Within-subject Comparisons Research Articles

Biomechanical factors influencing mental health in college students and the role of physical activity in cognitive resilience

The Mental Health (MH) of college students is increasingly becoming a public health concern, with rising rates of depression, anxiety, and stress. This study aims to explore the relationship between Biomechanical Factors (BF), Physical Activity (PA), and MH outcomes in college students, addressing gaps in current research that frequently overlook the biomechanical features of physical well-being. A cross-sectional observational design was employed, involving 200 college students aged 18–24. SP underwent comprehensive assessments, including postural analysis, movement pattern evaluation, and MH screening. Physical activity levels and cognitive resilience were also measured to evaluate their roles in mediating and moderating the relationships between BF and MH. Key findings revealed that poor biomechanical alignment, such as forward head posture and movement asymmetry, were significantly associated with higher levels of depression, anxiety, and stress. Correlation analysis showed that forward head posture correlated positively with depression (r = 0.52, p < 0.01) and anxiety (r = 0.47, p < 0.01). Movement asymmetry was also associated with MH disturbances (depression: r = 0.45, p < 0.01). PA mediated the relationship between BF and MH, with significant indirect effects via PA for forward head posture (0.18, p < 0.05). Cognitive resilience emerged as a significant moderator, buffering the negative impact of biomechanical inefficiencies on MH outcomes. Within-subject comparisons indicated improvements in BF and MH scores over a one-month follow-up, with decreases in forward head posture (−2.2 ± 1.5 degrees, p < 0.05) and depression scores (−1.5 ± 1.2, p < 0.01).

The subjective experience of transcranial electrical stimulation: a within-subject comparison of tolerability and side effects between tDCS, tACS, and otDCS.

Low-intensity transcranial electrical stimulation (tES), including techniques like transcranial direct current stimulation (tDCS), transcranial alternating current stimulation (tACS), and oscillatory transcranial direct current stimulation (otDCS), has been widely explored for its neuromodulatory effects on motor, cognitive, and behavioral processes. Despite well-established safety, these techniques can induce varying degrees of discomfort and side effects, potentially impacting their application. This study presents a within-subject sham-controlled experiment directly comparing the subjective experience and side effects of tDCS, tACS, and otDCS. Participants reported their discomfort levels at multiple time points during 20-min stimulation sessions and completed a side-effects questionnaire before and after each session. Results indicated that the overall discomfort levels were low across all conditions, with ≥95% reporting the absence of discomfort or mild procedure-induced discomfort. Nevertheless, tDCS and otDCS were slightly less comfortable compared to sham, especially at the beginning of stimulation, with tACS-induced discomfort levels being overall comparable to sham. The most common side / adverse effects were mild skin sensations, including itching and tingling, particularly with tDCS and otDCS, while tACS occasionally caused phosphenes and blurred vision. These findings provide a systematic comparison of tES-induced discomfort and side effects between different tES techniques, highlighting the high safety of tES, but also the importance of considering within- and between-person variability and time-course effects in tES applications.

Comparison of denture space and patient satisfaction for neutral zone versus standard-designed digital dentures restoring mandibular resorbed ridges: A crossover randomized clinical trial.

To compare neutral-zone-designed and standard-designed digital complete dentures used to restore severely resorbed ridges through differential digital analysis of teeth arrangement position, shape of the polished surface, and assessment of patient satisfaction. This study applied a within-subject comparison of two denture forms: computer-aided design and computer-aided manufacturing (CAD-CAM) dentures designed based on the bone-support concept (control group) and CAD-CAM dentures designed based on the neutral-zone concept (test group). Twelve completely edentulous patients exhibiting advanced ridge atrophy were recruited, and they were randomly assigned to use one of the two dentures before the other. A comparison between the two groups' virtual denture confines was conducted using "Medit compare" digital software. The average values of three-dimensional deviations between the two dentures at different regions were calculated. The "patient denture assessment" questionnaire was used to gauge participants' satisfaction with their dentures. The obtained scores were used to compare the two denture types. The position of the neutral zone was significantly shifted at the level of both denture teeth and denture base outer limits (p = 0.001). The greatest deviation was calculated at the region of the palatal polished surface followed by lingual flange contours, while the buccal flanges displayed the least deviations (p≤0.05). Statistically significant differences were observed between patients' satisfaction with neutral zone and standard dentures regarding function and comfort, retention, and stability of lower dentures (p≤0.05). CAD-CAM neutral-zone dentures have distinctly different anatomical confines that can be clinically correlated to their better impact on patient acceptance.

