % fat of the population with Class 2 and 3 obesity (p> 0.001) and Class 2 and 4 ((p> 0.002), both with strong effect sizes (0.7 and 0.5, respectively). It was possible to observe a significant difference in lean mass between the sarcopenia classification groups (p<0.001) but no significant difference was observed between the physical activity levels. The candidates for bariatric surgery predominantly have Class II and III obesity, interfering with body composition (lean mass, % body fat, and BMD), and, consequently, exposing greater physical and functional fragility. Although sarcopenia and a sedentary lifestyle are presented in the literature as conditions that impact body composition, it was not possible to identify significant differences in the sample. Keywords: Sarcopenia. Obesity. Body mass index.

Newborn glomerular function and gestational particulate air pollution

Nephron number variability may hold significance in the Developmental Origins of Health and Disease hypothesis. We explore the impact of gestational particulate pollution exposure on cord blood cystatin C, a marker for glomerular function, as an indicator for glomerular health at birth. From February 2010 onwards, the ENVIRONAGE cohort includes over 2200 mothers giving birth at the East-Limburg hospital in Genk, Belgium. Mothers without planned caesarean section who are able to fill out a Dutch questionnaire are eligible. Here, we evaluated cord blood cystatin C levels from 1484 mother-child pairs participating in the ENVIRONAGE cohort. We employed multiple linear regression models and distributed lag models to assess the association between cord blood cystatin C and gestational particulate air pollution exposure. Average±SD levels of cord blood cystatin C levels amounted to 2.16±0.35mg/L. Adjusting for covariates, every 0.5μg/m³ and 5μg/m³ increment in gestational exposure to black carbon (BC) and fine particulate matter (PM2.5) corresponded to increases of 0.04mg/L (95% CI 0.01-0.07) and 0.07mg/L (95% CI 0.03-0.11) in cord blood cystatin C levels (p<0.01), respectively. Third-trimester exposure showed similar associations, with a 0.04mg/L (95% CI 0.00-0.08) and 0.06mg/L (95% CI 0.04-0.09) increase for BC and PM2.5 (p<0.02). No significant associations were observed when considering only the first and second trimester exposure. Our findings indicate that particulate air pollution during the entire pregnancy, with the strongest effect sizes from week 27 onwards, may affect newborn kidney function, with potential long-term implications for later health. Special Research Fund (Bijzonder Onderzoeksfonds, BOF), Flemish Scientific Research Fund (Fonds Wetenschappelijk Onderzoek, FWO), and Methusalem.

Microscopic analysis of cut mark characteristics from chopping/hacking tools

Evaluating sharp force trauma (SFT) injuries to bone inflicted by a larger class of chopping/hacking tools (i.e., swords, axes, hatchets, machetes, and cleavers) is a growing area within the field of forensics. Previous studies have demonstrated promise regarding tool differentiation through the utilization of microscopic cut mark characteristics. However, this is an area that warrants additional investigation as there has yet to be a comprehensive study that incorporates the majority of these microscopic chopping/hacking cut mark characteristics into one analysis. The purpose of the current research was to analyze a large sample of microscopic cut mark characteristics derived from the current chopping/hacking literature to determine if differentiation of tool type could be made based on the microscopic cut mark characteristics. An additional goal of the current research is to develop standardization guidelines for the assessment of cut marks, focusing on a comprehensive suite of microscopic cut mark characteristics commonly observed in the existing literature. The skeletal sample for the current research was derived from a previous macroscopic cut mark characteristic experiment where trauma was inflicted to 20 partially fleshed domestic pig (Sus scrofa domesticus) limbs utilizing four chopping/hacking tools (i.e., axe, hatchet, machete, and cleaver) as well as a large carving knife for comparison. Cut marks were evaluated for 15 microscopic cut mark characteristics to assess statistical significance. Utilizing a chi-square analysis, nine of the 15 microscopic cut mark characteristics demonstrated statistically significant differences in relation to the tool utilized, indicating moderate to relatively strong effect sizes. For example, it should be possible to use a combination of microscopic cut mark characteristics to potentially indicate which chopping/hacking tool inflicted trauma when analyzing bones. In particular, examining the characteristics such as regularity of the cut mark edges along with the occurrence of uprising, fossae/depressions, and microscopic fractures can suggest or exclude tool class within forensic contexts.

