scholarly journals The Efficiency, Efficacy, and Retention of Task Practice in Chronic Stroke

2020 ◽  
Vol 34 (10) ◽  
pp. 881-890 ◽  
Author(s):  
Chunji Wang ◽  
Carolee Winstein ◽  
David Z. D’Argenio ◽  
Nicolas Schweighofer
Keyword(s):  
Controlled Trial ◽  
Practice Effect ◽  
Chronic Stroke ◽  
Skill Learning ◽  
Retention Rates ◽  
Lower Efficiency ◽  
Motor Practice ◽  
Negative Effect ◽  
Task Practice ◽  
Learning Principles

In motor skill learning, larger doses of practice lead to greater efficacy of practice, lower efficiency of practice, and better long-term retention. Whether such learning principles apply to motor practice after stroke is unclear. Here, we developed novel mixed-effects models of the change in the perceived quality of arm movements during and following task practice. The models were fitted to data from a recent randomized controlled trial of the effect of dose of task practice in chronic stroke. Analysis of the models’ learning and retention rates demonstrated an increase in efficacy of practice with greater doses, a decrease in efficiency of practice with both additional dosages and additional bouts of training, and fast initial decay following practice. Two additional effects modulated retention: a positive “self-practice” effect, and a negative effect of dose. Our results further suggest that for patients with sufficient arm use post-practice, self-practice will further improve use.

scholarly journals The Efficiency, Efficacy, and Retention of Motor Training in Chronic Stroke

2020 ◽  
Author(s):  
Chunji Wang ◽  
Carolee Winstein ◽  
David Z. D’Argenio ◽  
Nicolas Schweighofer
Keyword(s):  
Controlled Trial ◽  
Chronic Stroke ◽  
Skill Learning ◽  
Retention Rates ◽  
Motor Training ◽  
Negative Effect ◽  
Long Term Retention ◽  
Additional Therapy

AbstractIn motor skill learning, the greater the dose of training, the greater the efficacy of training, the lower the efficiency of training, and the better the long-term retention. Whether such principles apply to motor training after stroke is unclear. Here, we developed novel mixed-effects models of the change in the quality of arm movements during and following training fitted to data from a recent randomized controlled trial of the effect of the dose of training in chronic stroke. Analysis of the model’s learning and retention rates demonstrated an increase in efficacy of training with greater doses, a decrease in efficiency of training with both additional doses and additional bouts of training, and fast initial decay following training. Two additional effects modulated retention: a positive “self-training” effect, and an un-expected negative effect of dose. Our results suggest that for patients with sufficient arm use post-training, self-training will further improve use, but additional therapy may be in vain.

scholarly journals Effect of seasonal malaria chemoprevention plus azithromycin on Plasmodium falciparum transmission: gametocyte infectivity and mosquito fitness

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Koudraogo Bienvenue Yaméogo ◽  
Rakiswendé Serge Yerbanga ◽  
Seydou Bienvenu Ouattara ◽  
Franck A. Yao ◽  
Thierry Lefèvre ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Malaria Transmission ◽  
Life History Traits ◽  
Controlled Trial ◽  
Double Blind ◽  
Membrane Feeding ◽  
Seasonal Malaria Chemoprevention ◽  
Negative Effect ◽  
Transmission Period ◽  
Membrane Feeding Assay

Abstract Background Seasonal malaria chemoprevention (SMC) consists of administration of sulfadoxine-pyrimethamine (SP) + amodiaquine (AQ) at monthly intervals to children during the malaria transmission period. Whether the addition of azithromycin (AZ) to SMC could potentiate the benefit of the intervention was tested through a double-blind, randomized, placebo-controlled trial. The effect of SMC and the addition of AZ, on malaria transmission and on the life history traits of Anopheles gambiae mosquitoes have been investigated. Methods The study included 438 children randomly selected from among participants in the SMC + AZ trial and 198 children from the same area who did not receive chemoprevention. For each participant in the SMC + AZ trial, blood was collected 14 to 21 days post treatment, examined for the presence of malaria sexual and asexual stages and provided as a blood meal to An. gambiae females using a direct membrane-feeding assay. Results The SMC treatment, with or without AZ, significantly reduced the prevalence of asexual Plasmodium falciparum (LRT X22 = 69, P < 0.0001) and the gametocyte prevalence (LRT X22 = 54, P < 0.0001). In addition, the proportion of infectious feeds (LRT X22 = 61, P < 0.0001) and the prevalence of oocysts among exposed mosquitoes (LRT X22 = 22.8, P < 0.001) was reduced when mosquitoes were fed on blood from treated children compared to untreated controls. The addition of AZ to SPAQ was associated with an increased proportion of infectious feeds (LRT X21 = 5.2, P = 0.02), suggesting a significant effect of AZ on gametocyte infectivity. There was a slight negative effect of SPAQ and SPAQ + AZ on mosquito survival compared to mosquitoes fed with blood from control children (LRTX22 = 330, P < 0.0001). Conclusion This study demonstrates that SMC may contribute to a reduction in human to mosquito transmission of P. falciparum, and the reduced mosquito longevity observed for females fed on treated blood may increase the benefit of this intervention in control of malaria. The addition of AZ to SPAQ in SMC appeared to enhance the infectivity of gametocytes providing further evidence that this combination is not an appropriate intervention.

