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Effect size estimates: Current use, calculations, and interpretation
... p<0.001, generalized ÿ2=0.20, which, according to C. Fritz et al. [17], is considered a large effect): the relative improvement in word recognition in the AM noise condition was greater in TR children than in children with ASD. Thus, the analysis of covariance confirmed the results obtained by the method of paired comparisons: children with ASD, to a lesser extent than children with TD, improved speech recognition due to short pauses of silence in noise. ...
... There was also a significant effect of the Age factor (F(1, 75)=12.08, p<0.001, effect size: ÿ2=0.14, which, according to C. Fritz et al. [17], is considered a large effect), which did not depend on the group (Age*Group: F(1, 75)=0.24, p=0.622). ...
p style="text-align: justify;">Children with autism spectrum disorders (ASD) have more difficulty than typically developing peers understanding speech in noisy environments. Underlying this difficulty may be their decreased noise tolerance and/or difficulty integrating fragments of speech over temporal gaps, which usually present in noise. We investigated the role of these factors in children with ASD with a wide range of cognitive abilities. The sample consisted of 42 children with ASD and 38 typically developing children aged 7–12 years. The participants were asked to repeat two-syllable words presented in the background of noise. Two types of masking were used: stationary noise and amplitude-modulated noise. Intelligence was assessed using the Kaufman Assessment Battery for Children (KABC-II). The results show that children with ASD are worse at recognizing words in stationary noise than typically developing children. Even after adjusting for performance in stationary noise, the presence of gaps in the amplitude-modulated noise improved their performance to a lesser degree than in typically developing children (F<sub>(1,75)</sub>=18.57, p<0.001). Neither performance in stationary noise nor the ability to benefit from gaps in amplitude-modulated noise correlated with IQ in children with ASD (Spearman's coefficients, all p>0.80). We concluded that difficulties with speech perception in noise in children with ASD do not depend on the level of their cognitive abilities and are associated with two separate factors: low noise tolerance and poor temporal integration of phonemes into the auditory word form.</p
... Figure 1 shows the flow chart of selecting the study population. First, we selected adolescents aged 10-15 years who participated in the CFPS survey in 2018 and who were capable to fill in the self-reported questionnaires (n = 2,607) (27). Second, we excluded adolescents whose parents did not have identification information (n = 23). ...
... It has acceptable reliability with Cronbach's alpha coefficient of the internalizing problem dimension as 0.65, and 0.64 for the externalizing problem dimension. The CFPS recommended researchers calculate dimension scores (i.e., the score of the internalizing problem behavior and the score of externalizing problem behavior) and the total score (27). In this study, we have internalizing problem score, externalizing problem score, and total score by adding two scores together. ...
Introduction:
We aimed to assess the associated factors for adolescent depression, problem behavior and cognitive level in China.
Methods:
A total of 2,584 adolescents aged from 10 to 15 years old in 2018 were included for analyses. Information on a comprehensive set of potential determinants was collected by the questionnaire, including demographic, health-, school- and family-related factors. Differences in average scores of depression, problem behavior, and cognitive level across subgroups were assessed by two independent sample t-tests and one-way analysis of variance (ANOVA). The clinical relevance among subgroups was assessed by the effect size. Multivariate linear regression models were applied to identify the statistically significant determinants.
Results:
School-related factors and parental depressive status were strongly associated with depression. Low maternal education, poor/bad health of adolescents, high academic pressure, and parental depression were significantly associated with behavior problems. The socioeconomic factors, poor academic performance and father's depression were significantly associated with adolescent cognitive level.
Discussion:
Multiple associated factors were identified for depression, problem behavior, and cognition of Chinese adolescents, which will provide insights into developing more targeted public health policies and interventions to improve their mental health.
... We used Bonferroni corrected post-hoc tests. The non-parametric effect size (ES) r was calculated and the magnitude of change was evaluated according to Cohen's criteria (0.5 = large, 0.3 = medium, 0.1 = small) [40]. We applied two-tailed tests with the level for statistically significant results at p < 0.05. ...
... When we compared baseline results with follow-up results, we found that all three groups had worsened on the MMSE, with a medium to large effect size according to Cohen's guidelines [40]. Both those who developed iNPH and remained as Unlikely worsened on the Radscale, with a large effect for the prior and small for the latter. ...
Background
Idiopathic normal pressure hydrocephalus (iNPH) is a progressive syndrome affecting gait, incontinence, and cognition in a significant number of older adults. Still, prospective studies on early development of symptoms are scarce.
Aim
To investigate how neuropsychological functions develop before and in already diagnosed iNPH over a two-year period in a population-based material.
Method
A sample of 104 participants (median [IQR] 75 [72–80] years old) from the general population underwent CT-imaging and clinical assessment at baseline and follow-up. We used the iNPH symptom scale covering four domains (Neuropsychology, Gait, Balance, Incontinence) and additional tests of executive functions. Morphological signs were rated with the iNPH Radscale. Non-parametric statistics with Bonferroni corrections and a significance-level of p < 0.05 were used.
Results
Median (IQR) time to follow-up was 25 (23–26) months. Effect size (ES) for individuals who developed iNPH ( n = 8) showed a large (ES r = -0.55) decline in the Gait domain and on the Radscale (ES r = -0.60), with a medium deterioration in declarative memory (ES r = -0.37). Those having iNPH at baseline ( n = 12) performed worse on one executive sub-function i.e., shifting ( p = 0.045).
Conclusion
Besides deterioration in gait and radiology, our results suggest that a neuropsychological trajectory for those developing iNPH includes a reduction in declarative memory. Executive dysfunction was limited to those already having iNPH at baseline. These findings could suggest that memory impairments are included in the early development of iNPH.
... We used Bonferroni corrected post-hoc tests. The non-parametric effect size (ES) r was calculated and evaluated the magnitude of change according to Cohen's criteria (0.5 = large, 0.3 = medium, 0.1 = small) [40]. We applied two-tailed tests with the level for statistically signi cant results at p <0.05. ...
... Results from follow-up are presented in Table 4. When we compared baseline results with follow-up results, we found that all three groups had worsened on the MMSE, with a medium to large effect size according to Cohen's guidelines [40]. Both those who developed iNPH and remained as Unlikely worsened on the Radscale, with a large effect for the prior and small for the latter. ...
Background: Idiopathic normal pressure hydrocephalus (iNPH) is a progressive syndrome affecting gait, incontinence, and cognition in a significant number of older adults. Still, prospective studies on early development of symptoms are scarce.
Aim: To investigate how neuropsychological functions develop before and in already diagnosed iNPH over a two-year period in a population-based material.
Method: A sample of 104 participants (median [IQR] 75 [72–80] years old) from the general population underwent CT-imaging and clinical assessment at baseline and follow-up. We used the iNPH symptom scale covering four domains (Neuropsychology, Gait, Balance, Incontinence) and additional tests of executive functions. Morphological signs were rated with the iNPH Radscale. Non-parametric statistics with Bonferroni corrections and a significance-level of p <0.05 were used.
Results: Median (IQR) time to follow-up was 25 (23–26) months. Effect size (ES) for individuals who developed iNPH (n = 8) showed a large (ES r = -0.55) decline in the Gait domain and on the Radscale (ES r = -0.60), with a medium deterioration in declarative memory (ES r = -0.37). Those having iNPH at baseline (n = 12) performed worse on one executive sub-function i.e., shifting (p = 0.045).
Conclusion: Besides deterioration in gait and radiology, our results suggest that a neuropsychological trajectory for those developing iNPH includes a reduction in declarative memory. Executive dysfunction was limited to those already having iNPH at baseline. These findings could suggest that memory impairments are included in the early development of iNPH.
... We used Bonferroni corrected posthoc tests. The non-parametric effect size (ES) r was calculated [40]. We applied two-tailed tests with the level for statistically signi cant results at p < 0.05. ...
... Results from follow-up are presented in Table 4. When we compared baseline results with follow-up results, we found that all three groups had worsened on the MMSE, with a medium to large effect size according to Cohen's guidelines [40]. Both those who developed iNPH and remained as Unlikely worsened on the Radscale, with a large effect for the prior and small for the latter. ...
Background: Idiopathic normal pressure hydrocephalus (iNPH) is a progressive syndrome affecting gait, incontinence, and cognition in a significant number of older adults. Still, prospective studies on early development of symptoms are scarce.
Aim: To investigate how neuropsychological functions develop before and in already diagnosed iNPH over a two-year period in a population-based material.
Method: A sample of 104 participants (median [IQR] 75 [72–80] years old) from the general population underwent CT-imaging and clinical assessment at baseline and follow-up. We used the iNPH symptom scale covering four domains (Neuropsychology, Gait, Balance, Incontinence) and additional tests of executive functions. Morphological signs were rated with the iNPH Radscale. Non-parametric statistics with Bonferroni corrections and a significance-level of p <0.05 were used.