3D-printed custom ankle braces for people with Charcot-Marie-Tooth disease: A pilot study.

Charcot-Marie-Tooth disease (CMT) is a neurodegenerative condition resulting in footdrop, ankle instability and impaired balance and gait. This study aimed to determine (1) whether 3D-printed custom ankle braces improve function and balance in people with CMT and (2) whether this is an acceptable device for use in this population. A within-subject comparison pragmatic/pilot study was undertaken. Ten people with CMT (mean [SD] age 48 [14] years, 60% male) were fitted with 3D-printed ankle braces. Following a 4-week wear-in period, walking and balance tests and patient-reported outcomes were assessed in two experimental conditions: (i) usual shoes and (ii) usual shoes with 3D-printed custom ankle braces. Differences in outcome measures between experimental conditions were analysed using linear mixed models. Comfort, aesthetics and overall satisfaction of the brace were assessed via 100-mm visual analogue scale (VAS). Adverse events and tripping/falls associated with the brace during the wear-in period were also recorded by participants using daily diaries. A significant improvement was seen during single-leg balance with eyes open (p=0.026, Cohen's d=0.55) and a significant reduction in foot pain (p=0.045, Cohen's d=0.82), with use of the ankle brace. Mean (SD) 100mm VAS scores were 62.7mm (17.9) for overall comfort and 73.9mm (21.2) for overall satisfaction. Subjective data from the daily dairies showed that one participant found the brace too firm around the ankle due to loss of soft tissue mass and two participants found it challenging to don and doff the brace due to loss of hand dexterity. This pilot study suggests that a 3D-printed custom ankle brace may improve balance and reduce foot pain in people with CMT; however, larger-scale trials are needed to further explore the impact of this brace on function and balance. Further customisation of the brace may also be required to improve acceptability for some people.

Within-subject time series angular velocity differences between in-game high and low velocity fastballs in college baseball pitchers

PurposeThe purpose of the current study is to investigate the within-pitcher differences in time series angular velocities of the pelvis, trunk, shoulder, and elbow for high and low velocity fastballs in college baseball pitchers. MethodsIn-game data were retrospectively analyzed from 82 NCAA Division 1 pitchers ([1.89 ​± ​0.06] m, [92.8 ​± ​9.5] kg). Kinematic data were collected using an in-game markerless motion capture system. Time series data of pelvis, trunk, shoulder, and elbow angular velocities for each pitcher's fastest and slowest fastball were extracted for the pitch cycle (foot contact to ball release) and used for analysis. Within-subject time series comparisons were conducted using statistical parametric mapping (SPM) paired samples t-tests (α ​= ​0.012 5). ResultsEach of the tested segments were significantly faster in the fastest fastball trial compared to the slowest fastball trial. The duration of significance in reference to the pitch cycle, test statistic, and p-value, for each segment are as follows: Pelvis: 0%–4%, t ​= ​3.54, p ​= ​0.012; Trunk: 30%–67%, t ​= ​5.62, p ​< ​0.001; Shoulder External Rotation: 3%–50%, t ​= ​−6.03, p ​< ​0.001; Shoulder Internal Rotation: 96%–100%, t ​= ​4.11, p ​= ​0.008; Elbow: 75%–86%, t ​= ​4.13, p ​< ​0.001. DiscussionWithin-subjects differences exist in time series angular velocities when comparing the fastest and slowest fastball. These time series differences provide additional information to distinguish fastball velocity beyond what discrete metrics can provide. Pitchers should look to rotate each segment faster, and optimize the sequencing of these movements, to increase pitch velocity.

