Effect Size Guidelines for Individual and Group Differences in Physiotherapy.

Most common preventive eccentric-based exercises, such as Nordic hamstring do not include any hip flexion. So, the elongation stress reached is lower than during the late swing phase of sprinting. The aim of this study was to assess the evolution of hamstring architectural (fascicle length and pennation angle) and functional (concentric and eccentric optimum angles and concentric and eccentric peak torques) parameters following a 3-week eccentric resistance program performed at long (LML) vs. short muscle length (SML). Both groups performed eight sessions of 3–5 × 8 slow maximal eccentric knee extensions on an isokinetic dynamometer: the SML group at 0° and the LML group at 80° of hip flexion. Architectural parameters were measured using ultrasound imaging and functional parameters using the isokinetic dynamometer. The fascicle length increased by 4.9% (p < 0.01, medium effect size) in the SML and by 9.3% (p < 0.001, large effect size) in the LML group. The pennation angle did not change (p = 0.83) in the SML and tended to decrease by 0.7° (p = 0.09, small effect size) in the LML group. The concentric optimum angle tended to decrease by 8.8° (p = 0.09, medium effect size) in the SML and by 17.3° (p < 0.01, large effect size) in the LML group. The eccentric optimum angle did not change (p = 0.19, small effect size) in the SML and tended to decrease by 10.7° (p = 0.06, medium effect size) in the LML group. The concentric peak torque did not change in the SML (p = 0.37) and the LML (p = 0.23) groups, whereas eccentric peak torque increased by 12.9% (p < 0.01, small effect size) and 17.9% (p < 0.001, small effect size) in the SML and the LML group, respectively. No group-by-time interaction was found for any parameters. A correlation was found between the training-induced change in fascicle length and the change in concentric optimum angle (r = −0.57, p < 0.01). These results suggest that performing eccentric exercises lead to several architectural and functional adaptations. However, further investigations are required to confirm the hypothesis that performing eccentric exercises at LML may lead to greater adaptations than a similar training performed at SML.

The survey research reported in this paper aimed to show how foreign language teachers’ (N = 69) self-efficacy beliefs and concerns related to implementing inclusive instructional practices with learners with dyslexia, as well as their attitudes to inclusion in foreign language education, change as a result of the teachers’ participation in an intensive face-to-face course on dyslexia and foreign language teaching. The pre-post comparisons identified a statistically significant improvement in self-efficacy beliefs and attitudes, with large and medium effect sizes, respectively, as well as a decrease in concerns, with a small effect size. Moreover, the perceived level of knowledge of dyslexia reported by course participants after the course increased significantly compared to pre-course knowledge, with a large effect size. The perceptions of knowledge were crucially related to pre-course self-efficacy beliefs and concerns, as well as to post-course self-efficacy beliefs. The impact of several background variables on self-efficacy beliefs, concerns and attitudes was investigated. We found no significant effects of general teaching experience, experience in teaching learners with dyslexia, teaching context (country), full-time employment and level of education on self-efficacy beliefs and attitudes both before and after the course. The initial effect of previous training on self-efficacy beliefs disappeared in the post-course questionnaire. No significant effects of previous training were observed for pre-course and post-course concerns and attitudes. The initial effect of level of education and experience in teaching a foreign language to learners with dyslexia on concerns disappeared in the post-course questionnaire. Teaching context (country) and full-time employment differentiated participants with regard to how concerned they were about implementing inclusive teaching before the course, and these differences persisted after the course. Age differentiated participants in the attitudes to inclusion they held before the course, but this difference disappeared after the course. Finally, teacher trainers differed significantly from other course participants regarding pre-course self-efficacy and post-course concerns, with a small to medium effect size.