Results: Median (IQR) time to follow-up was 25 (23–26) months. Effect size (ES) for individuals who developed iNPH (n = 8) showed a large (ES r = -0.55) decline in the Gait domain and on the Radscale (ES r = -0.60), with a medium deterioration in declarative memory (ES r = -0.37). Those having iNPH at baseline (n = 12) performed worse on one executive sub-function i.e., shifting (p = 0.045).
Conclusion: Besides deterioration in gait and radiology, our results suggest that a neuropsychological trajectory for those developing iNPH includes a reduction in declarative memory. Executive dysfunction was limited to those already having iNPH at baseline. These findings could suggest that memory impairments are included in the early development of iNPH.
... The level of significance was set to α ≤ 0.05 (two-sided). Effect sizes were interpreted to be small (r < 0.30), medium (0.30 ≤ r < 0.5) and large (r ≥0.50) [53]. ...
... Cohen's d effect sizes were calculated for t-tests and pairwise comparisons using the formula d = 2t /√(df). For chi-square tests, Phi (φ) coefficients are reported as effect sizes and were calculated using the formula φ = √(X 2 /n) (Fritz et al., 2012;Tomczak & Tomczak, 2014). Effect sizes seven items that are each rated on a Likert-type scale from 0 to 4, with 0 indicating the absence of symptoms and 4 indicating more severe symptoms. ...
IntroductionTrichotillomania is a heterogeneous disorder with a wide range of presentations. Past studies have described the phenomenology of trichotillomania, but individual differences based on the body site from which hair is pulled have not been thoroughly explored. Contextual variables relevant to pulling (e.g., settings, tool use) may vary as a function of pulling site. We constructed a detailed profile of individual and clinical characteristics based on pulling site and describe contextual factors associated with different pulling sites.Methods
Data were drawn from two randomized control trials of psychotherapy for trichotillomania. Participants included treatment-seeking adults with trichotillomania (N = 153; 89% women; Mage=33.41) who took part in either a face-to-face (n = 92) or an online (n = 61) trial. Study 1 explored differences in age, gender, trichotillomania symptom severity, and levels of automatic and focused pulling as a function of pulling site. Study 2 included a subset of Study 1 participants (n = 65) and examined pulling site differences for relevant contextual variables.ResultsStudy 1 revealed differences in age, gender, and level of automatic vs. focused pulling based on pulling site. Study 2 showed that pulling from different bodily sites was more likely to occur in specific settings and with certain tools.DiscussionThese results reflect considerable variability in the phenomenology of trichotillomania across pulling sites and contribute to the overall understanding of trichotillomania. A clearer picture of contextual cues and clinical characteristics for different hair pulling sites has treatment implications. Clinical applications and future research directions are discussed.
... I estimated effect sizes for each individual data set using Hedge's g formula (Hedges, 1981). Ιn order to quantify the overall effect size of TMS, I used the absolute values of the effect sizes in my metaanalysis models (see Fritz et al.,2012;Morrissey, 2016), which has several advantages compared to the use of signed effect sizes. Specifically, absolute effect sizes avoid alternative explanations for the inhibitory and facilitatory TMS effects that were identified and cannot be explored due to the small number of the included studies that restrict me from exploring moderator effects in the analyses. ...
The sensory visual cortex (SVC) is involved in encoding information in visual short-term memory (VSTM). Yet, it remains unclear if the SVC is a necessary component of the brain network necessary for maintaining information in VSTM. The aim of this thesis was to shed light on the debated role of the SVC in VSTM. Thus, I focused on transcranial magnetic stimulation (TMS). TMS uses a coil to transfer electromagnetic stimulation at localized brain areas making the exploration of causal evidence plausible. Through a systematic review and meta-analysis of previous SVC TMS studies I indicated that the SVC is similarly involved in both the encoding and maintenance VSTM phase, and that the controversy was likely due to methodological issues in TMS studies. Building on these findings I conducted two TMS experiments that covered the previous methodological oversights by ensuring the monocular presentation of orientation stimuli. TMS was delivered at different times during the maintenance phase of a delayed change-detection VSTM task, on one side of the occipital hemisphere. Decreased VSTM performance in the ipsilateral occipital hemisphere to visual hemifield, and in the real TMS (compared to sham TMS) condition indicated inhibitory TMS effects, and thus, a causal involvement of the SVC during VSTM maintenance. After establishing the role of the SVC in VSTM maintenance through TMS, I turned to memory load manipulations to further investigate the relationship between short-term memory and perception. I combined short-term memory tasks with perceptual detection tasks, where I manipulated the sensory load of the memory items and measured the effect of this load manipulation on perceptual detection. A combined VSTM and visual perception task provided additional evidence in favor of the sensory recruitment framework, since visual detection was reduced due to the increased VSTM load. Evidence against any cross-modal effects between VSTM and auditory perception was found, and evidence from a combined auditory short-term memory and auditory perception task indicated that sensory recruitment was not supported for the auditory modality. Overall, my findings support the sensory recruitment framework of VSTM, which proposes that sensory visual areas have a dual function: they are involved in the precise sensory encoding of elemental visual features and the short-term maintenance of this information.
... Thus, we have reported effect sizes in the univariate comparisons that measure the strength of the relationship between two variables along with the p values to assess whether the effect of a variable is real and large enough to be useful or not. Cohen's d statistic with sample size adjustment was used for normally distributed continuous variables, Cohen's r value, which is calculated by dividing the z value obtained from the Mann-Whitney test by the square root of the sample size, was used for non-normally distributed variables, and Cramér's V is used for categorical variables (Fritz et al., 2012). For various machine learning applications, confusion matrices were generated. ...
To what extent an individual or group will be affected by the damage of a hazard depends not just on their exposure to the event but on their social vulnerability – that is, how well they are able to anticipate, cope with, resist, and recover from the impact of a hazard. Therefore, for mitigating disaster risk effectively and building a disaster-resilient society to natural hazards, it is essential that policy makers develop an understanding of social vulnerability. This study aims to propose an optimal predictive model that allows decision makers to identify households with high social vulnerability by using a number of easily accessible household variables. In order to develop such a model, we rely on a large dataset comprising a household survey (n = 41 093) that was conducted to generate a social vulnerability index (SoVI) in Istanbul, Türkiye. In this study, we assessed the predictive ability of socio-economic, socio-demographic, and housing conditions on the household-level social vulnerability through machine learning models. We used classification and regression tree (CART), random forest (RF), support vector machine (SVM), naïve Bayes (NB), artificial neural network (ANN), k-nearest neighbours (KNNs), and logistic regression to classify households with respect to their social vulnerability level, which was used as the outcome of these models. Due to the disparity of class size outcome variables, subsampling strategies were applied for dealing with imbalanced data. Among these models, ANN was found to have the optimal predictive performance for discriminating households with low and high social vulnerability when random-majority under sampling was applied (area under the curve (AUC): 0.813). The results from the ANN method indicated that lack of social security, living in a squatter house, and job insecurity were among the most important predictors of social vulnerability to hazards. Additionally, the level of education, the ratio of elderly persons in the household, owning a property, household size, ratio of income earners, and savings of the household were found to be associated with social vulnerability. An open-access R Shiny web application was developed to visually display the performance of machine learning (ML) methods, important variables for the classification of households with high and low social vulnerability, and the spatial distribution of the variables across Istanbul neighbourhoods. The machine learning methodology and the findings that we present in this paper can guide decision makers in identifying social vulnerability effectively and hence let them prioritise actions towards vulnerable groups in terms of needs prior to an event of a hazard.
... To analyze differences between the five main FRA categories (Reinisch & Fricke, 2022) the Kruskal-Wallis test and the Mann-Whitney U test were applied. For the interpretation of the effect size measure, Cohen's d, Cohen's (1988) recommendation of small (d > 0.2), medium (d > 0.5), and large (d > 0.8) effects was applied (Fritz et al., 2012). ...
Studies on the quality of nature of science (NOS) representations in school science textbooks report them being mostly of implicit manner and not fully adequate. However, the often underlying NOS framework of the consensus list in these studies is criticized as undifferentiated and inadequate. The family resemblance approach (FRA) to NOS shows potential to give differentiated insights into the appropriateness of NOS representations with avoidance of specifying certain philosophical directions. Based on a fine-grained differentiated FRA category system (11 main categories, e.g., “knowledge”; 52 subcategories, e.g., “hypotheses”), the quality of cognitive-epistemic NOS representations identified in seven biology school textbooks from Germany was analyzed. For this, a category system was developed. Cognitive-epistemic NOS representations in four chapters of each of the seven textbooks were evaluated regarding manner (implicit, explicit) and adequacy (adequate, (partly) not adequate). Results indicate, among others, that explicit representations of the cognitive-epistemic system of science were mainly placed in the introduction chapters, whereas subject-related chapters include mostly implicit representations. In this article, we present the evaluation of the quality of cognitive-epistemic NOS representations and discuss implications for science education.