Within-subject Comparison Reveals Enhanced Satellite Cell Response To Eccentric Overload During Heavy Resistance Exercise

Within-subject Comparison Reveals Enhanced Satellite Cell Response To Eccentric Overload During Heavy Resistance Exercise

Effect of various active reminders via mobile phone on cooperation of orthodontic teenage patients regarding oral hygiene and ClassII elastics use : Athree-month follow-up prospective cohort study.

The purpose of this prospective cohort study was to assess the impact of reminders via mobile phone, such as text messages or video/multimedia images, on orthodontic patients' cooperation with regard to oral hygiene and the use of ClassII intermaxillary elastics. The study included 124 orthodontic patients aged 12-20years (mean age14.06 ± 2.0 years, 63females and 61males). The patients were divided into two groups: group1 (n = 56) was evaluated for oral hygiene, while group2 (n = 68) was evaluated for the use of ClassII intermaxillary elastics. Each main group was divided into three subgroups: text message group, video message group, and control group. Specific messages were sent to the participants in the study groups twice aweek for 12weeks. Data were collected at the beginning of the study (T0), after 6weeks (T1), and 12weeks (T2) and compared to determine the impact of the reminders. Oral hygiene was evaluated using plaque and gingival index scores, and the use of ClassII elastics was evaluated using digital model measurements. Between-subject comparisons were performed using Kruskal-Wallis or one-way analysis of variance (ANOVA). For within-subject comparisons (T0-T1, T1-T2, and T0-T2 time intervals), one-way repeated measures ANOVA or Friedman test was performed. There was no significant difference between the control group (1.49 ± 0.22) and the message groups (video: 1.58 ± 0.34 and text: 1.51 ± 0.28) in terms of plaque index scores and gingival index (control: 1.56 ± 0.26, text: 1.51 ± 0.36, video: 1.52 ± 0.26) scores. However, in the intragroup comparison, it was observed that both plaque index scores and gingival index scores at T0, T1, and T2 increased for both the study and control groups. While there was no difference between the subgroups in overjet measurement at T0 (control: 3.46 ± 1.20, video: 3.34 ± 1.20, text: 2.73 ± 1.03; p = 0.51), there was asignificant difference at T2 (control: 2.62 ± 0.85, video: 2.32 ± 1.41, text: 1.48 ± 0.72, p < 0.01). Mobile active reminders had no effect on improving oral hygiene. Despite repeated reminders, hygiene worsened over time. The use of ClassII elastics seemed to have increased as aresult of the mobile reminders.

Within-subject comparison of near-death and psychedelic experiences: acute and enduring effects.

Mystical-like states of consciousness may arise through means such as psychedelic substances, but may also occur unexpectedly during near-death experiences (NDEs). So far, research studies comparing experiences induced by serotonergic psychedelics and NDEs, along with their enduring effects, have employed between-subject designs, limiting direct comparisons. We present results from an online survey exploring the phenomenology, attribution of reality, psychological insights, and enduring effects of NDEs and psychedelic experiences (PEs) in individuals who have experienced both at some point during their lifetime. We used frequentist and Bayesian analyses to determine significant differences and overlaps (evidence for null hypotheses) between the two. Thirty-one adults reported having experienced both an NDE (i.e. NDE-C scale total score ≥27/80) and a PE (intake of lysergic acid diethylamide, psilocybin/mushrooms, ayahuasca, N,N-dimethyltryptamine, or mescaline). Results revealed areas of overlap between both experiences for phenomenology, attribution of reality, psychological insights, and enduring effects. A finer-grained analysis of the phenomenology revealed a significant overlap in mystical-like effects, while low-level phenomena (sensory effects) were significantly different, with NDEs displaying higher scores of disembodiment and PEs higher scores of visual imagery. This suggests psychedelics as a useful model for studying mystical-like effects induced by NDEs, while highlighting distinctions in sensory experiences.