Augmented Reality in Natural Sciences and Biology Teaching: Systematic Literature Review and Meta-Analysis

This article presents the results of a systematic literature review followed by a meta-analysis of studies on the use of Augmented Reality (AR) in the teaching and learning of Natural Sciences and Biology, among primary and secondary school students. The variables considered were the effects on student learning and motivation, as well as other variables like students understanding and students’ perception of the cognitive load. The teaching contexts and strategies used in association with AR were also considered. The PRISMA methodology was used in articles published between 2010 and 2023, in EBSCO, Science Direct, Scopus, Springer Link, Taylor &amp; Francis and Web of Science databases. Seven hundred and twenty-one articles (721) were found, which, after applying the inclusion and exclusion criteria, were reduced to 15. The results showed that, in most studies, AR associated with certain teaching strategies and using a quasi-experimental research methodology produced better results in learning and student motivation and other variables such as student understanding and memorization (from Bloom's taxonomy), and perception of cognitive load. The overall analysis of the data allowed us to observe a strong effect size value (d = 1.13 [0.39;1.86]) in favour of the experimental group regarding learning and a moderate effect on motivation when using AR (d = 0.52 [0.30;0.74]). The same occurred with other variables studied where students obtained better results, which translated into a small or medium effect size. For example, in the perception of cognitive load, the effect size was d= 0.73. Doi: 10.28991/ESJ-2024-08-04-025 Full Text: PDF

Influence of titanium surface roughness on a nanoscale on the zeta potential and platelet adhesion.

Thromboembolic complications still arise on blood contacting surfaces. Surface charge and topography influence the subsequent deposition of proteins and platelets, potentially leading to thrombi. Research showed a correlation of surface charge and nanoscale roughness, and a negative surface charge as well as a smooth surface finish are associated with lower thrombogenicity. The aim of this study was to compare the platelet adhesion on titanium with different nanoscale roughnesses and to examine if those roughness variations caused a change in surface charge. Titanium samples were polished and roughened to four different nanoscale roughness levels. Platelet adhesion (covered surface area (CSA), N = 8) was tested in flow chambers with human whole blood using fluorescence imaging. ζ-potential was measured over a broad range of pH-values and interpolated to obtain the ζ-potential for pHBlood (7.4). Platelet adhesion tests were evaluated in terms of p-values and the Wilcoxon test effect size and the trend of the ζ-potential at pHBlood and the CSA was compared. Ra-values ranged between 35 (polished) and 156 nm. Regarding platelet adhesion, the polished sample showed the lowest mean CSA with a medium or strong effect size compared to the roughened samples. The interpolated ζ-potentials for pHBlood follow a similar trend as the CSA, with the lowest ζ-potential measured for the polished surface. These findings suggest that the decreasing ζ-potential due to lower nanoscale roughness might be an additional explanation for the improved hemocompatibility besides the smoother topography.

Sensitization to Lanolin in North-Eastern Italy, 1997-2021: Prevalence, Risk Factors and the Impact of Occupation.