... The level of significance was set to α ≤ 0.05 (two-sided). Effect sizes were interpreted to be small (r < 0.30), medium (0.30 ≤ r < 0.5) and large (r ≥0.50) [53]. ...
BACKGROUND
Telerehabilitation is gaining in relevance as a tool to provide and supervise a therapy/ training, which can be equally effective as traditional rehabilitation methods, yet more accessible and affordable. An exergame-based telerehabilitation system was recently developed within the scope of the international COCARE-project. The system comprises training devices for the use in clinics (Dividat Senso) and at home (Dividat Senso Flex), an assessment system, and a rehabilitation-cockpit and its focus lays on a home-based, combined cognitive and physical training, which is remotely managed by healthcare-professionals (HPs).
OBJECTIVE
The present study aimed at analyzing the usability, acceptability, and enjoyment of the whole COCARE-system for use in older adults (OAs).
METHODS
In total, 45 OAs and 15 HPs (15 OAs and 5 HPs in each of the three trial sites (Switzerland, Italy, and Cyprus)) were invited to try out the system in a single session. Mixed methods (qualitative and quantitative questions and questionnaires) were applied to analyze OAs’ and HPs’ perceptions of the system and to figure out possible barriers to its implementation in a home setting. In addition, potential usability-influencing factors (i.e., performance during gameplay, demographics, and training-related contextual factors) were explored.
RESULTS
The COCARE-system received good acceptance ratings (83.2% (OAs) and 81% (HPs) of the maximum score) and OAs indicated high enjoyment (73.3±12.7 out of 100 points in the Exergame Enjoyment Questionnaire) while playing the exergames. The system´s usability, assessed with the System Usability Scale, was rated with a score of 68.1±18.8 (OAs), respectively 70.6±12.2 (HPs) out of 100 points, whereas significant differences between the trial sites were observed. A number of requirements and recommendations for improvement were revealed. Mostly mentioned barriers to adoption included the movement-recognition sensitivity of the Senso Flex, its limited markings, and difficulties understanding certain instructions of assessments and games.
CONCLUSIONS
The results of this study will serve as input to the further development of the COCARE-system towards a user-friendly and accepted version, aiming to stimulate older adult’s cognitive and physical functions. Feasibility and effectiveness of the system should further be evaluated in future randomized controlled trials.
... Now, the result's effect size is also of importance. Handedness had an effect size of 0.376 which is a medium effect size for Cohen's d (Cohen, 1977;Fritz, Morris and Richler, 2012). This also means that 65% of the right handed individuals will be above the mean of the left handed participants. ...
The psychological well-being of an individual is affected by various factors. However, its association with handedness needs to be clarified. To understand the relationship better, data on psychological well-being were collected using the psychological well-being questionnaire from 123 participants. Using the independent samples t-test, ANOVA and ANCOVA, the significance and effect size of various demographic factors and other important influencing factors were calculated. A statistically significant relation was established between handedness and psychological well-being. The handedness of an individual affects psychological well-being along with other demographic factors. Further studies are needed to shed more light on the relations of variables with each other.
... We categorize effect sizes of r ≤ .1 / .3 / .5 as small /medium/large effects [21]. For ranked variables, we computed Spearman Rank-Order correlations, with effect sizes .0-.19 very weak, .20-.39 weak, .40-.59 moderate, .60-.79 strong, .80-1.0 very strong [55]. ...
... Cuando se observaron diferencias significativas, se evaluó el tamaño del efecto a través de la d de Cohen, donde los valores de r de 0,1 a 0,3 se consideraron efectos pequeños, hasta 0,5 medios, y por encima de dicho valor, efectos grandes (Fritz et al., 2012). ...
El objetivo de este trabajo ha sido analizar el efecto de un aprendizaje basado en proyectos, utilizando el método científico, en la enseñanza de los contenidos sobre la luz y los colores y las emociones experimentadas por el alumnado. En la experiencia participaron 32 alumnos de 5.º y 6.º de educación primaria. Se utilizó una metodología cuantitativa, con un diseño preexperimental pretest y postest. Los resultados muestran que hubo un efecto alto al aumentar los conocimientos adquiridos por los estudiantes tras la implementación de la propuesta. La actividad se ha valorado de forma muy positiva, especialmente en las dimensiones de interacción-colaboración y aprendizaje. Además, ha generado emociones positivas con un efecto alto sin modificación de las emociones negativas. Dichos resultados no se vieron influidos por el sexo o el curso al que pertenecían los estudiantes.
... Differences between patients and TDs of normal distributed data were compared with an independent t-test and non-normal distributed data with a Mann-Whitney-U-test (SPSS, 26, IBM Corporation, New York, NY, USA). The effect size r of the anthropometrics and the walking speed was calculated 63 . r > 0.1 described a small effect size, r > 0.3 a medium effect size and r > 0.5 a large effect size 64 . ...
Compressive knee joint contact force during walking is thought to be related to initiation and progression of knee osteoarthritis. However, joint loading is often evaluated with surrogate measures, like the external knee adduction moment, due to the complexity of computing joint contact forces. Statistical models have shown promising correlations between medial knee joint contact forces and knee adduction moments in particularly in individuals with knee osteoarthritis or after total knee replacements (R2 = 0.44–0.60). The purpose of this study was to evaluate how accurately model-based predictions of peak medial and lateral knee joint contact forces during walking could be estimated by linear mixed-effects models including joint moments for children and adolescents with and without valgus malalignment. Peak knee joint moments were strongly correlated (R2 > 0.85, p < 0.001) with both peak medial and lateral knee joint contact forces. The knee flexion and adduction moments were significant covariates in the models, strengthening the understanding of the statistical relationship between both moments and medial and lateral knee joint contact forces. In the future, these models could be used to evaluate peak knee joint contact forces from musculoskeletal simulations using peak joint moments from motion capture software, obviating the need for time-consuming musculoskeletal simulations.
... We used a nonparametric Mann-Whitney U test to compare FEP patients, control subjects and diagnostic subgroups. We calculated effect sizes based on the Mann-Whitney U value (Fritz et al., 2012;Lenhard and Lenhard, 2017), and calculated post-hoc power for group analyses based on the calculated effect sizes using the G*power software (Faul et al., 2007). We performed a Wilcoxon signed-rank test to control for longitudinal within-subject effects between baseline and follow-up. ...
Multiple different cognitive biases, among them the liberal acceptance (LA) bias, have been suggested to contribute to reality distortion in psychotic disorders. Earlier studies have been cross-sectional and considered a limited set of cognitive correlates of psychosis, thus the relationship between LA bias and psychosis remains poorly known. We studied a similar bias (acceptance of the implausible (AOI)) in 62 first-episode psychosis (FEP) patients and 62 control subjects, who watched movie scenes with varying degrees of realism and were asked to evaluate the probability of these events occurring in real life. We assessed theory of mind (ToM) performance using the Hinting task and delusion severity using Brief Psychiatric Rating Scale item 11. We correlated the magnitude of AOI with the severity of delusions and performance in the ToM task. Furthermore, we used 1-year follow-up data from 40 FEP patients and 40 control subjects to disentangle state vs trait-like characteristics of AOI. At baseline FEP patients expressed more AOI than control subjects, and the magnitude of AOI correlated positively with the severity of delusions and negatively with ToM performance. At the one-year follow-up, when most patients were in remission, patients still displayed increased AOI, which no longer correlated with delusions. These findings support the notion that the AOI bias could represent a trait rather than a state feature and support further studies to test the hypothesis that it could be one of the causal factors of psychotic disorders, possibly associated with ToM.
... Due to the non-normal distribution of these data and the small sample size, non-parametric tests were used to examine pre-post differences across variables [33]. Given this was a pilot study underpowered for traditional significance testing, we calculated the within-group effect sizes using methods described by Fritz, Morris and Richler [34]. In order to illustrate the magnitude and direction of cue-induced physiological changes, difference scores were calculated at both time points by subtracting the resting HR mean from the in-vivo exposure mean. ...