Using systems modeling to facilitate undergraduate physiology student learning and retention of difficult concepts.

Physiology concepts, such as acid-base balance, may be difficult for students to understand. Systems modeling, a cognitive tool, allows students to visualize their mental model of the problem space to enhance learning and retention. Methods: We performed a within-subjects three-period randomized control comparison of systems modeling versus written discussion activities in an undergraduate asynchronous online Anatomy and Physiology II course. Participants (n=108) were randomized to groups with differing treatment orders across three course units: endocrine, immune, and acid-base balance. Participants demonstrated content understanding either through constructing systems modeling diagrams (M) or written discussion posts (W) in a MWM, MMW, or WMM sequence. Results: For each of three units, student performance was assessed on six standardized multiple-choice questions embedded within a 45-question exam. The same six questions per unit, eighteen questions total, was again assessed on the 75-question final exam. The groups demonstrated no significant difference in performance in the endocrine unit exam (mean difference, MD=-0.036). However, the modeling group outperformed the writing group in the immune unit exam (MD=0.209) and widened the gap in the acid-base balance unit exam (MD=0.243). On the final exam, performance was again higher for the modeling group on acid-base balance content as mean difference increased to 0.306 despite the final exam content for acid-base balance being significantly more difficult compared to other units (modeling: F(2)=29.882, p<.001; writing: F(2)=25.450, p<.001). Conclusions: These results provide initial evidence that participation in systems modeling activities enhance student learning of difficult physiology content as evidenced by improved multiple-choice question performance.

Beyond HIV Shame: Effects of Self-Forgiveness in Improving Mental Health in HIV-Positive Individuals in Poland.

Guided by the bio-psycho-socio-spiritual approach, this randomized controlled trial assessed the efficacy of a self-forgiveness intervention among 60 HIV-positive individuals in Poland. Participants underwent a 90-min "Restore: The Journey Toward Self-Forgiveness" session, in contrast to a wait-list control group. The intervention significantly enhanced self-forgiveness, spirituality, mental well-being, and heart rate variability in response to a cognitive stressor (i.e., a mental arithmetic challenge). Significant effects were observed in both between-group and within-subject comparisons. These results support the incorporation of self-forgiveness into psychological rehabilitation programs for HIV to improve quality of life and health outcomes.

Neural mechanism underlying preview effects and masked priming effects in visual word processing.

Two classic experimental paradigms - masked repetition priming and the boundary paradigm - have played a pivotal role in understanding the process of visual word recognition. Traditionally, these paradigms have been employed by different communities of researchers, with their own long-standing research traditions. Nevertheless, a review of the literature suggests that the brain-electric correlates of word processing established with both paradigms may show interesting similarities, in particular with regard to the location, timing, and direction of N1 and N250 effects. However, as of yet, no direct comparison has been undertaken between the two paradigms. In the current study, we used combined eye-tracking/EEG to perform such a within-subject comparison using the same materials (single Chinese characters) as stimuli. To facilitate direct comparisons, we used a simplified version of the boundary paradigm - the single word boundary paradigm. Our results show the typical early repetition effects of N1 and N250 for both paradigms. However, repetition effects in N250 (i.e., a reduced negativity following identical-word primes/previews as compared to different-word primes/previews) were larger with the single word boundary paradigm than with masked priming. For N1 effects, repetition effects were similar across the two paradigms, showing a larger N1 after repetitions as compared to alternations. Therefore, the results indicate that at the neural level, a briefly presented and masked foveal prime produces qualitatively similar facilitatory effects on visual word recognition as a parafoveal preview before a single saccade, although such effects appear to be stronger in the latter case.