Background: Direct skin contact with items containing lanolin can induce sensitization and development of contact dermatitis (CD). This multi-centric study investigated prevalence of lanolin sensitization among 30,269 outpatients from North-Eastern Italy patch tested during 1997-2021. Methods: European baseline and extended Triveneto series were applied on the upper part of patients' back and removed after 48 h. Risk factors for lanolin sensitization were investigated by multiple logistic regression analysis, reporting adjusted odds ratios (aOR) with 95% confidence interval (95%CI). Results. Overall lanolin patch test positive ratio (PTPR) was 1.64% (=501/30,629), with variability over time and by research center. The body area most frequently affected by CD were hands (36.32%), followed by face (19.52%) and legs (8.09%), with a lanolin PTPR of 1.68%, 1.37% and 3.07%, respectively. Prevalence of occupational CD was 8.24%, and 1.83% patients with occupational CD patch tested positive against lanolin. Lanolin sensitization was significantly higher in males (aOR = 1.34; 95%CI: 1.08; 1.65) and among patients with leg CD aged 49-60 years (aOR = 2.34; 95%CI: 1.20; 4.57) or older than 60 (aOR = 4.21; 95%CI: 2.59; 6.85). Sub-group analysis confirmed the significantly higher sensitization rate of older patients with leg CD, with much stronger effect size in females 61+ years old (aOR = 5.33; 95%CI 2.87; 9.89) than males in the same age group (aOR = 2.92; 95%CI: 1.34; 6.39). Moreover, female house painters were more likely to test positive to lanolin. Conclusions: The variability of lanolin PTPR over time and by research center endorsed the ongoing debate on the relevance of the respective skin reaction. Clinicians assessing patients with dermatitis should collect information on potential risk factors for lanolin sensitization, particularly use of skin care products containing the hapten. Occupational exposure to lanolin-containing varnishes should also be considered.

The Role of Immunomodulatory Therapy with Oxiris in COVID-19 with Renal Failure and Immune Dysfunction

Introduction: The main objective of this study was to evaluate the impact of hemoadsorption on the elimination of inflammatory mediators. Methods: A prospective, bicenter, observational cohort study was conducted between March 2020 and February 2022 to explore the immunomodulatory response, demographic and clinical characteristics of individuals with COVID-19 admitted to the ICU with severe acute respiratory failure and in need of CRRT with Oxiris® with or without AKI. Results: Sixty-four patients were analyzed. Statistically significant differences were observed between exposed and unexposed groups, in relation to the reduction in D-dimer levels −15,614 (24,848.9) versus −4,136.5 (9,913.47) (p 0.031, d: 1.59, 95% CI: −21,830, −1,126). An increase in PCT was observed 0.47 (2.08) versus −0.75 (2.3) (p 0.044 95% CI: 0.03, 2.44). No differences were found in a decrease in CRP −4.21 (7.29) versus −1.6 (9.02) (p 0.22) nor in the rest of inflammatory parameters fibrinogen, IL-6, ferritin, lymphocytes, and neutrophils. Subgroup analysis in patients exposed to therapy also showed a significant decrease in D-dimer of 55% from baseline: 6,000 (1,984.5–27,750) pre-therapy versus 2,700 (2,119.5–6,145) (95% CI: −23,000, −2,489) post-therapy with a strong effect size (p 0.001, d: 0.65). Conclusion: The hemoadsorptive therapy in COVID-19 was associated with a significant decrease in D-dimer parameters without showing decreases in the rest of the clinical, inflammatory parameters and severity scales analyzed.

Treating Mental Health and Quality of Life in Older Cancer Patients with Cognitive Behavioral Therapy: A Systematic Review and Meta-Analysis.

Cognitive behavioral therapy (CBT) has been successfully utilized in improving mental health (MH) and quality of life (QoL) in the general population, regardless of age. Cancer, which is most frequently diagnosed in older adults, is a debilitating illness that has a detrimental and long-lasting effect on patients' MH and QoL. While numerous studies have demonstrated CBT's efficacy, little evidence exists for its role in older cancer patients. This study, using MH and QoL metrics, evaluates the effectiveness of CBT for older adult cancer patients. Focusing on MH and QoL and an average age of over 60 years old, a final analysis was performed on 17 clinical trials with a total of 124 effect sizes, including 3073 participants receiving CBT. "Metaphor" and "Robumeta" packages in R Statistical Software (version 4.2.2) were used for analysis, which included robust variance estimation (RVE) in intercept-only meta-regression, and univariate meta-regression for moderator analysis. With 17 clinical trials and 124 effect sizes, our results show that CBT moderately improves MH and QoL in cancer patients d = 0.19, 95% CI 0.0166-0.364, p < 0.0399. The delivery format was shown to be a strong moderator of CBT effectiveness with interpersonal technological interventions combined with pre-programmed segments having a very strong treatment effect size (d = 1.7307, 95% CI 1.5244-1.937, p < 0.001). The use of CBT in older adult cancer patients statistically improves MH and QoL, with delivery format and stages of treatment having important roles. Tech-only interpersonal interventions combined with pre-programmed CBT provide an avenue for targeting older adult cancer patients.