A study published in 2001 reported that sample sizes in the randomized controlled trials (RCTs) published in major orthopaedic journals in 1997 were too small, resulting in low power to detect reasonable effect sizes. Low power is the fundamental reason for the poor reproducibility of research findings and serves to erode a cornerstone of the scientific method. The aim of this study was to ascertain whether improvements have been made in orthopaedic research during the past 2 decades. The electronic table of contents from the 2016 and 2017 volumes of 7 major orthopaedic journals were searched issue by issue in chronological order to identify possible RCTs. A posteriori (after-the-fact) power to detect small, medium, and large effect sizes, defined by the Cohen d value, were calculated from the sample sizes reported in the studies. The power to detect effect sizes associated with the most commonly used patient-reported outcome measures (PROMs) was also calculated. Finally, the use of a priori power analysis in the included studies was assessed. In total, 233 studies were included in the final analyses. None of the negative studies had sufficient power (≥0.80) to detect a small effect size. Only between 15.0% and 32.1% of the negative studies had adequate power to detect a medium effect size. When categorized by anatomic region, 0% to 52.6% had adequate power to detect an effect size corresponding to the minimal clinically important difference (MCID). An a priori power analysis was employed in 196 (84%) of the 233 studies. However, the power analysis could not be replicated in 46% of the studies that used a mean comparison. Although small improvements in orthopaedic RCTs have occurred during the past 2 decades, many RCTs are still underpowered: the sample sizes are still too small to have adequate power to detect what would be deemed clinically relevant.

The purpose of this study was to examine the effect of pilates participation on body composition and cardiometabolic parameters in women, by analyzing the current literature. The data from 38 studies were included for meta-analysis, and Comprehensive Meta Analysis(CMA) Version 2.0 was used for statistical analysis. A total 759 subjects were included in this analysis. An average duration of the pilates intervention was 11.17 weeks, 2.97 session per week, and 48.86 minutes per session. Significant reduction in body fat percentage, total cholesterol, triglycerides. adiponectin, insulin resistance were observed while significant increase in HDL-cholesterol. There were large effect size were observed for insulin, adiponectin while medium and small effect size were observed for total cholesterol, triglycerides, LDL-C. In conclusion, pilates participation resulted in positive changes in body composition and cardiometablolic parameter in women.

Real-World Benefits of Hearing Aids Beyond Better Speech Understanding

In-person schooling has been disrupted for most school-aged youth during the COVID-19 pandemic, with low-income, Black, and Hispanic populations most likely to receive fully remote instruction. Disruptions to in-person schooling may have negatively and inequitably affected children's mental health. To estimate the association between school closures and child mental health outcomes and how it varies across sociodemographic factors. This cross-sectional population-based survey study included a nationally representative sample of US adults aged 18 to 64 years with at least 1 child in the household. The survey was administered between December 2 and December 21, 2020, via web and telephone in English and Spanish. Participants were recruited from the NORC AmeriSpeak panel, an address-based panel with known probability sampling and coverage of 97% of US households. Schooling modality (in person, fully remote, or hybrid), household income, age. Child mental health difficulties were measured with the parent-report version of the Strengths and Difficulties Questionnaire, with small, medium, and large effect sizes defined as 1.3-, 3.3-, and 5.2-point differences, respectively. A total of 2324 adults completed the survey. Overall, 1671 respondents (71.9%) were women, 244 (10.5%) were Black, 372 (16.0%) were Hispanic, and 421 (18.1%) had a high school education or less. Children attending school in-person had higher household incomes (mean difference, $9719; 95% CI, $4327 to $15 111; P < .001) and were more likely to be White compared with those attending remotely (366 of 556 [65.8%] vs 597 of 1340 [44.5%]; P < .001). Older children in remote schooling had more mental health difficulties than those attending in-person schooling (standardized effect size, 0.23 [95% CI, 0.07 to 0.39] per year older; P = .006), corresponding to small effect sizes in favor of in-person schooling for older children and very small effect sizes favoring remote schooling for younger children. Children from families with higher income benefitted more from attending schools in-person compared with their peers from families with lower income (B = -0.20 [95% CI, -0.10 to -0.30] per $10 000-increase in annual income; P < .001), although this advantage was not apparent for children attending hybrid school (B = -0.05 [95% CI, -0.16 to 0.06] per $10 000-increase in annual income; P = .34), and directionally lower but not significantly different for children attending remote school (B = -0.12 [95% CI, -0.04 to -0.20] per $10 000-increase in annual income; P < .001). Learning pods fully buffered the associations of hybrid schooling (d = -0.25; 95% CI, -0.47 to -0.04) but not remote schooling (d = 0.04; 95% CI, -0.10 to 0.18) with negative mental health outcomes. The findings of this study suggest that older and Black and Hispanic children as well as those from families with lower income who attend school remotely may experience greater impairment to mental health than their younger, White, and higher-income counterparts. Ensuring that all students have access to additional educational and mental health resources must be an important public health priority, met with appropriate funding and workforce augmentation, during and beyond the COVID-19 pandemic.