Variant patterns of electrical activation and recovery in normal human hearts revealed by noninvasive electrocardiographic imaging.

Although electrical activity of the normal human heart is well characterized by the electrocardiogram, detailed insights into within-subject and between-subject variations of ventricular activation and recovery by noninvasive electroanatomic mapping are lacking. We characterized human epicardial activation and recovery within and between normal subjects using non-invasive electrocardiographic imaging (ECGI) as a basis to better understand pathology. Epicardial activation and recovery were assessed by ECGI in 22 normal subjects, 4 subjects with bundle branch block (BBB) and 4 with long-QT syndrome (LQTS). We compared characteristics between the ventricles [left ventricle (LV) and right ventricle (RV)], sexes, and age groups (<50/≥50years). Pearson's correlation coefficient (CC) was used for within-subject and between-subject comparisons. Age of normal subjects averaged 49 ± 14 years, 6/22 were male, and no structural/electrical heart disease was present. The average activation time was longer in LV than in RV, but not different by sex or age. Electrical recovery was similar for the ventricles, but started earlier and was on average shorter in males. Median CCs of between-subject comparisons of the ECG signals, activation, and recovery patterns were 0.61, 0.32, and 0.19, respectively. Within-subject beat-to-beat comparisons yielded higher CCs (0.98, 0.89, and 0.82, respectively). Activation and/or recovery patterns of patients with BBB or LQTS contrasted significantly with those found in the normal population. Activation and recovery patterns vary profoundly between normal subjects, but are stable individually beat to beat, with a male preponderance to shorter recovery. Individual characterization by ECGI at baseline serves as reference to better understand the emergence, progression, and treatment of electrical heart disease.

Renewal of instrumental avoidance in humans.

The ABA renewal effect occurs when behavior is trained in one context (A), extinguished in a second context (B), and the test occurs in the training context (A). Two mechanisms that explain ABA renewal are context summation at the test and contextual modulation of extinction learning, with the former being unlikely if both contexts have a similar associative history. In two experiments, we used within-subjects designs in which participants learned to avoid a loud noise (unconditioned stimulus) signaled by discrete visual stimuli (conditioned stimuli [CSs]), by pressing the space bar on the computer keyboard. The training was conducted in two contexts, with a different pair of CSs (CS+ and CS-) trained in each context. During extinction, CS+ and CS- stimuli were presented in the alternative context from that of training, and participants were allowed to freely respond, but no loud noise was presented. Finally, all CSs were tested in both contexts, resulting in a within-subjects ABA versus ABB comparison. Across experiments, participants increased avoidance responses during training and decreased them during extinction, although Experiment 2 revealed less extinction. During the test, responding was higher when CS+ were tested in the training context (ABA) versus the extinction context (ABB), revealing the renewal of instrumental avoidance. Experiment 2 also measured expectancy after the avoidance test and revealed a remarkable similarity between avoidance responses and expectancy ratings. This study shows the renewal of instrumental avoidance in humans, and the results suggest the operation of a modulatory role for the context in renewal, similar to the occasion setting of extinction learning by the context. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Comparison of Radiographic Outcomes Assessed via the Radiographic Union Scale for Tibial Fractures and Alkaline Phosphatase Levels during the Tibial Healing Process: A Series of Case Reports.