Perceived Strengths and Difficulties in Children and Adolescents With Chronic Physical Health Conditions

Abstract: Theoretical Background: The Strengths and Difficulties Questionnaire (SDQ) is often used for screening of psychological problems in children with chronic physical health conditions (CPHC). Objective: The present meta-analysis tested (a) whether the SDQ scores of young people with CPHC show elevated psychological symptoms and lower prosocial behavior compared with healthy peers or test norms, (b) which conditions are associated with the strongest increase in symptoms, and (c) whether results vary by sample and study characteristics. Method: Studies that compared SDQ scores between young people with CPHC and healthy peers or test norms or that provided sufficient information for a comparison with established normative data or sociodemographically equivalent healthy groups from that country, and if studies were published or made available online before July, 2023, were included in the meta-analysis. Study quality was evaluated with the Mixed Methods Appraisal Tool. A systematic search in the electronic databases Medline, PsycINFO, PSYNDEX, Web of Science, and the SDQ database resulted in 605 studies of 217,440 children and adolescents with CPHC that were included in random-effects meta-analyses. Results: There were, on average, small-to-moderate elevations in total difficulties (parent/self-report: g = .52/.31) and the four problem scales as well as slight reductions in parent reports on prosocial behavior ( g = -.17). Elevations in parent- and self-reports on emotional symptoms ( g = .48/.31) and peer problems ( g = .43/.26) were significantly stronger than elevations in conduct problems ( g = .30/.10) and hyperactivity–inattention ( g = .33/.13). In addition, children with cerebral palsy (parent/self-report of total problems: g = .82/.66), chronic fatigue syndrome ( g = .82/.66), and epilepsy ( g = .95/.40) showed above-average elevations in psychological symptoms. Stronger effect sizes were found, among others, in older children and in the case of a later age at onset. Direct comparisons of the results of published and unpublished studies on self-rated SDQ found some evidence for a possible publication bias, while results of published and unpublished studies did not vary when parent ratings were used. With regard to limitations, only few studies were available on teacher ratings and from non-Western countries. Illness-specific analyses were impossible for rarely assessed conditions, such as cystic fibrosis and spina bifida. Discussion and Conclusion: It is concluded that children with epilepsy, cerebral palsy, chronic fatigue syndrome, and other conditions affecting the brain should be, in particular, screened for psychological problems. Symptom overlap of some CPHC with the Emotional Symptoms scale has to be considered when interpreting the data.

Effects of a communication skills training program to improve capacity to engage in advance care planning in caregivers of patients with malignant gliomas

Abstract Background: Family and friend caregivers play a critical role in advance care planning (ACP) discussions, which are difficult but necessary to carry out patients' goals of care. This role is particularly important among caregivers of patients with malignant gliomas (MGs), who are often tasked with quickly taking responsibility for healthcare communication. We developed and evaluated the feasibility, acceptability, and preliminary effects of a virtual communication skills training program to equip caregivers of patients with recurrent MGs with skills to navigate ACP conversations with patients and healthcare providers. Methods: Our 2-hour communication skills training combined a series of didactic exercises with roleplay scenarios and follow-up coaching through a booster call conducted 2 weeks after training completion. Caregivers were randomized to receive either the communication skills training or enhanced usual care (EUC), which included screening and the provision of targeted referrals. Assessments were completed at baseline (T1) and at 2 (T2) and 5 (T3) months of follow-up. Results: A total of 34 caregivers enrolled and were randomized, of whom 19 completed the T2 and 18 completed the T3 assessment. 10 of the 13 caregivers who completed the training participated in interviews at T2 about their experiences and perceived benefits of participation. At T3, results indicated a strong effect size for reduced anxiety and distress and increased preparedness for death in caregivers who received the intervention relative to EUC. Participants reported that the training helped them feel confident initiating ACP conversations, validated in their fears about death, and helped them feel supported and less alone. Conclusion: Despite the challenges of recruiting a highly distressed group of caregivers, there were notable benefits of our communication skills training. Additional larger trials are needed to rigorously evaluate the efficacy of the training program and those that include caregivers of patients with other sites and stages of cancer to determine the generalizability of findings.