... ت حيث �ري � � أث �لتا حجم �لة � � حم�س من �ة � � �لعين �م � � حج �ري � � أث تا �ة � � إز�ل � �م � � يت و94.0 و03.0 �ل�سعيف، أثري للتا و92.0 0.10 بني ما و�ل�سعف �لقوة حيث من أثري �لتا (Corder & Foreman, �لكبري;9002 أثري للتا 0.50 من أكرث و� �ملتو�سط، أثري للتا .،&Fritz et al., 2012) �لقبلي �لقيا�سني يف �لرتب متو�سطات بني للفروق أثري �لتا حجم ح�ساب وعند علي �لربنامج أثري تا �م � � حج كان ،)1( �ملعادل �تخد�م � � با�س �لعقلية �ة � � �ليقظ يف �دي� � و�لبع أثري. للتا كبري حجم على تدل قيمة وهي 0.887 = ES �لعقلية �ليقظة بني للفروق �ري � � أ ...
... The effect size was calculated using the G Power 3.1 Program in the analyzes performed with the Paired Samples T Test. [11] Cohen's d values: [12] Effect Size (d)= 0.20 ≤ small<0.50, 0.50 ≤ medium<0.80 ...
Introduction: Coronavirus disease 2019 (COVID-19) requires a multidisciplinary approach owing to its multisystem involvement. Pulmonary rehabilitation may be required in patients with COVID-19. In our study, we aimed to examine the effect of the pulmonary rehabilitation program applied after the acute period of back pain in patients with severe pulmonary involvement, dyspnea and health profiles of the patients.
Method: In our retrospectively planned study, 50 patients with advanced pulmonary involvement who were treated for COVID-19 and discharged from the hospital and who were diagnosed with shortness of breath, back pain and difficulties in daily living activities in the 1st month chest diseases polyclinic controls and who were given a pulmonary rehabilitation program for a period of
1 month were included in our study. Before and 1 month after the pulmonary rehabilitation program, back pain was evaluated with the VAS, respiratory functions were evaluated with the Modified Medical Research Council Scale, and activities of daily living were evaluated with the Notthingham scale.
Results: A statistically significant difference was found between the beginning and the end of the pulmonary rehabilitation program in the Modified Medical Research Council Scale scores (p
... Además, se analizó la normalidad de la distribución con la prueba Kolmogorov-Smirnov y la homogeneidad de las varianzas entre las distribuciones de hombres y mujeres para cada dimensión de la escala con el test de Levene. Finalmente, para la comparación de rendimiento entre hombres y mujeres en cada una de las subescalas del IRI se utilizó la prueba U de Mann-Whitney y se analizó el tamaño del efecto (r) de acuerdo a lo propuesto por Fritz et al., (2012). Todos los análisis fueron realizados con RStudio versión 1.3.1073 ...
Introducción: Investigaciones previas mostraron el efecto del género sobre las puntuaciones obtenidas por sujetos sanos en la escala de empatía Interpersonal Reactivity Index (IRI). Actualmente, se conoce poco sobre este tema en la población de sujetos adultos de Buenos Aires. Objetivo: Comparar el rendimiento de adultos sanos, de la Ciudad Autónoma de Buenos Aires y Gran Buenos Aires, en una escala de empatía para analizar el efecto que tiene el género sobre dicho rendimiento. Metodología: Se administró la escala IRI a una muestra de 90 participantes (56 mujeres y 34 hombres) para evaluar si existen diferencias en la habilidad empática debido al género. Resultados: Los datos obtenidos indicaron que las mujeres obtuvieron puntuaciones más elevadas en las subescalas Fantasía y Preocupación empática, con un tamaño del efecto pequeño y mediano respectivamente, mientras que no se encontraron diferencias significativas en las subescalas restantes. Conclusiones: Se observan diferencias por género en las puntuaciones de la escala IRI de los individuos que viven en Buenos Aires. Las mujeres se destacaron con respecto a los hombres en la tendencia a identificarse con acciones y sentimientos de personajes ficticios, y en la tendencia a experimentar sentimientos de compasión hacia otros que se encuentran en situaciones desafortunadas.
... The effect sizes of the two-way and three-way interactions were assessed using eta squared. Effect sizes ( 2 ) of 0.01, 0.06, and 0.14 were considered small, medium, or large, respectively ( Fritz et al., 2012 ). Significant effects were further analyzed to assess the source of change using Sidak Analysis. ...
Objective: Parent management training (PMT) is a well-established approach for treating young children's dis-ruptive behavior. This randomized controlled trial (RCT) examined the effectiveness of Positive Parenting for Oppositional Preschoolers (PPOP), an Israeli-developed PMT intervention for treating young children's opposition and accompanying disruptive behaviors. Method: Eighty-five Israeli parental couples (170 individuals: 85 fathers, and 85 mothers) with a 3-6-year-old child exhibiting non-clinical disruptive behavior were randomly assigned to either an 8-session PPOP (N = 42) or a waitlist control group (N = 43). Parents completed measures of child disruptive behavior, parenting stress, and parental self-efficacy before and after the intervention and at a 3-month follow-up. Results: The intervention effects (Cohen's d) were very large for children's disruptive behavior (d = 3.35), par-enting stress (d = 1.78), and self-efficacy (d = 1.32). Improvements were only evident for the PPOP group, and all gains were maintained at follow-up. Participants in the waitlist control group did not report changes in their child's behavior, parenting stress, or parental self-efficacy. PPOP had a very low dropout rate (4.76%) and a very high attendance rate for mothers (100%) and fathers (98.7%). Both parents were highly satisfied with the parent training program. Conclusions: This study provides evidence of the effectiveness of PPOP, a new home-based PMT intervention developed in Israel. In the short and long term, PPOP effectively treats young children's non-clinical disruptive behavior, reduces parenting stress, and increases parental self-efficacy.
... Além disso, o efeito das viagens, necessárias no jogo fora, pode aumentar os níveis de fadiga e, ao mesmo tempo, dificultar a aplicação de métodos de recuperação (Field et al., 2021; foi atribuído um ponto à classificação "não importante" ou "nunca utilizado" e cinco pontos à classificação "extremamente importante" ou "sempre utilizado" (i.e., a menor e a maior posição do ranking, respetivamente). (Cohen, 1988;Fritz et al., 2012). O teste de correlação de Spearman foi também aplicado para determinar o coeficiente de correlação (ρ) entre a ordem de importância e a ordem de utilização dos métodos de recuperação. ...
A adoção de métodos de recuperação tem sido comum no futebol mas a literatura é escassa no que respeita à frequência de utilização, à eficácia na recuperação, ao modo de implementação após o jogo e às recomendações metodológicas.
A presente tese teve como objetivos: i) desenvolver e validar um questionário em língua portuguesa sobre os métodos de recuperação utilizados no futebol; ii) caracterizar as práticas de recuperação adotadas nas 72 horas seguintes ao jogo de futebol; iii) examinar a eficácia dos métodos de recuperação em parâmetros físicos, fisiológicos e percetivos; iv) identificar os modos de aplicação dos métodos de recuperação no final do jogo de futebol, no dia após e dois dias após o jogo.
Para estes propósitos, foram realizados quatro estudos. O ESTUDO 1 consistiu na conceção e validação de um questionário sobre os métodos de recuperação no futebol de elite. O ESTUDO 2 consistiu na aplicação do questionário a equipas de futebol de elite em Portugal. O ESTUDO 3 reviu de forma sistemática a literatura, atribuindo graus de recomendação aos cinco métodos de recuperação mais utilizados no futebol. O ESTUDO 4 apresentou um modelo de priorização, periodização e individualização dos métodos de recuperação após o jogo. Concluiu-se que a frequência de utilização dos métodos de recuperação varia em função do período de recuperação e do local do jogo. Apenas a imersão em água fria, a massagem e o vestuário de compressão apresentam eficácia na recuperação de parâmetros percetivos, sendo que a recuperação dos parâmetros físicos e fisiológicos carece de evidência científica. Desenvolveu-se então um modelo de aplicação prática dos métodos de recuperação após o jogo. Futuras propostas de recuperação assim como estudos com maior qualidade metodológica são necessários de forma a aumentar a eficácia da recuperação após o jogo de futebol, em particular a nível físico e fisiológico.
... The effect size estimate for the Mann-Whitney test ofTable S6, calculated asSt.Test Stat. , is equal to 0.523 for the ABS-CBS comparison and, thus, categorised to be 'large'(Fritz et al., 2012). ...
We propose a novel experimental design aimed at investigating whether inducing individuals to use certain choice procedures has an effect on the outcome of their decision. Specifically, by implementing a modification of the mouse-tracing method, we induce subjects to use either alternative-based or characteristic-based search procedures in a between-subject lottery-choice experiment. We find that encouraging subjects to search by characteristic systematically makes them choose riskier options. Consistently with existing literature, our evidence indicates that individuals typically look up information within alternatives. However, when induced to search by characteristic, high prizes receive more attention, leading individuals to switch to non-compensatory heuristics and – consequently – make riskier choices. Our findings are robust to variations in the complexity of the choice problem and individual differences in risk-attitudes, CRT scores, and gender.