Tibial diaphysis fractures are common injuries resulting from high-to-low-energy traumas in patients of all age groups, but few reports currently provide complementary parameters for the assessment of bone healing processes in the postoperative period. Serum alkaline phosphatase (ALP) and the scores from the Radiographic Union Scale for Tibial Fractures (RUST) can promote new horizons in this context. Therefore, the aim of this study was to assess the behavior of ALP and RUST through within-subject comparisons from immediately post-surgery to 49 days after tibial diaphysis fracture repair. This article included four case studies where patients underwent the same procedures. Adults of both sexes aged 18 to 60 years with tibial fractures requiring surgery were included. After surgical intervention (T1), the patients were followed for 49 days after surgery, returning for follow-up appointments on the 21st (T2) and 49th (T3) days. At the follow-up appointments, new X-ray images were obtained, and blood samples were collected for ALP measurement. Serum ALP levels increased by T2 following tibial reamed intramedullary nailing surgery. While this increase persisted into T3 for two patients, a decline was observed during the same period for the other two patients. Both events are indicative of the bone consolidation process, and RUST scores at the T3 corroborate this perspective for all patients included in this study. Considering that delta ALP (T3-T1 value) was lower in patients who exhibited the highest RUST score, we suggest that a synchronized analysis between ALP and RUST allows medics to diagnose bone consolidation. Therefore, it can be concluded that the analysis of ALP alongside RUST may be complementary for evaluating bone consolidation following tibial reamed intramedullary nailing surgery, but future studies are needed to confirm this assertion.

Health Outcomes and Health Services Utilization Evaluation Protocol: Assessing the Impact of the Nova Scotia Rapid Access and Stabilization Program

IntroductionEmergency psychiatric care, unplanned hospital admissions, and inpatient health care are the costliest forms of mental health care. According to Statistics Canada (2018), almost 18% (5.3 million) of Canadians reported needing mental health support. However, just above half of this figure (56.2%) have reported their needs were fully met. To further expand capacity and access to mental health care in the province, Nova Scotia Health has launched a novel mental health initiative, the Rapid Access, and Stabilization Program (RASP).ObjectivesThis study evaluates the effectiveness and impact of the RASP on high-cost health services utilization (e.g. ED visits, mobile crisis visits, and inpatient treatments) and related costs. It also assesses healthcare partners’ (e.g. healthcare providers, policymakers, community leaders) perceptions and patient experiences and satisfaction with the program and identifies sociodemographic characteristics, psychological conditions, recovery, well-being, and risk measures in the assisted population.MethodsThis is a hypothesis-driven program evaluation study that employs a mixed methods approach. A within-subject comparison will examine health services utilization data from patients attending RASP, one year before and one year after their psychiatry assessment at the program. A controlled between-subject comparison will use historical data from a control population will examine whether possible changes in high-cost health services utilization are associated with the intervention (RASP). The primary analysis involves extracting secondary data from provincial information systems, electronic medical records, and regular self-reported clinical assessments. Additionally, a qualitative sub-study will examine patient experience and satisfaction, and examine health care partners’ impressions.ResultsThe results for the primary, secondary, and qualitative outcome measures to be available within 6 months of study completion. We expect that RASP evaluation findings will demonstrate a minimum 10% reduction in high-cost health services utilization and corresponding 10% cost savings, and also a reduction in the wait times for patient consultations with psychiatrists to less than 30 calendar days. In addition, we anticipate that patients, healthcare providers, and healthcare partners would express high levels of satisfaction with the new service.ConclusionsThis study will demonstrate the results of the Mental Health and Addictions Program (MHAP) efforts to provide stepped-care, particularly community-based support, to individuals with mental illnesses. Results will provide new insights into a novel community-based approach to mental health service delivery and contribute to knowledge on how to implement mental health programs across varying contexts.Disclosure of InterestNone Declared

Impact of Benzodiazepines and Illness Duration on Obsessive-Compulsive Disorder during COVID-19 in Italy: Exploring Symptoms' Evolutionary Benefits.