Validation of the German Pruritus Questionnaire for the systematic assessment of chronic pruritus.

Chronic pruritus is a clinically heterogeneous symptom that manifests itself with varying duration, intensity, or quality. To date, there is no validated German-language instrument that systematically assesses the relevant parameters. With the support of the Pruritus Research Working Group (Arbeitsgemeinschaft Pruritusforschung, AGP), a questionnaire for the assessment of chronic pruritus (AGP questionnaire) was developed in 2008. The subsequently revised instrument, now called the German Pruritus Questionnaire, records pruritus-specific parameters such as localization, course, intensity and quality, anamnestic data on the general state of health, sociodemographic data, quality of life, and coping methods. It is to be validated in the study presented here. The questionnaire was used in 366 patients with chronic pruritus of different etiologies from Germany (University Hospitals Heidelberg, Münster, Mainz, Erlangen, Giessen, private practice Bad Bentheim, TU Munich, Wiesbaden Kidney Center), Austria (Graz University Hospital) and Switzerland (Aarau Cantonal Hospital). The reliability for repeated completion (retest reliability) with regard to localization, first occurrence, and concomitant diseases showed high values for Cohen's kappa (>0.8). The data on the retest reliability of the pruritus characteristics showed lower values (<0.7). With regard to the measurability of practically relevant changes (change sensitivity), medium to strong effect sizes were found (0.09-0.19). A statistically significant differentiation of the pruritus etiologies based on the recorded parameters was not possible. The German Pruritus Questionnaire allows a comprehensive and structured recording of patient- and clinician-reported, relevant dimensions of chronic pruritus of different etiologies. Further adaptation and development are planned.

Impact of National Lockdown Measures on the Association Between Social Media Use and Sleep Disturbance During COVID-19: A Meta-Analysis of 21 Nations.

During the COVID-19 pandemic, the extensive lockdown measures implemented for disease mitigation triggered a surge in round-the-clock social media use, giving rise to widespread concerns regarding its impact on sleep health. This meta-analysis examined the association between social media use and sleep disturbance during the pandemic, along with potential moderators. The dataset included 43 independent samples comprising 68,247 residents of 21 countries across 7 world regions. The three-level mixed-effects meta-analysis revealed a weak, positive overall effect size (r = 0.1296, 95% confidence interval: 0.0764-0.1828, k = 90). The magnitude of the effect size varied by the type of social media use: compulsive use exhibited a moderately strong effect size, whereas information-focused use showed marginal significance. The effect size was more pronounced in countries imposing stricter (vs. less strict) lockdown measures. Lockdown status also moderated this association, with a marginally significant effect size observed during lockdowns but a significant effect size after lockdowns. For demographics, samples involving emerging adults demonstrated moderately strong effect sizes, whereas those involving the general population had modest effect sizes. Notably, the interaction between the type of social media use and lockdown status was significant. Specifically, the positive association with information-focused use was significant only during lockdowns, whereas that with general use was significant after, but not during, lockdowns. However, compulsive use showed a moderately strong effect size both during and after lockdowns. These findings underscored the importance of considering multiple factors-such as the type of social media use, context, and demographics-when studying social media use and sleep health.