... Ayrıca ölçülen özelliğin ortalamaları arasında anlamlı farklılık olması durumunda bu farklılığın daha kapsamlı incelemek için eta-kare (η 2 ) etki büyüklüğü hesaplanmıştır. Bu hesaplama η 2 = Z 2 / N formülü ile yapılmıştır (Fritz, Morris ve Richler, 2012). Etki büyüklüğü 0,1'den küçük değerler için düşük düzeyde, 0,3 etki büyüklüğü orta düzey ve 0,5'ten büyük değerler için ise yüksek düzeyde açıkladığı anlamına gelmektedir (Coolican, 2009). ...
Bu çalışmada fen bilimleri öğretmenlerinin bağlam temelli üst düzey öğrenme düzeyini ölçen soru maddesi yazma özyeterliği çeşitli değişkenler açısından incelenmiştir. Çalışma nicel kökenli tarama modelindedir. Çalışmanın örneklemini Türkiye’de Millî Eğitim Bakanlığı’na bağlı resmi ortaokullarda görev yapan 492 fen bilimleri öğretmenleri oluşturmaktadır. Veriler elektronik ortam yoluyla araştırmacılar tarafından geliştirilen fen bilimleri öğretmenlerinin bağlam temelli üst düzey öğrenme becerisini ölçen soru yazma özyeterliği ölçeği ile toplanmıştır. Verilerin analizi betimsel istatistik ve fark testleri ile yapılmıştır. Sonuçta fen bilimleri öğretmenlerinin bağlam temelli üst düzey öğrenme becerisini ölçen soru yazma özyeterliği puan ortalamalarının yüksek olduğu kıdem ve öğrenim düzeyi açısından anlamlı fark olmadığı ancak cinsiyet bakımından erkek öğretmenler lehine anlamlı fark olduğu belirlenmiştir. Çalışmanın sonunda öğretmenlere bağlam temeli üst düzey soru yazma eğitim programlarının düzenlenmesi gibi bir dizi öneride bulunulmuştur.
... The agreement of utility scores between the EQ-5D and SF-6D was visually evaluated by the Bland-Altman (B-A) plot. Pearson's [utility score (continuous data)] and Spearman's [dimensions (categorical data)] correlation coefficients were employed to assess the hypothesized associations between the health utility scores and dimensions (e.g., mobility of the EQ-5D and physical functioning of the SF-6D) of the two measures (> 0.3, moderate; > 0.5, strong) [14]. Tobit linear regression models were developed to examine the predictors of socioeconomic factors on the EQ-5D and SF-6D utility scores. ...
Objective
This study assessed patient-reported health-related quality of life (HRQoL) using two generic preference-based measures in Chinese patients with spinal and bulbar muscular atrophy (SBMA) and identified demographic and clinical determinants of health utility scores in this population.
Methods
This study used cross-sectional data of 212 Chinese patients with SBMA who completed both the EQ-5D and SF-6D. Association between response to EQ-5D and SF-6D dimensions was examined using Spearman’s correlation coefficient, and the association between the two utility scores was assessed using Pearson’s correlation coefficient. The variations in utility scores across patients in different subgroups were compared using one-way ANOVA. Bland–Altman (B–A) plot was used to assess the agreement of utility scores between EQ-5D and SF-6D. A multivariate Tobit regression model was employed to estimate the association between utility scores and the presence of symptoms and chronic conditions.
Results
The mean utility scores for the EQ-5D and SF-6D were 0.54 and 0.56, respectively. The hypothesized correlation between the EQ-5D and SF-6D dimensions ranged from 0.31 to 0.58, and the correlation between their utility scores was 0.64. An acceptable agreement between EQ-5D and SF-6D utility scores was identified by B–A plot. Patients with chronic diseases, misdiagnosis, high financial burden, and several clinical symptoms were highly likely to report a low health utility score.
Conclusions
This study is the first to investigate the HRQoL of patients with SBMA worldwide. The estimated health utility scores for EQ-5D and SF-6D can be utilized as baseline data for future cost-utility analyses of SBMA-related interventions.
... Furthermore, we report Ω 2***73-75 , which is a more conservative but conceptually similar measure of overall explanatory power compared to R 2 . Of note, Ω 2 corrects the overestimation of R 2 for population parameters, often resulting in somewhat smaller, more conservative-and less biased-estimates 76,77 . Additionally, following Nakagawa and Schielzeth 69 , we also included AIC and BIC as information criteria indices. ...
Social face evaluation is a common and consequential element of everyday life based on the judgement of trustworthiness. However, the particular facial regions that guide such trustworthiness judgements are largely unknown. It is also unclear whether different facial regions are consistently utilized to guide judgments for different ethnic groups, and whether previous exposure to specific ethnicities in one’s social environment has an influence on trustworthiness judgements made from faces or facial regions. This registered report addressed these questions through a global online survey study that recruited Asian, Black, Latino, and White raters (N = 4580). Raters were shown full faces and specific parts of the face for an ethnically diverse, sex-balanced set of 32 targets and rated targets’ trustworthiness. Multilevel modelling showed that in forming trustworthiness judgements, raters relied most strongly on the eyes (with no substantial information loss vis-à-vis full faces). Corroborating ingroup–outgroup effects, raters rated faces and facial parts of targets with whom they shared their ethnicity, sex, or eye color as significantly more trustworthy. Exposure to ethnic groups in raters’ social environment predicted trustworthiness ratings of other ethnic groups in nuanced ways. That is, raters from the ambient ethnic majority provided slightly higher trustworthiness ratings for stimuli of their own ethnicity compared to minority ethnicities. In contrast, raters from an ambient ethnic minority (e.g., immigrants) provided substantially lower trustworthiness ratings for stimuli of the ethnic majority. Taken together, the current study provides a new window into the psychological processes underlying social face evaluation and its cultural generalizability.
Protocol registration
The stage 1 protocol for this Registered Report was accepted in principle on 7 January 2022. The protocol, as accepted by the journal, can be found at: https://doi.org/10.6084/m9.figshare.18319244.
According to the ecological model of female social
relationships (EMFSR), within-group competition and
between-group competition in female-bonded species are
shaped by food distribution. Strong between-group contests
are expected over large, monopolizable resources and high
population density, but not when low-quality food is
distributed across large, undefended home ranges. Within-group contests are expected to be more frequent with
increasing heterogeneity among feeding sites and with group
size. We tested these predictions in female Asian elephants,
which show traits associated with infrequent contests—
graminivory, high fission–fusion and overlapping home
ranges. We examined how food distribution and competitor
density affected agonistic interactions within and between
female elephant clans (social groupings) in the Kabini
grassland, southern India. We found stronger between-clan
contest in the grassland than that known from neighbouring
forests, and more frequent agonism between females between
clans than within clans. Such strong between-clan contest
was attributable to the grassland being a food-rich habitat
patch, thus supporting the EMFSR. Within-clan agonism was
also frequent, but did not increase with food heterogeneity,
contradicting the EMFSR. Contrary to recent claims,
increasing within-clan agonism with group size suggested
ecological constraints on large groups despite high fission–
fusion. High population density may explain such frequent
contests despite graminivory and fission–fusion.
The development of civilization and technological advances have led to fundamental changes in the use of marketing tools. The evolution of the concept from Marketing 1.0 to Marketing 5.0 has contributed to a change in the perception of the role of modern technologies in advertising. This is reflected, among other things, in the change in the structure of advertising expenditures. It is important to note that in 2021, for the first time, Internet advertising accounted for the largest share of the overall advertising expenditure. The evolution of online advertising is characteristic – from traditional display formats, through mailing, to more and more sophisticated forms of advertising in social media. The purpose of the chapter is to analyze the perception of online advertising and its impact on Generation Z consumers. The considerations contained in this paper are based on the findings of a survey conducted among Polish Internet users, representatives of Generation Z, which was carried out in 2022. The results showed Generation Z’s relatively high criticism towards online
advertising. It appears that the representatives of this generation are critical of the number of online ads and reluctant to respond to them. Also, they do not value highly their motivational qualities or
recognize the impact they may exert on purchase decisions. At the same time, it is worth noting that women surveyed in the study present a more positive attitude in this case. They are less skeptical of online advertising activities (or at least express less critical opinions about them). This is particularly true in the case of social media advertising: it performs better compared to other forms of online advertising, primarily due to the greater involvement of young people in social media.
New methodologies are becoming especially important in the training of future teachers. Traditional lectures at the University are being left behind, for teachers to acquire a more theoretical-practical orientated method that allows them to implement and apply new learning strategies and active methodologies in the classroom. It is time to transform conventional methodologies in university classrooms, with very theoretical nuance, towards a new reality with more practical content for the benefit of future teachers.