Pain control with ultrasound-guided inguinal field block compared with spinal anesthesia after hernia surgery: A randomized trial

The findings from 30 research investigations examining the effectiveness of occupational therapy interventions were reviewed and analyzed. The statistical conclusion validity was determined by computing post hoc power coefficients for the statistical hypothesis tests included in the examined studies. Data analysis revealed the median power values to detect small, medium, and large effect sizes were .09, .33, and .66, respectively. These results suggest a high probability of Type II errors in the sample of occupational therapy intervention research examined. In practical terms, this means the intervention produced a potentially useful treatment effect, but the effect was not detected as significant. Examples are provided that illustrate how low statistical power contributes to increases in Type II errors and inhibits the development of consensus through replication in the research literature. The presence of low-power studies with high rates of false negative findings prevents the establishment of guidelines for evidence-based practice and impedes the scientific progress of rehabilitation professions such as occupational therapy.

BackgroundMidfoot osteoarthritis (OA) is a common condition, however its aetiology is not well understood. Understanding how plantar pressures differ between people with and without midfoot OA may provide insight into the aetiology and how best to manage this condition. Research questionTo compare plantar pressures between people with and without symptomatic radiographic midfoot OA. MethodsThis was a cross-sectional study of adults aged ≥ 50 years registered with four UK general practices who reported foot pain in the past year. Symptomatic radiographic midfoot OA was defined as midfoot pain in the last four weeks, combined with radiographic OA in one or more midfoot joints. Cases were matched 1:1 for sex and age ( ± 5 years) to controls. Peak plantar pressure and maximum force in 10 regions of the foot were determined using a pressure platform (RSscan International, Olen, Belgium) and compared between the groups using independent samples t-tests and effect sizes (Cohen’s d). ResultsWe included 61 midfoot OA cases (mean age 67.0, SD 8.1, 31 males, 30 females) and matched these to 61 controls (mean age 66.0, SD 7.9). Midfoot OA cases displayed greater force (d=0.79, medium effect size, p = <0.001) and pressure at the midfoot (d=0.70, medium effect size, p = <0.001), greater force at the fourth metatarsophalangeal (MTP) joint (d=0.28, small effect size, p = 0.13), and fifth MTP joint (d=0.37, small effect size, p = 0.10) and greater pressure at the fifth MTP joint (d=0.34, small effect size, p = 0.13). They also displayed lower force (d=0.40, small effect size, p = 0.02) and pressure at the hallux (d=0.50, medium effect size, p = <0.001) and lower force (d=0.54, medium effect size, p = <0.001) and pressure at the lesser toes (d=0.48, small effect size, p = <0.001) compared with controls. SignificanceMidfoot OA appears to be associated with lowering of the medial longitudinal arch, greater lateral push off and less propulsion at toe off. Longitudinal studies are needed to establish causal relationships.