Obsessive-compulsive disorder (OCD) is believed to follow a waxing and waning course, often according to environmental stressors. During the COVID-19 pandemic, pre-existing OCD symptoms were reported to increase and to change from checking to washing behaviors, while new-onset symptoms were predominantly of the hoarding type. In the present study, we followed the evolution of OCD symptoms, anxiety, depression, and insights of illness in forty-six OCD patients throughout the pandemic. Clinical measures were collected at four different time points before and during the COVID-19 pandemic in Italy. Within-subject comparisons were used to compare clinical scale scores across time, and correlations were examined between patients' baseline characteristics and changes in clinical scores. We found that all clinical measures increased during the first Italian lockdown with respect to the pre-pandemic values. Anxiety decreased during the temporary elimination of restriction provisions, whereas the severity of OCD symptoms and insight returned to pre-pandemic values during the second mandatory lockdown. These results were observed only in two sub-groups of patients: those taking benzodiazepines and those with shorter illness duration. Our findings suggest the need for additional clinical attention to these specific sub-groups of OCD patients in case of particularly distressing circumstances while pointing to a possible adaptive role of their OCD symptoms when the environment requires a higher care of hygiene and an extraordinary supply of essential resources.

Reducing wait times and avoiding unnecessary use of high-cost mental health services through a Rapid Access and Stabilization Program: protocol for a program evaluation study.

Emergency psychiatric care, unplanned hospital admissions, and inpatient health care are the costliest forms of mental health care. According to Statistics Canada (2018), almost 18% (5.3 million) of Canadians reported needing mental health support. However, just above half of this figure (56.2%) have reported their needs were fully met. In light of this evidence there is a pressing need to provide accessible mental health services in flexible yet cost-effective ways. To further expand capacity and access to mental health care in the province, Nova Scotia Health has launched a novel mental health initiative for people in need of mental health care without requiring emergency department visits or hospitalization. This new service is referred to as the Rapid Access and Stabilization Program (RASP). This study evaluates the effectiveness and impact of the RASP on high-cost health services utilization (e.g. ED visits, mobile crisis visits, and inpatient treatments) and related costs. It also assesses healthcare partners' (e.g. healthcare providers, policymakers, community leaders) perceptions and patient experiences and satisfaction with the program and identifies sociodemographic characteristics, psychological conditions, recovery, well-being, and risk measures in the assisted population. This is a hypothesis-driven program evaluation study that employs a mixed methods approach. A within-subject comparison (pre- and post-evaluation study) will examine health services utilization data from patients attending RASP, one year before and one year after their psychiatry assessment at the program. A controlled between-subject comparison (cohort study) will use historical data from a control population will examine whether possible changes in high-cost health services utilization are associated with the intervention (RASP). The primary analysis involves extracting secondary data from provincial information systems, electronic medical records, and regular self-reported clinical assessments. Additionally, a qualitative sub-study will examine patient experience and satisfaction, and health care partners' impressions. We expect that RASP evaluation findings will demonstrate a minimum 10% reduction in high-cost health services utilization and corresponding 10% cost savings, and also a reduction in the wait times for patient consultations with psychiatrists to less than 30 calendar days, in both within-subject and between-subject comparisons. In addition, we anticipate that patients, healthcare providers and healthcare partners would express high levels of satisfaction with the new service. This study will demonstrate the results of the Mental Health and Addictions Program (MHAP) efforts to provide stepped-care, particularly community-based support, to individuals with mental illnesses. Results will provide new insights into a novel community-based approach to mental health service delivery and contribute to knowledge on how to implement mental health programs across varying contexts.

Comprehensive linear and nonlinear analysis of the effects of spinning on dynamic balancing ability in Hungarian folk dancers