This study analyses the learning context of students in the second year of the Bachelor’s degree in Early Childhood Education in terms of motivation, interest and learning in the subject “Early Learning of the Foreign Language: English”, applying Project Based Learning (PBL) to the university classroom.
The research is based on a qualitative questionnaire and is completed with personal interviews with a sample of several groups of undergraduate students in the last two academic years. The results reflect excellent levels of motivation and learning, as well as the acquisition of strategies and teaching skills for teaching foreign language in Early Childhood Education. According to the results obtained, there is evidence that Project Based Learning implemented with ICT facilitates active participation, competences ́ development, social skills and improvement in the acquisition of content by student teachers.
During the lockdowns associated with the COVID-19 pandemic, many people tried to compensate for limited face-to-face interaction by increasing digital communication. Results of a four-week experience sampling study in the German-speaking countries (N = 411 participants; k = 9791 daily questionnaires) suggest, however, that digital communication was far less relevant for lockdown mental health than face-to-face communication. Digital text-based communication (e.g., e-mail, WhatsApp, SMS) nevertheless was meaningfully associated with mental health, and both face-to-face and digital text communication were more predictive of mental health than either physical or outdoor activity. Our results underscore the importance of face-to-face communication for mental health. Our results also suggest that videoconferencing was only negligibly associated with mental health, despite providing more visual and audible cues than digital text communication.
Significance tests play a very important role in the scientific community, and the biomedical research community is not an exception. This is due, on the one hand, to the widespread use of the test in scientific methodology and the corresponding frequency of its application in research, and, on the other hand, to the general misinterpretation of the results obtained using this method. Misunderstanding of significance testing in academia and erroneous conclusions in research, regardless of the scientific field, are at the root of the distrust of this statistical method. This article aims to give insight into the relevance of this kind of method in the biomedical field and find a theoretical explanation for this phenomenon, and subsequently regulate the correct interpretation of the null hypothesis significance test (NHST), as well as consider alternative statistical methods. In addition, some relevant empirical studies from a geographical and multidisciplinary perspective will be presented to determine the real extent of misspecification at the academic level. In this way, both practical and theoretical arguments will be applied to address the problem of NHST at multiple levels.
Objectives:
Caregivers of adult phase 1 oncology trial patients experience high levels of distress and face barriers to in-person supportive care. The Phase 1 Caregiver LifeLine (P1CaLL) pilot study assessed the feasibility, acceptability, and general impact of an individual telephone-based cognitive behavioral stress-management (CBSM) intervention for caregivers of phase I oncology trial patients.
Methods:
The pilot study involved 4 weekly adapted CBSM sessions followed by participant randomization to 4 weekly cognitive behavioral therapy sessions or metta-meditation sessions. A mixed-methods design used quantitative data from 23 caregivers and qualitative data from 5 caregivers to examine the feasibility and acceptability outcomes. Feasibility was determined using recruitment, retention, and assessment completion rates. Acceptability was assessed with self-reported satisfaction with program content and participation barriers. Baseline to post-intervention changes in caregiver distress and other psychosocial outcomes were assessed for the 8-session intervention.
Results:
The enrollment rate was 45.3%, which demonstrated limited feasibility based on an a priori criterion enrollment rate of 50%. Participants completed an average of 4.9 sessions, with 9/25 (36%) completing all sessions and an 84% assessment completion rate. Intervention acceptability was high, and participants found the sessions helpful in managing stress related to the phase 1 oncology trial patient experience. Participants showed reductions in worry and isolation and stress.
Significance of results:
The P1CaLL study demonstrated adequate acceptability and limited feasibility and provided data on the general impact of the intervention on caregiver distress and other psychosocial outcomes. Caregivers of phase 1 oncology trial patients would benefit from supportive care services; a telephone-based intervention may have more utilization and thus make a larger impact.
This study investigates Korean-Canadian children’s bilingual learning in the context of a community-based heritage language classroom. Due to a request made by the focus teacher, the author’s positionality shifted from an observer to a participant observer, resulting in collaborative activity planning and implementation. Using
classroom observations, interviews with the focus teacher, and children’s artefacts as data sources, this study examines how pedagogical changes alter heritage language learners’ engagement and interactions in classroom activities. This study showcases how translanguaging can be utilized to create new pedagogical possibilities in a heritage language classroom. Based on the findings, the author conceptualizes the continuum of classroom interactions with regards to linguistic, cultural, pedagogical, and socio-affective areas.
This study aimed to reinvestigate the skull morphometric variation among North American populations while attempting to unveil underlying causal factors. Skull shape showed within-population variations but provided evidence for a high morphological affinity among populations. Significant size-related differentiation was revealed within and among populations. Skull size could be related to three insulin-like growth factor-1 gene (IGF-1) alleles. Ecological conditions accounted for most of the skull size variation. In contrast, no evidence of geographical isolation of populations was detected. This study calls into question the validity of previously recognized species and subspecies.
Cognitive fatigue is defined by a reduced capacity to perform mental tasks. Despite its pervasiveness, the underlying neural mechanisms remain elusive. Specifically, it is unclear whether prolonged effort affects performance through alterations in overworked task-relevant neuronal assemblies. Our paradigm based on repeated passive visual stimulation discerns fatigue effects from the influence of motivation, skill and boredom. We induced performance loss and observed parallel alterations in the neural blueprint of the task, by mirroring behavioral performance with multivariate neuroimaging techniques (MVPA) that afford a subject-specific approach. Crucially, functional areas that responded the most to repeated stimulation were also the most affected. Finally, univariate analysis revealed clusters displaying significant disruption within the extrastriate visual cortex. In sum, here we show that repeated stimulation impacts the implicated brain areas' activity and causes tangible behavioral repercussions, providing evidence that cognitive fatigue can result from local, functional, disruptions in the neural signal induced by protracted recruitment.
Background
Femoroacetabular impingement (FAI) in patients with dysplasia presents a unique challenge to surgeons. Short-term outcomes are conflicting, while longer term follow-up data are only emerging.
Purpose
To quantify midterm (minimum 5-year follow-up) outcomes after the arthroscopic correction of FAI in the presence of lateral rim dysplasia compared with a matched control group with FAI with normal acetabular coverage.
Study Design
Cohort study; Level of evidence, 3.
Methods
Prospective outcome data, collected in a consecutive series of patients undergoing arthroscopic FAI correction with lateral rim dysplasia (lateral center-edge angle [LCEA] of 13°-25°), were reviewed (N = 75 cases). An age- and sex-matched control group of 120 cases was also formed (LCEA >25°). Survivorship was defined as the avoidance of total hip replacement and assessed using a Kaplan-Meier curve with the log-rank test. Survival rates and patient-reported outcome measure (PROM) scores (modified Harris Hip Score [mHHS], University of California, Los Angeles [UCLA], 36-Item Short Form Health Survey [SF-36], and Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] preoperatively and at 5 years postoperatively) were compared between the groups. The proportion of patients across groups achieving the minimal clinically important difference (MCID) was compared for each PROM. The dysplasia group was also analyzed independently to identify any factors that may indicate a less favorable outcome using regression analysis. The group was divided into 2 subgroups: borderline dysplasia (LCEA of 20°-25°) and severe dysplasia (LCEA <20°).
Results
The survival rate in the dysplasia group was 97%. There was no statistical difference with respect to survival rates or any PROM scores ( P > .05 for all) between the groups. There were similar rates of achieving the MCID between the groups for the mHHS, UCLA, and WOMAC. The FAI control group had a higher rate of achieving the MCID for the SF-36 ( P = .012; effect size = 0.274 [small]). Subgroup analysis indicated a lower survival rate (78% vs 100%, respectively; P < .001) in female cases in the dysplasia group (n = 9) compared with male cases in the dysplasia group (n = 66). The UCLA score in female cases in the dysplasia group at 5 years was statistically lower compared with that in male cases in the dysplasia group (6 vs 10, respectively; P = .003; effect size = 0.378 [medium]), but no other outcome revealed any differences between the sexes. There were also no variables identified on regression analysis that accurately predicted a poorer outcome in the dysplasia group. When stratified by severity, there was no difference in survivorship or outcomes between those with severe dysplasia (LCEA <20°; n = 11) and those with borderline dysplasia (LCEA of 20°-25°; n = 64).
Conclusion
An arthroscopic intervention was a successful treatment option for FAI in the presence of lateral rim dysplasia at midterm follow-up. Irrespective of the severity of dysplasia, patients can expect similar improvements to those in patients with normal femoral head coverage.
Aim:
Temporal lobe epilepsy is a neurological network disease in which genetics played a greater role than previously appreciated. This study aimed to explore shared functional network abnormalities in patients with sporadic temporal lobe epilepsy and their unaffected siblings.
