The AgingPLUS Trial: Intervening to Promote Physical Activity in Middle-Aged and Older Adults

This paper investigated whether the AgingPLUS program promotes physical activity in middle-aged and older adults by examining outcomes at weeks 4 and 8 with baseline scores included as covariates. The analyses assessed intervention effects on negative views of aging (NVOA), physical activity (CHAMPS), physical function (SPPB, VO2max), and accelerometry measures (e.g., minutes sedentary). We found significant intervention effects on NVOA (p < .001) and frequency of moderate intensity exercise (p = 0.048), but no significant effects on physical function, VO2max, or the accelerometry measures. Standardized effect sizes for the significant effects ranged from 0.31 to 1.03 standard deviation units. These findings suggest that AgingPLUS improved motivational factors for engaging in physical activity but did not lead to objective changes in physical activity in the short term. Further research will investigate the mediational role of these motivational factors in enhancing physical activity over the longer term (6 months).

A GNSS-based method to define athlete manoeuvrability in field-based team sports

This study presented a method of quantifying the manoeuvrability of two field-based team sport athletes and investigated its relationship with running velocity during competition. Across a season, 10 Hz Global navigation satellite system (GNSS) devices were worn during matches by 62 athletes (Australian Football League [AFL]; n = 36, 17 matches, National Rugby League [NRL]; n = 26, 21 matches). To quantify manoeuvrability, tortuosity was calculated from the X and Y coordinates from match GNSS files (converted from latitude and longitude). Tortuosity was calculated as 100 x natural logarithm of the chord distance (distance travelled between X and Y coordinates), divided by the straight-line distance. The maximal tortuosity was then quantified for each 0.5 m∙s-1 speed increment, ranging from 0 to the highest value for each game file. A quadratic model was fitted for each match file, controlling for the curvilinear relationship between tortuosity and velocity. A comparison of the quadratic coefficients between sports, and within sport between positions was investigated using linear mixed models. Resulting standard deviations (SDs) and mean differences were then assessed to establish standardized effect sizes (ES) and 90% confidence intervals (CI). A curvilinear relationship exists between maximal tortuosity and running speed, reflecting that as speed increases, athletes’ ability to deviate from a linear path is compromised (i.e., run in a more linear path). Compared to AFL, NRL had a greater negative quadratic coefficient (a) (ES = 0.70; 0.47 to 0.93) for the 5 second analysis, meaning that as speed increased, NRL athletes’ manoeuvrability reduced at a faster rate than when compared to AFL. There were no positional differences within each sport. GNSS derived information can be used to provide a measure of manoeuvrability tortuosity during NRL and AFL matches. The curvilinear relationship between tortuosity and speed demonstrated that as speed increased, manoeuvrability was compromised.

Interpreting published effect sizes in behavioral science: a thought-experiment

Standardized effect size measures (e.g., Cohen’s d) state the observed mean difference, m1-m0, relative to the observed standard deviation, s. These measures are commonly used in behavioral science today in meta-analytical research to quantify the observed m1-m0 across object-level studies that use different measurement-scales, as well as in theory-construction research to point-specify m1-m0 as a theoretically predicted parameter. Since standardization conceptually relates to the quality of measurement, m1-m0 can be interpreted fully only relative to whichever error-theory determines s. The error-theory, however, is what behavioral scientists must typically choose freely, because a theoretically motivated measurement-scale is normally unavailable. Using a thought-experiment, we show that differentially sophisticated error-theories let the observed m1-m0 vary massively given identical observations. This lets the common praxis of publishing m1-m0 “nakedly”—without a transparent error-theory—appear problematic, because it undermines the goals of a cumulative science of human behavior. We advocate reporting standardized effect sizes along with a transparent error-theory.

Statistical power in clinical trials of interventions for mood, anxiety, and psychotic disorders

Background: Previous research has suggested that statistical power is suboptimal in many biomedical disciplines, but it is unclear whether power is better in trials for particular interventions, disorders, or outcome types. We therefore performed a detailed examination of power in trials of psychotherapy, pharmacotherapy, and complementary and alternative medicine (CAM) for mood, anxiety, and psychotic disorders. Methods: We extracted data from the Cochrane Database of Systematic Reviews (Mental Health). We focused on continuous efficacy outcomes and estimated power to detect standardized effect sizes (SMD=0.20-0.80, primary effect size SMD=0.40) and the meta-analytic effect size (ESMA). We performed meta-regression to estimate the influence of including underpowered studies in meta-analyses. Results: We included 216 reviews with 8809 meta-analyses and 36540 studies. Statistical power for continuous efficacy outcomes was very low across intervention and disorder types (overall median [IQR] power for SMD=0.40: 0.33 [0.19-0.54]; for ESMA: 0.15 [0.07-0.44]), only reaching conventionally acceptable levels (80%) for SMD=0.80. Median power to detect the ESMA was higher in TAU/waitlist-controlled (0.54-0.66) or placebo-controlled (0.15-0.40) trials than in trials comparing active treatments (0.07-0.10). Meta-regression indicated that adequately-powered studies produced smaller effect sizes than underpowered studies (B=-0.06, p=0.008). Conclusions: Power to detect both fixed and meta-analytic effect sizes in clinical trials in psychiatry was low across all interventions and disorders examined. As underpowered studies produced larger effect sizes than adequately-powered studies, these results confirm the need to increase sample sizes and to reduce reporting bias against studies reporting null results to improve the reliability of the published literature.