Language use and attitudes of prospective teachers: a comparison of the Basque and Friulian multilingual contexts

ABSTRACT Since educators play a decisive role in the formation of language attitudes, this study analyses perceived competence, habits of language use and attitudes towards three languages in contact harboured by prospective teachers. Our research replicates a 20-year-old study and is comparative, as it parallels two European regions: the Basque Autonomous Community in Spain, and Friuli Venezia Giulia in Italy. The sample was made up of 553 participants. Quantitative data were collected by means of the original questionnaire. Significant results were obtained, with strong effect sizes. As for the minority language, our results show that while Basque is mainly linked with the educational domain and tends to be used more often with younger people, the situation is different for Friulian, which is virtually absent from the educational domain and tends to be used in exchanges with older people. The status of majority language is especially true for Italian in FVG, which, in addition to being the main language in education, is predominantly used by future teachers in all domains of their daily life. As for English, our findings seem to indicate that its general position is becoming stronger, and this trend may be maintained in both contexts in the future.

The Effects of Goal-Setting Intervention with Mobile Apps on Behavioral Regulation and Life Quality

This study aims to evaluate the effectiveness of a mobile-based goal-setting intervention among university students compared to the control group. The main hypothesis of the study was that the intervention would affect the behavioral regulation and life quality of students. The participants of this study were first-year economics students from a Chinese university. The research method was a questionnaire. At the start, the life quality and behavioral regulation of students did not significantly differ. In the post-test, intergroup differences in behavioral regulation were generally significant, but the size of the effects was small. In terms of life quality, the post-test revealed significant intergroup differences with strong effect sizes. Changes in Intrinsic regulation predicted change in Social Relationships, and changes in lntrojected regulation and Identified regulation predicted change in Psychological Health. This study postulates the need to develop behavioral skills to systematically engage in physical activity.

The Impact of Educandy Word Search Game on Enhancing Students’ Vocabulary Mastery

This study has objective to ascertain the effect of the word search game Educandy on students’ vocabulary mastery. This research utilized a pre-experimental design with three treatments as its methods. The research sample encompassed 31 students of VIII G at SMPN 5 Pontianak during the academic year of 2023/2024. The researcher used a test as an instrument and a measurement technique as a data collection method to complete this research. The results indicated that using the word search game Educandy enhanced students’ vocabulary mastery of learning vocabulary. According to the Mean score of the pre-test and post-test, alongside the t-test analysis, the research outcomes showed an enhancement in students’ advancement. The mean score obtained during the pre-test was 70.32, whereas the mean score during the post-test was 88.14. The calculated t-test value was 10,36, higher than the t-table value of 1.697 at a significance level of 0.05 and degree of freedom of 30. Moreover, the effect size was 1.761, which corresponds to a strong effect size with a range of effect size &gt; 0.5. In brief, the results showed that using the word search game Educandy enhanced students’ vocabulary mastery.

Refined movement analysis in the staircase test reveals differential motor deficits in mouse models of stroke

Accurate assessment of post-stroke deficits is crucial in translational research. Recent advances in machine learning offer precise quantification of rodent motor behavior post-stroke, yet detecting lesion-specific upper extremity deficits remains unclear. Employing proximal middle cerebral artery occlusion (MCAO) and cortical photothrombosis (PT) in mice, we assessed post-stroke impairments via the Staircase test. Lesion locations were identified using 7 T-MRI. Machine learning was applied to reconstruct forepaw kinematic trajectories and feature analysis was achieved with MouseReach, a new data-processing toolbox. Lesion reconstructions pinpointed ischemic centers in the striatum (MCAO) and sensorimotor cortex (PT). Pellet retrieval alterations were observed, but were unrelated to overall stroke volume. Instead, forepaw slips and relative reaching success correlated with increasing cortical lesion size in both models. Striatal lesion size after MCAO was associated with prolonged reach durations that occurred with delayed symptom onset. Further analysis on the impact of selective serotonin reuptake inhibitors in the PT model revealed no clear treatment effects but replicated strong effect sizes of slips for post-stroke deficit detection. In summary, refined movement analysis unveiled specific deficits in two widely-used mouse stroke models, emphasizing the value of deep behavioral profiling in preclinical stroke research to enhance model validity for clinical translation.