Methods:
Fifty-eight patients with sporadic temporal lobe epilepsy, 13 unaffected siblings, and 30 healthy controls participated in this cross-sectional study. We examined the task-based whole-brain functional network topology and the effective functional connectivity between networks identified by group-independent component analysis.
Results:
We observed increased global efficiency, decreased clustering coefficiency, and decreased small-worldness in patients and siblings (p < 0.05, false discovery rate-corrected). The effective network connectivity from the ventral attention network to the limbic system was impaired (p < 0.001, false discovery rate-corrected). These features had higher prevalence in unaffected siblings than in normal population and was not correlated with disease burden. In addition, topological abnormalities had a high intraclass correlation between patients and their siblings.
Conclusion:
Patients with temporal lobe epilepsy and their unaffected siblings showed shared topological functional disturbance and the effective functional network connectivity impairment. These abnormalities may contribute to the pathogenesis that promotes the susceptibility of seizures and language decline in temporal lobe epilepsy.
Taking advice from others requires confidence in their competence. This is important for interaction with peers, but also for collaboration with social robots and artificial agents. Nonetheless, we do not always have access to information about others’ competence or performance. In these uncertain environments, do our prior beliefs about the nature and the competence of our interacting partners modulate our willingness to rely on their judgments? In a joint perceptual decision making task, participants made perceptual judgments and observed the simulated estimates of either a human participant, a social humanoid robot or a computer. Then they could modify their estimates based on this feedback. Results show participants’ belief about the nature of their partner biased their compliance with its judgments: participants were more influenced by the social robot than human and computer partners. This difference emerged strongly at the very beginning of the task and decreased with repeated exposure to empirical feedback on the partner’s responses, disclosing the role of prior beliefs in social influence under uncertainty. Furthermore, the results of our functional task suggest an important difference between human–human and human–robot interaction in the absence of overt socially relevant signal from the partner: the former is modulated by social normative mechanisms, whereas the latter is guided by purely informational mechanisms linked to the perceived competence of the partner.
Background
Music therapy (MT) has been shown to improve outcomes for patients with sickle cell disease (SCD) and patients with hematologic and/or oncologic conditions excluding SCD (HemOnc) in prior randomized trials. While few studies have described the clinical delivery (ie, volume, clinical settings, patient characteristics, referrals, and session characteristics) of MT and examined its real-world effectiveness, no studies have compared responses between hematology/oncology populations. The purpose of this study was to examine the clinical delivery and effectiveness of MT at a freestanding academic cancer center and compare the effectiveness of MT on pain, anxiety, and fatigue between adult patients in the HemOnc and SCD groups.
Methods
A retrospective review was conducted of all MT sessions provided at a freestanding academic cancer center between January 2017 and July 2020. The unadjusted single-session effects of MT on pain, anxiety, and fatigue were assessed among patients reporting symptoms ≥1 out of 10 on a 0 to 10 scale. Adjustments were made for multiple sessions on the same patient using a mixed model to compare pre-session and change scores between the HemOnc and SCD groups. Patients’ comments were analyzed using conventional qualitative content analysis.
Results
Music therapists provided 4002 sessions to 1152 patients including 1012 in the HemOnc group and 140 in the SCD group. In the combined sample, statistically significant reductions in pain (1.48 units), anxiety (2.58 units), and fatigue (0.84 units) were observed, with changes in pain and anxiety exceeding clinically significant thresholds. After adjustment, the SCD group reported significantly greater pre-session pain (7.22 vs 5.81) and anxiety (6.11 vs 5.17) as well as greater anxiety reduction (2.89 vs 2.23) than the HemOnc group. Patients’ comments contained themes including enjoyment, gratitude, and improvements in mood, pain, and anxiety.
Conclusions
This study supports the delivery and clinical effectiveness of MT for addressing the needs of patients throughout their course of treatment at an academic cancer center and justifies the inclusion of individuals with SCD within integrative oncology services.
Objective:
Interictal spikes help localize seizure generators as part of surgical planning for drug-resistant epilepsy. However, there are often multiple spike populations whose frequencies change over time, influenced by brain state. Understanding state changes in spike rates will improve our ability to use spikes for surgical planning. Our goal was to determine the effect of sleep and seizures on interictal spikes, and to use sleep and seizure-related changes in spikes to localize the seizure onset zone.
Methods:
We performed a retrospective analysis of intracranial EEG data from patients with focal epilepsy. We automatically detected interictal spikes and we classified different time periods as awake or asleep based on the ratio of alpha to delta power, with a secondary analysis using the recently published SleepSEEG algorithm. We analyzed spike rates surrounding sleep and seizures. We developed a model to localize the seizure onset zone using state-dependent spike rates.
Results:
We analyzed data from 101 patients (54 women, age range 16-69). The normalized alpha-delta power ratio accurately classified wake from sleep periods (area under the curve = 0.90). Spikes were more frequent in sleep than wakefulness and in the postictal compared to the preictal state. Patients with temporal lobe epilepsy had a greater wake-to-sleep and pre-to-postictal spike rate increase compared to extra-temporal epilepsy. A machine-learning classifier incorporating state-dependent spike rates accurately identified the seizure onset zone (area under the curve = 0.83). Spike rates tended to be higher and better localize the seizure onset zone in NREM sleep than in wake or REM sleep.
Significance:
The change in spike rates surrounding sleep and seizures differs between temporal and extratemporal lobe epilepsy. Spikes are more frequent and better localize the seizure onset zone in sleep, particularly in NREM sleep. Quantitative analysis of spikes may provide useful ancillary data to localize the seizure onset zone and improve surgical planning.
Background and purpose
The aim of this study was to explore the effectiveness of manual therapy as an adjunctive treatment to usual care in females severely affected with chronic migraine.
Methods
This was a pragmatic, randomised controlled trial (RCT) in a tertiary headache clinic in the UK. Sixty-four female participants with severe chronic migraine were randomised into two groups: Onabotulinum A (Botox TM) and Botox TM with manual therapy. The Botox TM was given to both groups at the start on a 12-week schedule. The manual therapy was a combination of mobilisation, manipulation and soft tissue release technique and was given 5 times over 12 weeks. The RCT consisted of 3 months intervention with primary outcome measures taken at the end of the study period.
The primary outcome was the between-group difference in change scores using the Headache Impact Test (HIT6). Secondary outcomes were Patient Global Impression of Change (PGIC) and responder rates.
Results
The primary outcome favoured the use of manual therapy as an adjunct to usual tertiary care over usual tertiary care (BotoxTM)alone with a significant difference in between-group HIT6 change scores (p=0.006, d=0.51) The manual therapy group also had significantly more responders based on HIT6 (p=0.006) and PGIC (p= 0.002) outcomes.
Conclusions
This study has found that manual therapy is an effective adjunct to the usual tertiary care (BotoxTM) of chronic migraine in women.
Trial Registration
The trial received a favourable opinion from the UK Health Research Authority (IRAS 228901) and is registered at ClinicalTrials.gov.number NCT03395457. Registered 1st March 2018.
Objective:
Pediatric epilepsy surgery promises seizure freedom or even cure of epilepsy. We evaluated the long-term (≥10 years) adult clinical outcome including surgery-related adverse events and complications, which are generally underreported.
Methods:
A monocentric, single-arm, questionnaire study in now adult patients who underwent epilepsy surgery during childhood. A novel ad hoc parental/patient questionnaire, which addressed diverse outcome domains was applied.
Results:
From a total of 353 eligible patients, 203 could be contacted (3 patients died of causes unknown) and 101 (50%) returned appropriately filled-in surveys. No evidence for a survey-response bias was found. The rate of surgical complications according to the patient records was 9%. As regards the survey, half of the parents/patients reported surgical adverse events (expected and unexpected issues) and one-third reported permanent aversive sequels. Two-thirds of the patients were seizure-free during the last year before follow-up; 63% were Engel class 1A; favorable seizure outcomes (including auras only) were obtained in 73%; and 54% were seizure-free and off antiseizure medicine (ASM), that is, cured of epilepsy. In non-seizure-free patients, seizure relapse occurred at any time during the follow-up interval but 87% of those with a seizure-free first postoperative year were seizure-free at follow-up. One patient experienced a seizure relapse during the ASM withdrawal trial but became seizure-free again with ASMs. Eleven patients reported an increased number of ASMs as compared to the time before surgery. Earlier focal surgery did not affect the long-term clinical outcome.
Significance:
Pediatric epilepsy surgery was capable of curing epilepsy in about one-half of the children and to significantly control seizures in about three-fourths. Long-term success of focal surgery did not depend on age at surgery or duration of epilepsy. Surgical adverse events including complications may be underreported and must be assessed more thoroughly.