More than a century ago, Emil Kraepelin proposed the concept of schizophrenia as dementia praecox, or premature dementia, in order to capture the young age of onset and inevitable decline into a state of dementia which he observed to be characteristic of this population. In the modern age, Kraepelin’s dementia praecox may correspond to a small group of severely-unwell and treatment-resistant patients with chronic schizophrenia. This subtype of schizophrenia has been termed Kraepelinian schizophrenia. Compared to the broader community-dwelling chronic schizophrenia group, this poorly-functioning subpopulation may be subjected to recurrent hospitalisations and dependency on others in daily living. Carer reports of functional and cognitive decline often raise the suspicion of an underlying dementia. In the research literature, parallels have been drawn between the clinical, cognitive, and neuroimaging profiles of patients with schizophrenia and patients with behavioural variant frontotemporal dementia (FTD). However, no study has comprehensively compared neurocognition and social cognition in these two patient populations, particularly between hospitalised patients with schizophrenia who are chronically and severely unwell (i.e., the Kraepelinian schizophrenia subtype) and FTD. The overall aim of this thesis was to compare patients with severe chronic schizophrenia and patients with FTD in a number of neurocognitive and social cognitive domains in a series of three studies. In the first study, retrospective neuropsychological data was compared between 26 inpatients with severe chronic schizophrenia and 34 inpatients with FTD. Out of 16 cognitive domains, group differences were significant only in the executive function subdomain of set-shifting,with a 45% overlap in score distributions between groups. Differences in several domains were associated with small-to-moderate effect sizes and less than 85% overlap. In the second study, 7 inpatients with severe chronic schizophrenia, 13 outpatients with chronic schizophrenia who maintained community-living, 12 patients with FTD, and 18 healthy controls were administered a battery of neuropsychological measures. Across 16 cognitive domains, the inpatient schizophrenia-FTD groups were found to share more similar profiles than the outpatient schizophrenia-FTD groups. Differences between the inpatient schizophrenia and FTD groups were not significant, although medium and large effect sizes were observed in several domains. In the third study, the same groups from the second study were administered a social cognition battery consisting of measures for emotion recognition, theory of mind, and empathy. The FTD group demonstrated pervasive deficits across social cognitive domains, the inpatient schizophrenia group was similarly impaired but to a lesser degree, and the outpatient schizophrenia group showed more circumscribed deficits. The studies here are the only ones to have comprehensively investigated various domains of cognition in the two disorders. There are several important clinical and research implications of the current findings. Taken together, the findings demonstrate that hospitalised chronic schizophrenia patients and patients with FTD share more similarities than differences in their cognitive profiles. The findings support the Kraepelinian-non-Kraepelinian dichotomy and highlight the value of adopting a subtyping approach in schizophrenia research.

Objective: Eye movement difficulties in multiple sclerosis (MS) are common and may influence performance on cognitive tests. The following studies examined associations between a new measure of speedy eye movement speed and visual/nonvisual cognitive tests. Method: In Experiment 1, MS patients (N = 71) were administered cognitive tests and the Speedy Eyes Test (SET) as a measure of purposeful speedy eye movements under timed conditions. Experiment 2 was composed of MS patients (n = 60) and a neurologically healthy comparison group (n = 31) and examined group differences in an abbreviated version of the SET. Results: In both studies, slower eye movements were significantly associated with poorer performance on cognitive tests with a large effect size in Experiment 1 and a medium effect size in Experiment 2. Analyses in Experiment 2 also revealed significant group differences in an abbreviated measure of the SET, where MS patients had slower eye movements than the comparison group. Conclusions: Pending further research, the SET, a brief, inexpensive, and nontechnical measure of speedy eye movement, may serve as a visual/oculomotor indicator of cognitive impairment in multiple sclerosis.

The last three decades have witnessed significant advances in psychotherapy. Numerous scholarly articles and books have been devoted to pertinent topics in the field, making it difficult for the practicing clinician to keep up with this rapidly growing area. The purpose of this article is to provide some guidelines on how to evaluate the empirical literature in psychotherapy and then to explore three key areas: evidence-based psychotherapies for patients with psychiatric disorders, individual variables that predict differential outcome to treatment, and the therapeutic alliance. Finally, two case examples will be presented to illustrate how knowledge of the empirical literature can facilitate an evidence-based approach to the daily practice of psychotherapy in general psychiatry.

Pilot RCT of a telehealth intervention to reduce symptoms of depression and anxiety in adults with cystic fibrosis

Stabilisation and Phase-Orientated Psychological Treatment for Posttraumatic Stress Disorder: A Systematic Review and Meta-analysis

Preschool teacher training (TT) about children's neurodevelopmental concerns consisted of six monthly workshops and one booster session 3 months after the sixth session that lasted 90–105 min each. Each teacher was responsible for one child and provided different interventions between sessions. A questionnaire was administered pre‐ and post‐workshop. Of the 46 participants, we analyzed the results of 44. The Total Deviance/Difficulties score on the Strengths and Difficulties Questionnaire (SDQ) for children decreased significantly post‐training, with a large effect size. The SDQ subscale scores revealed larger effect sizes for Peer Problems and Prosocial Behavior and medium effect sizes for Hyperactivity and Emotional Symptoms. Teachers' Rosenberg Self‐Esteem Scale scores increased significantly with a medium effect size. The Pre‐School Teacher Efficacy Scale showed no significant differences with a small effect size. Thus, TT may benefit both children's behavior and teacher's self‐esteem. However, it is unclear whether these changes are attributable to actual changes in the children's or teachers' understanding of their growth and development, or to both. Further studies are required to confirm these findings.