Leo program, a short multi-family skill-based psychoeducational program for caregivers of relatives living with a severe mental disorder: a retrospective pilot study.

Caring for a relative with a severe mental disorder (SMD) is associated with high levels of burden and poor physical and mental health. There is a dire need for family psychoeducational programs that can be provided as early as possible. This manuscript describes the pilot testing of "Leo" a motivational-based psychoeducational program for caregivers of individuals with a SMD. The Leo program aims to provide caregivers with skills to best support their relative and to adopt self-care behaviors. We retrospectively analyzed medical records of caregivers who enrolled in a short, multi-family, skill-based psychoeducational program, consisting of eight 3-hour sessions over 8 weeks. Outcomes of interest included: i) adherence to the program, ii) satisfaction and perceived usefulness, and iii) pre-post changes in self-reported levels of depression (CES-D), burden (ZBI), and skills (10 Likert-scaled items). A network analysis was used to investigate the relationships between pre-post changes in self-evaluated skills and pre-post changes in burden and depression levels. Over the 91 enrolled participants, 87 (95.6%) completed the program attending at least 5/8 sessions, 80.5% attending all sessions. Seventy-six caregivers fulfilled the questionnaires at baseline and after the program, and were included in the analysis. Although there was no evidence for significant change in self-reported depression levels (Cohen's d=0.19, p=0.210), burden scores and all evaluated skills were improved post-intervention, with medium to strong effect size (Cohen's ds from 0.47 to 0.87; p<0.001). Network output indicated that increased self-evaluated competence in 5 skills were associated with a global improvement in caregivers' burden and/or depression scores. Post-intervention, 89.7% of caregivers were "very satisfied" and 82.1% found the program "extremely useful". This pilot retrospective study shows high levels of satisfaction, perceived usefulness, and adherence to "Leo", a short, multi-family, skill-based psychoeducational program with promising results in improving caregivers' burden, self-evaluated competence in coping with caregiving demands and in self-care behaviors. This study provides preliminary insights into the mechanisms by which family psychoeducation might alleviate burden of care. A larger-scaled, controlled, randomized study with follow-up assessments is warranted to determine how burden, depression, and skills, as well as their inter-relationships, evolve over time.

Disability reduction following a lumbar stabilization exercise program for low back pain: large vs. small improvement subgroup analyses of physical and psychological variables

BackgroundLittle is known about why patients with low back pain (LBP) respond differently to treatment, and more specifically, to a lumbar stabilization exercise program. As a first step toward answering this question, the present study evaluates how subgroups of patients who demonstrate large and small clinical improvements differ in terms of physical and psychological changes during treatment.MethodsParticipants (n = 110) performed the exercise program (clinical sessions and home exercises) over eight weeks, with 100 retained at six-month follow-up. Physical measures (lumbar segmental instability, motor control impairments, range of motion, trunk muscle endurance and physical performance tests) were collected twice (baseline, end of treatment), while psychological measures (fear-avoidance beliefs, pain catastrophizing, psychological distress, illness perceptions, outcome expectations) were collected at four time points (baseline, mid-treatment, end of treatment, follow-up). The participants were divided into three subgroups (large, moderate and small clinical improvements) based on the change of perceived disability scores. ANOVA for repeated measure compared well-contrasted subgroups (large vs. small improvement) at different times to test for SUBGROUP × TIME interactions.ResultsStatistically significant interactions were observed for several physical and psychological measures. In all these interactions, the large- and small-improvement subgroups were equivalent at baseline, but the large-improvement subgroup showed more improvements over time compared to the small-improvement subgroup. For psychological measures only (fear-avoidance beliefs, pain catastrophizing, illness perceptions), between-group differences reached moderate to strong effect sizes, at the end of treatment and follow-up.ConclusionsThe large-improvement subgroup showed more improvement than the small-improvement subgroup with regard to physical factors typically targeted by this specific exercise program as well as for psychological factors that are known to influence clinical outcomes.