PurposeIn the case of Hungarian folk dancers, it is crucial to maintain correct posture and promptly respond to imbalances. However, traditional dances often lack specific training to develop these skills.MethodsIn this present study, twelve dancers (8 male, 4 female, age: 21.7 ± 3.6 years) and ten non-dancers subjects forming a control group (6 male, 4 female, age: 21.6 ± 2.87 years) participated. During the measurements a 60-second long bipedal balancing test on the balance board was completed two times, and a spinning intervention was inserted in between the two sessions. The balance capabilities of the two groups were assessed through the characterization of motion on an unstable board, and the analysis of subject’s center of mass and head movements.ResultsDancers applied a more sophisticated and resource-intensive strategy to address the balancing task, yielding a better balancing performance in terms of balance board parameters. By preferring a solid stability in the medio-lateral direction, a greater fluctuation in the anterior-posterior direction can be observed (e.g., significantly lower SampEn values). The overall more successful performance is further evidenced by within-subject comparison since significant differences were observed mostly within the control group. Based on the results, the advanced balancing ability of the folk dancer group is more likely to be acquired through years of experience.ConclusionThe results indicate that additional specialized training could further enhance this ability, encouraging the reliance on poorly memorized corrective movements and reducing the risk of injury.

Exploring the effects of antimicrobial treatment on the gut and oral microbiomes and resistomes from elderly long-term care facility residents via shotgun DNA sequencing.

Monitoring antibiotic-resistant bacteria (ARB) and understanding the effects of antimicrobial drugs on the human microbiome and resistome are crucial for public health. However, no study has investigated the association between antimicrobial treatment and the microbiome-resistome relationship in long-term care facilities, where residents act as reservoirs of ARB but are not included in the national surveillance for ARB. We conducted shotgun metagenome sequencing of oral and stool samples from long-term care facility residents and explored the effects of antimicrobial treatment on the human microbiome and resistome using two types of comparisons: cross-sectional comparisons based on antimicrobial treatment history in the past 6 months and within-subject comparisons between stool samples before, during and 2-4 weeks after treatment using a single antimicrobial drug. Cross-sectional analysis revealed two characteristics in the group with a history of antimicrobial treatment: the archaeon Methanobrevibacter was the only taxon that significantly increased in abundance, and the total abundance of antimicrobial resistance genes (ARGs) was also significantly higher. Within-subject comparisons showed that taxonomic diversity did not decrease during treatment, suggesting that the effect of the prescription of a single antimicrobial drug in usual clinical treatment on the gut microbiota is likely to be smaller than previously thought, even among very elderly people. Additional analysis of the detection limit of ARGs revealed that they could not be detected when contig coverage was <2.0. This study is the first to report the effects of usual antimicrobial treatments on the microbiome and resistome of long-term care facility residents.

Linear mixed models and latent growth curve models for group comparison studies contaminated by outliers.

The linear mixed model (LMM) and latent growth model (LGM) are frequently applied to within-subject two-group comparison studies to investigate group differences in the time effect, supposedly due to differential group treatments. Yet, research about LMM and LGM in the presence of outliers (defined as observations with a very low probability of occurrence if assumed from a given distribution) is scarce. Moreover, when such research exists, it focuses on estimation properties (bias and efficiency), neglecting inferential characteristics (e.g., power and type-I error). We study power and type-I error rates of Wald-type and bootstrap confidence intervals (CIs), as well as coverage and length of CIs and mean absolute error (MAE) of estimates, associated with classical and robust estimations of LMM and LGM, applied to a within-subject two-group comparison design. We conduct a Monte Carlo simulation experiment to compare CIs and MAEs under different conditions: data (a) without contamination, (b) contaminated by within-subject outliers, (c) contaminated by between-subject outliers, and (d) both contaminated by within- and between-subject outliers. Results show that without contamination, methods perform similarly, except CIs based on S, a robust LMM estimator, which are slightly less close to nominal values in their coverage. However, in the presence of both within- and between-subject outliers, CIs based on robust estimators, especially S, performed better than those of classical methods. In particular, the percentile CI with the wild bootstrap applied to the robust LMM estimators outperformed all other methods, especially with between-subject outliers, when we found the classical Wald-type CI based on the t statistic with Satterthwaite approximation for LMM to be highly misleading. We provide R code to compute all methods presented here. (PsycInfo Database Record (c) 2024 APA, all rights reserved).