A randomized controlled trial testing the efficacy of a Nurse Home Visiting Program for Pregnant Adolescents

To test the efficacy of a nurse home visiting program (HVP) on child development, maternal and environmental outcomes in the first years of life. We conducted a randomized controlled trial to test the efficacy of Primeiros Laços, a nurse HVP for adolescent mothers living in a poor urban area of São Paulo, Brazil. Eighty adolescent mothers were included and randomized to receive either Primeiros Laços (intervention group, n = 40) or healthcare as usual (control group, n = 40). Primeiros Laços is a home visiting intervention delivered by trained nurses that starts during the first 16 weeks of pregnancy and continues to the child’s age of 24 months. Participants were assessed by blind interviewers at 8–16 weeks of pregnancy (baseline), 30 weeks of pregnancy, and 3, 6, 12, and 24 months of child’s age. We assessed oscillatory power in the mid-range alpha frequency via electroencephalography when the children were aged 6 months. Child development was measured by the Bayley Scales of Infant Development Third Edition (BSID-III). Weight and length were measured by trained professionals and anthropometric indexes were calculated. The home environment and maternal interaction with the child was measured by the Home Observation and Measurement of the Environment. Generalized estimating equation models were used to examine intervention effects on the trajectories of outcomes. Standardized effect sizes (Cohen’s d) were calculated using marginal means from endpoint assessments of all outcomes. The trial was registered at clinicaltrial.gov: NCT02807818. Our analyses showed significant positive effects of the intervention on child expressive language development (coefficient = 0.89, 95% CI [0.18, 1.61], p = 0.014), maternal emotional/verbal responsivity (coefficient = 0.97, 95% CI [0.37, 1.58], p = 0.002), and opportunities for variety in daily stimulation (coefficient = 0.37, 95% CI [0.09, 0.66], p = 0.009). Standardized effect sizes of the intervention were small to moderate. Primeiros Laços is a promising intervention to promote child development and to improve the home environment of low-income adolescent mothers. However, considering the limitations of our study, future studies should be conducted to assess Primeiros Laços potential to benefit this population.Clinical Trial Registration: The study was registered at clinicaltrial.gov (Registration date: 21/06/2016 and Registration number: NCT02807818).

Brain-Wide Inferiority and Equivalence Tests in fMRI Group Analyses: Selected Applications

Null hypothesis significance testing is the major statistical procedure in the field of fMRI, but provides only a rather limited picture of the effects in a data set. When sample size and power is low relying only on strict significance testing may lead to a host of false negative findings. In contrast, with very large data sets virtually every voxel might become significant.It is thus desirable to complement significance testing with procedures like inferiority and equivalence tests that allow to formally compare effect sizes within and between data sets and offer novel approaches to obtain insight into fMRI data. The major component of these tests are estimates of standardized effect sizes and their confidence intervals. Here we show how Hedge’s g, the bias corrected version of Cohen’s d, and its confidence interval can be obtained from SPM t maps. We then demonstrate how these values can be used to evaluate whether non-significant effects are really statistically smaller than significant effects to obtain “regions of undecidability” within a data set, and to test for the replicability and lateralization of effects.This method allows the analysis of fMRI data beyond point estimates enabling researchers to take measurement uncertainty into account when interpreting their findings.

Physical fitness reference standards for Chinese children and adolescents

To develop age- and sex-specific physical fitness reference standards and express the age- and sex-related differences using standardized effect sizes for Chinese children and adolescents. A total of 85,535 children and adolescents (48.7% girls) aged 7–18 years were recruited from six geographical divisions of China using a stratified randomized cluster sampling method. Seven physical fitness items including grip strength, standing long jump, 30-s sit-ups, sit and reach, 50-m dash, 20-s repeated straddling, and 20-m SRT were measured following a standardized procedure. Percentile curves for each physical fitness test were calculated using the LMS. Age- and sex-related differences were expressed as standardized effect sizes. We observed that the performance improved with age along with the analyzed percentiles in all tests. Boys had higher values compared to girls in all the physical fitness items except for sit and reach test, where girls showed better performance in all analyzed percentiles. Also, the sex differences increased with ages except sit and reach. There is a need for a differentiated approach in the physical education class in terms of adjustment of physical activity based on sex, level of fitness abilities in China.