Interprofessional socialization of first-year medical and midwifery students: effects of an ultra-brief anatomy training

BackgroundInterprofessionalism is considered a key component in modern health profession education. Nevertheless, there remains ongoing debate about when and where to introduce interprofessional trainings in the curriculum. We identified anatomy, a subject commonly shared among health professionals, as a practical choice for initiating early intergroup-contact between first-year medical and midwifery students. Our study examined the effects of a four-hour block course in anatomy on interprofessional socialization and valuing, as well as long-term effects on intergroup contact.MethodsBased on different concepts and theories of learning, we implemented 12 interprofessional learning stations. Several measures were taken to foster group cohesion: (1) self-directed working in interprofessional tandems on authentic obstetric tasks, (2) competing with other tandems, (3) creating positive interdependencies during task completion, and (4) allowing room for networking. In a pre-post design with a three-month follow-up, we assessed the outcomes of this ultra-brief training with qualitative essays and quantitative scales.ResultsAfter training, both groups improved in interprofessionalism scores with strong effect sizes, mean difference in ISVS-21 = 0.303 [95% CI: 0.120, 0.487], P < .001, η² = 0.171, while the scales measuring uniprofessional identity were unaffected, mean difference in MCPIS = 0.033 [95% CI: -0.236, 0.249], P = .789. A follow-up indicated that these positive short-term effects on the ISVS-21 scale diminished after 12 weeks to baseline levels, yet, positive intergroup contact was still reported. The qualitative findings revealed that, at this initial stage of their professional identity development, both medical and midwifery students considered interprofessionalism, teamwork and social competencies to be of importance for their future careers.ConclusionThis study advocates for an early implementation of interprofessional learning objectives in anatomical curricula. Young health profession students are receptive to interprofessional collaboration at this initial stage of their professional identity and derive strong advantages from a concise training approach. Yet, maintaining these gains over time may require ongoing support and reinforcement, such as through longitudinal curricula. We believe that an interprofessional socialization at an early stage can help break down barriers, and help to avoid conflicts that may arise during traditional monoprofessional curricula.

The Impact of Baseline Pain Intensity on the Effectiveness of Whole-Body Electromyostimulation (WB-EMS) for Nonspecific Chronic Back Pain.

Recent clinical studies confirmedthat whole-body electromyostimulation (WB-EMS) training is a safe and time-efficient therapeutic method for patients with nonspecific chronic back pain (NSCBP). However, significant variations in initial pain intensity among subjects in these studies have been observed. This study aims to determine if patients with differing initial pain intensities experience varying degrees of benefit from WB-EMS and to assess the overall correlation between initial pain levels and pain reduction. Pain intensity datasets from two studies were combined. The pooled data included 121 NSCBP patients (38 males and 83 females) with an average age of 55.1 years (±11.8 years). Data was categorized by baseline pain intensity on the numeric rating scale (NRS) into seven groups: 0 to 2, >2 to 3, >3 to 4, >4 to 5, >5 to 6, >6 to 7, and >7. Both absolute and relative changes were analyzed. Additionally, a Spearman rho correlation test was performed on the entire dataset to evaluate the relationship between initial pain level and pain reduction. Significant improvements were noted across all NRS11 categories, with strong effect sizes (p) in all classes above 2, ranging from 0.56 to 0.90. The >7 category exhibited the highest rate of clinically significant changes (80%) and an average improvement of 3.72 points. The overall group from >1 to 10 showed an average improvement of 1.33 points, with 37% of the participants experiencing clinically significant improvements. The Spearman rho correlation test revealed a moderate positive relationship between initial pain level and pain reduction (r_s = 0.531, p < 0.001), indicating that, generally, higher initial pain levels are associated with greater pain reduction. The findings support the hypothesis that NSCBP patients with higher baseline NRS values benefit more substantially from WB-EMS. Those with NRS values above 7 show the greatest improvement and highest rate of clinical significance. The overall positive correlation between initial pain intensity and pain reduction further underscores the efficacy of WB-EMS in managing NSCBP across different pain intensities.