Background
Effective multicomponent interventions in the community targeted at preventing frailty in at-risk older adults can promote healthy ageing. However, there is a lack of studies exploring the effectiveness of technology-enabled autonomous multi-domain community-based interventions for frailty. We developed a novel end-to-end System for Assessment and Intervention of Frailty (SAIF) with exercise, nutrition, and polypharmacy components. This pilot study aimed to explore SAIF’s effectiveness in improving frailty status, physical performance and strength, and its usability in pre-frail older adults.
Materials and methods
This is a single arm 8-week pilot study in 20 community-dwelling older adults who were pre-frail, defined using the Clinical Frailty Scale (CFS) as CFS 3 + (CFS 3 and FRAIL positive) or CFS 4. For outcomes, we assessed frailty status using the modified Fried Frailty Phenotype (FFP) and CFS; physical performance using Short Physical Performance Battery (SPPB); and Hand Grip Strength (HGS) at baseline and 8-week. User experience was explored using the System Usability Scale (SUS), interest-enjoyment subscale of the Intrinsic Motivation Inventory and open-ended questions. We analyzed effectiveness using repeated-measures tests on pre-post scores, and usability using a convergent mixed-method approach via thematic analysis of open-ended responses and descriptive statistics of usability/interest-enjoyment scales.
Results
Sixteen participants (71.8 ± 5.5 years) completed the 8-week study. There was a significant improvement in FFP score (−0.5, p < 0.05, effect size, r = 0.43), but not CFS (−1.0, p = 0.10, r = 0.29). Five (31.3%) improved in frailty status for both FFP and CFS. SPPB (+1.0, p < 0.05, r = 0.42) and HGS (+3.5, p < 0.05, r = 0.45) showed significant improvements. Three themes were identified: “Difficulty in module navigation” (barriers for SAIF interaction); “User engagement by gamification” (facilitators that encourage participation); and “Perceived benefits to physical health” (subjective improvements in physical well-being), which corroborated with SUS (68/100) and interest-enjoyment (3.9/5.0) scores. Taken together, user experience results cohere with the Senior Technology Acceptance and Adoption Model.
Conclusion
Our pilot study provides preliminary evidence of the effectiveness of SAIF in improving frailty status, physical performance and strength of pre-frail older adults, and offers user experience insights to plan the follow-up large-scale randomized controlled trial.
Background:
Referral for kidney transplantation is influenced by patient education; digital technologies can enhance broad information accessibility. This single-group study tested the feasibility and acceptability of patient-centered self-directed educational animated videos to improve mediators of kidney transplant referral.
Methods:
Community-based adults with chronic kidney disease stage ≥4 invited from a clinical registry viewed eight sequential videos (19:36 min total duration) remotely on their own device. Change in kidney transplant knowledge, concerns, and confidence talking about kidney transplantation to doctors was assessed with self-report surveys before and immediately after viewing. Program feedback was assessed by survey and self-selected exit interview.
Results:
Viewers of the video set (n = 50) demonstrated increases in mean kidney transplantation knowledge by +22%, confidence discussing with their doctor by +6%, and reductions in concerns by -2%. Knowledge results were consistent across age, race, and literacy level. Over 90% indicated positive ratings on understanding, engaging, and helpfulness. In post-study interviews viewers indicated the videos promoted confidence in obtaining a kidney transplant and none reported that the 19-min duration of the home education was too long.
Conclusion:
The animated video education is promising to improve diverse individuals' knowledge, concerns, and communication confidence about kidney transplantation and is highly acceptable. This article is protected by copyright. All rights reserved.
1. Socioecological theory attributes variation in social organization of female-bonded species to differences in within- and between-group competition, shaped by food distribution. Strong between-group contests are expected over large, monopolisable resources, and are not generally expected in species that feed on low quality resources distributed across large, undefended home ranges. Within groups, frequent contests are expected over discrete feeding sites but not over low-quality, dispersed resources.
2. We report on the first tests of socioecological theory, largely unexplored in non-primate species, in female Asian elephants. Asian elephants show graminivory, overlapping home ranges, and high fission-fusion dynamics, traits that are thought to be associated with infrequent contests.
3. We studied agonistic interactions within and between female elephant clans with respect to food distribution, food abundance, and competitor density effects of group size and clan density, in a grassland habitat around the Kabini backwaters, southern India.
4. We found that the Kabini grassland had three times the grass biomass as adjacent forests, and between-clan encounters were considerably higher than that known from a neighbouring forest. Individual-level agonism was also more frequent between clans than within clans. Thus, the food-rich habitat patch probably enabled strong between-clan contest competition under graminivory. Moreover, the rate of between-clan encounters increased when more clans were present, and the duration of encounters was positively related to grass biomass at the contested sites. Despite fission-fusion dynamics, within-clan agonism was also somewhat frequent, but not influenced by food distribution, in contradiction to classic socioecological predictions, possibly because of intensified competition due to high density. Interestingly, within-clan agonism increased with female group size until intermediate group sizes, suggesting that the tension between within-group and between-group competition might govern group size, since larger groups are advantageous in this strong between-clan contest regime.
5. Our findings refine the current understanding of female elephant socioecology. Despite predominant graminivory and fission-fusion dynamics, within-group agonism can be frequent, especially when large groups face ecological constraints at high density. Further, frequent between-group contests may arise despite graminivory and non-territoriality when food becomes patchy and density is high. These changes may be effected by anthropogenic alteration of habitats.
Older adults from underrepresented racial and ethnic backgrounds and with low vision have independently been found to be at an increased risk of depression. This retrospective cross-sectional pilot study found that non-White older adults with low vision reported significantly more depressive symptoms than White older adults with low vision (P = .005). When controlling for diagnosis and functional impairment, the relationship was no longer significant. Older adults with low vision from underrepresented racial and ethnic groups may be more at risk for depression than White older adults with low vision, with comorbid visual conditions potentially contributing to this relationship.
Background:
Functioning in children consists of different aspects, including their ability to execute activities and participate in life situations. Several studies on children with clubfeet showed limited motor abilities and walking capacity compared with healthy control children, while other studies showed comparable athletic abilities and gross motor development. Although participation in activities of daily life plays an important role in the development of children, this has not yet been investigated in children with clubfeet. The study aims to determine the level of parents' perceived motor ability and participation in Ponseti-treated children with clubfeet compared with age-matched healthy controls.
Methods:
Parents of children aged 5 to 9 years with and without idiopathic Ponseti-treated clubfeet were asked to complete an online questionnaire about their child's motor abilities and participation level using the Dutch version of the Assessment of Life Habits for Children (LIFE-H) version 3 to assess participation and the Dutch Movement Assessment Battery for Children-2 Checklist (MABC-2 Checklist) to assess motor abilities. Statistical analysis focused on differences between groups and the relationship between motor abilities and level of participation.
Results:
Questionnaires of 86 children with clubfeet (mean age 7.1, 73% boys) and 62 controls (age 6.7, 53% boys) were analyzed. Despite a large variation, results showed no significant differences between groups on the total scores of the LIFE-H and the MABC-2 Checklist. Children with clubfeet, however, scored lower on Mobility and better on the categories Communication and Responsibility of the LIFE-H. Furthermore, children with clubfeet showed lower scores on the MABC-2 Checklist subscale "movement in a static and/or predictable environment." High levels of the parents' perceived participation correlate with good results, as perceived by the parents, in motor ability.
Conclusions:
Although differences on some aspects of motor ability and participation existed, children with clubfeet in general showed high levels of parents' perceived motor ability and participation. High levels of participation correlated with good results in motor ability.
Level of evidence:
Level II.
Patient engagement during inpatient rehabilitation is an important component of rehabilitation therapy, as lower levels of engagement are associated with poorer outcomes. Cognitive deficits may impact patient engagement during inpatient stroke rehabilitation. Here, we assess whether patient performance on the cognitive tasks of the 30-min National Institute of Neurologic Disorders and Stroke - Canadian Stroke Network (NINDS-CSN) screening battery predicts engagement in inpatient stroke rehabilitation. Prospective data from 110 participants completing inpatient stroke rehabilitation at an academic medical center were utilized for the present analyses. Cognitive functioning was assessed at inpatient stroke rehabilitation admission using the NINDS-CSN cognitive battery. Patient engagement was evaluated at discharge from an inpatient rehabilitation unit using the Hopkins Rehabilitation Engagement Rating Scale. The results demonstrate that the NINDS-CSN cognitive battery, specifically subtests measuring executive functioning, attention and processing speed, predicts patient engagement in inpatient stroke rehabilitation. Cognitively impaired patients undergoing rehabilitation may benefit from modifications and interventions to increase engagement and improve functional outcomes.
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