A Nurse Home Visiting Program for Pregnant Adolescents: A Randomized Controlled Trial

Objective To test the efficacy of a nurse home visiting program (HVP) on child development, maternal and environmental outcomes in the first years of life.Methods We conducted a randomized controlled trial to test the efficacy of Primeiros Laços, a nurse HVP for adolescent mothers living in a poor urban area of São Paulo, Brazil. Eighty adolescent mothers were included and randomized to receive either Primeiros Laços (intervention group, n = 40) or healthcare as usual (control group, n = 40) groups. Primeiros Laços is a home visiting intervention delivered by trained nurses that starts during the first 16 weeks of pregnancy and continues to the child’s age of 24 months. Participants were assessed by blind interviewers at 8–16 weeks of pregnancy (baseline), 30 weeks of pregnancy, 3, 6, and 12 months of child’s age. Child development was measured by the Bayley Scales of Infant Development Third Edition (BSID-III). Weight and length were measured by trained professionals and anthropometric indexes were calculated. The home environment and maternal interaction with the child was measured by the Home Observation and Measurement of the Environment (HOME). Generalized estimating equation (GEE) models were used to examine intervention effects on the trajectories of outcomes. Standardized effect sizes (Cohen’s d) were calculated using marginal means from endpoint assessments of all outcomes. The trial was registered at clinicaltrial.gov: NCT02807818.Results Our analyses showed significant positive effects of the intervention on child expressive language development (coefficient = 0.89, 95% CI [0.18, 1.61], p = 0.014), maternal emotional/verbal responsivity (coefficient = 0.97, 95% CI [0.37, 1.58], p = 0.002), and opportunities for variety in daily stimulation (coefficient = 0.37, 95% CI [0.09, 0.66], p = 0.009). Standardized effect sizes of the intervention were small to moderate.Conclusions Primeiros Laços is a promising intervention to promote child development and to improve the home environment of low-income adolescent mothers.

Preparing for an Australian Football League Women's League Season

The aims were to investigate the externally measured weekly loads, and the distribution intensity relative to the 1-min maximal mean (MM) intensity of matches. Athletes (n = 28) wore 10 Hz GNSS devices during training and matches. For the descriptive analysis, a range of movement variables were collected, including total distance, high-speed distance, very high-speed distance, acceleration, and acceleration load. Using raw GNSS files, 1-min moving averages were calculated for speed (m·min−1) and acceleration (m·s−2), and were multiplied by time, specifying total distance (m), and by body mass to quantify impulse (kN·s−1). The distribution of distance and impulse accumulated at varied intensities relative to MMs was calculated, with percentages ranging from zero to 110%. Drills were categorized as either; warm-ups, skill drills, games (i.e., small-sided games), conditioning and matches. Linear mixed models determined if the distribution of intensity within each threshold (>50%) varied between drill types and matches, and if the distribution within drill types varied across the season. Effects were described using standardized effect sizes (ES) and 90% confidence limits (CL). Compared to matches, a higher proportion of distance was accumulated at 50% of the MM within warm-ups and conditioning (ES range 0.86–1.14). During matches a higher proportion of distance was accumulated at 60% of MM when compared to warms ups, skill drills and conditioning (0.73–1.87). Similarly, greater proportion of distance was accumulated between 70 and 100% MM in matches compared to skill drills and warm-ups (1.05–3.93). For impulse, matches had a higher proportion between 60 and 80% of the MM compared to conditioning drills (0.91–3.23). There were no other substantial differences in the proportion of impulse between matches and drill types. When comparing phases, during competition there was a higher proportion of distance accumulated at 50% MM than general preparation (1.08). A higher proportion of distance was covered at higher intensities within matches compared to drills. The proportion of impulse was higher between 60 and 80% MM within matches compared to conditioning. Practitioners can therefore ensure athletes are not only exposed to the intensities common within competition, but also the volume accumulated is comparable, which may have positive performance outcomes, but is also extremely important in the return to play process.

Behavioral Adjustment of Preschool Children With and Without Craniofacial Microsomia

Objective: The study aim was to assess behavioral adjustment in preschool children with and without craniofacial microsomia (CFM). Design: Multisite cohort study of preschoolers with CFM (“cases”) or without CFM (“controls”). Participants: Mothers (89%), fathers (9%), and other caregivers (2%) of 161 preschoolers. Outcome Measure: Child Behavior Check List (CBCL 1.5-5); linear regressions with standardized effect sizes (ES) adjusted for sociodemographic confounds. Results: Child Behavior Check Lists for 89 cases and 72 controls (average age 38.3 ± 1.9 months). Children were male (54%), white (69%), and of Latino ethnicity (47%). Cases had microtia with mandibular hypoplasia (52%), microtia only (30%), or other CFM-associated features (18%). Nearly 20% of cases had extracranial anomalies. Composite CBCL scores were in the average range compared to test norms and similar for cases and controls. On the subscales, cases’ parents reported higher Anxious/Depressed scores (ES = 0.35, P = .04), Stress Problems (ES = 0.40, P = .04), Anxiety Problems (ES = 0.34, P = .04), and Autism Spectrum Problems (ES = 0.41, P = .02); however, the autism subscale primarily reflected speech concerns. Among cases, more problems were reported for children with extracranial anomalies and certain phenotypic categories with small ES. Conclusions: Behavioral adjustment of preschoolers with CFM was comparable to peers. However, parental reports reflected greater concern for internalizing behaviors; thus, anxiety screening and interventions may benefit children with CFM. Among cases, more problems were reported for those with more complex presentations of CFM. Craniofacial microsomia–related speech problems should be distinguished from associated psychosocial symptoms during developmental evaluations.