scholarly journals Online screening and feedback to increase help-seeking for mental health problems: population-based randomised controlled trial

BJPsych Open ◽  
2016 ◽  
Vol 2 (1) ◽  
pp. 67-73 ◽  
Author(s):  
Philip J. Batterham ◽  
Alison L. Calear ◽  
Matthew Sunderland ◽  
Natacha Carragher ◽  
Jacqueline L. Brewer
Keyword(s):  
Mental Health ◽  
Social Anxiety ◽  
Help Seeking ◽  
Service Use ◽  
Mental Health Problems ◽  
Controlled Trial ◽  
Population Based ◽  
Health Problems ◽  
Professional Service ◽  
Negative Effect

BackgroundCommunity-based screening for mental health problems may increase service use through feedback to individuals about their severity of symptoms and provision of contacts for appropriate services.AimsThe effect of symptom feedback on service use was assessed. Secondary outcomes included symptom change and study attrition.MethodUsing online recruitment, 2773 participants completed a comprehensive survey including screening for depression (n=1366) or social anxiety (n=1407). Across these two versions, approximately half (n=1342) of the participants were then randomly allocated to receive tailored feedback. Participants were reassessed after 3 months (Australian New Zealand Clinical Trials Registry ANZCTR12614000324617).ResultsA negative effect of providing social anxiety feedback to individuals was observed, with significant reductions in professional service use. Greater attrition and lower intentions to seek help were also observed after feedback.ConclusionsOnline mental health screening with feedback is not effective for promoting professional service use. Alternative models of online screening require further investigation.

Let’s tweet again? Social networks and literature achievement in high school students

2021 ◽  
pp. 1-64
Author(s):  
Gian Paolo Barbetta ◽  
Paolo Canino ◽  
Stefano Cima
Keyword(s):  
High School ◽  
High School Students ◽  
Web 2.0 ◽  
Large Scale ◽  
Standardized Test ◽  
Controlled Trial ◽  
School Students ◽  
Negative Effect ◽  
Internet Connections ◽  
The Impact

Abstract The availability of cheap Wi-Fi internet connections has encouraged schools to adopt Web 2.0 platforms for teaching, with the intention of stimulating students’ academic achievement and participation in school. Moreover, during the recent explosion of the SARS-CoV-2 crisis that forced many countries to close schools (as well as offices and factories), the widespread diffusion of these applications kept school systems going. Despite their widespread use as teaching tools, the effect of adopting Web 2.0 platforms on students’ performance has never been rigorously tested. We fill this gap in the literature by analyzing the impact of using Twitter as a teaching tool on high school students’ literature skills. Based on a large-scale, randomized controlled trial that involved 70 schools and about 1,500 students, we find that using Twitter to teach literature has an overall negative effect on students’ average achievement, reducing standardized test scores by about 25 percent of a standard deviation. The negative effect is stronger on students who usually perform better.

Effects of Proximal Priority and Distal Priority Robotic Priming Techniques With Impairment-Oriented Training of Upper Limb Functions in Patients With Chronic Stroke: Study Protocol For A Single-Blind, Randomized Controlled Trial

2021 ◽  
Author(s):  
Yi-chen Lee ◽  
Yi-chun Li ◽  
KEH-CHUNG LIN ◽  
Chia-ling Chen ◽  
Yi-hsuan Wu ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Scientific Evidence ◽  
Body Part ◽  
Chronic Stroke ◽  
Comparative Efficacy ◽  
Chi Square ◽  
Robotic Therapy ◽  
Single Blind

Abstract BackgroundThe sequence of establishing proximal stability or function before facilitation of the distal body part has long been recognized in stroke rehabilitation practice but lacks scientific evidence. This study plans to examine the effects of proximal priority robotic priming and impairment-oriented training (PRI) and distal priority robotic priming and impairment-oriented training (DRI). MethodsThis single-blind, randomized, comparative efficacy study will involve 40 participants with chronic stroke. Participants will be randomized into PRI or DRI groups and receive 18 intervention sessions (90 min/d, 3 d/wk for 6 weeks). The Fugl-Meyer Assessment Upper Extremity subscale, Medical Research Council Scale, Revised Nottingham Sensory Assessment, and Wolf Motor Function Test will be administered at baseline, after treatment, and at the 3-month follow-up. Two-way repeated-measures analysis of variance and the chi-square automatic interaction detector method will be used to examine the comparative efficacy and predictors of outcome, respectively, after PRI and DRI. DiscussionThrough manipulating the sequence of applying wrist and forearm robots in therapy, this study will attempt to examine empirically the priming effect of proximal or distal priority robotic therapy in upper extremity impairment-oriented training for people with stroke. The findings will provide directions for further studies and empirical implications for clinical practice in upper extremity rehabilitation after stroke.Trial RegistrationThis trial was registered on June 23, 2020, at www.clinicaltrials.gov (NCT04446273).

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