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JASA Express Letters Jan 2023The increasing use of remote platforms for auditory research necessitates more in-depth evaluation of assessment protocols, especially when working with children. This...
The increasing use of remote platforms for auditory research necessitates more in-depth evaluation of assessment protocols, especially when working with children. This work investigates the influence of the presence of a moderator on remote audiovisual speech perception studies, by assessing how moderation impacts children's understanding and performance of the psychophysical tasks as well as their attention on these tasks. In sum, moderated and unmoderated methods can reliably assess audiovisual speech perception benefits. However, regardless of similar error patterns between both studies, unmoderated online studies with children are prone to more general attention lapses as suggested by higher overall error rates.
Topics: Humans; Child; Speech Perception; Attention
PubMed: 36725535
DOI: 10.1121/10.0016832 -
Frontiers in Public Health 2023Falls and fear of falling (FOF) are independent risk factors for functional limitations in older adults. However, the combined effect of falls and FOF on functional...
BACKGROUND
Falls and fear of falling (FOF) are independent risk factors for functional limitations in older adults. However, the combined effect of falls and FOF on functional limitations and the moderating role of living alone or not is unclear. We aimed to examine (1) the independent and combined effect of falls and FOF on functional limitations in older adults and (2) whether living alone moderates these associations.
METHODS
We used data from the National Health and Aging Trends Study (NHATS) and included 5,950 U.S. community-dwelling older adults aged 65 and older from Round 1 (Year 2011) and Round 2 (Year 2012). Falls and FOF were ascertained by asking participants whether they had any falls in the last year and whether they had worried about falling in the previous month at R1. Assessed functional limitations included any difficulties with mobility, self-care, or household activities at R2. Poisson regression models were used to examine the longitudinal associations of falls and FOF with functional limitations and the moderation effects of baseline living alone.
RESULTS
Of the 5,950 participants, 16.3% had falls only; 14.3% had FOF only; 14.3% had both, and 55.1% had neither at baseline. In the adjusted model, those who experienced concurrent falls and FOF in R1 had a higher risk of functional limitations at R2 than those with neither (Mobility: Incidence risk ratio [IRR] = 1.34, 95% CI: 1.24-1.45; Self-care: IRR = 1.18, 95% CI: 1.11-1.26; Household: IRR = 1.20, 95% CI: 1.11-1.30). Moreover, living alone significantly moderated the longitudinal associations of concurrent falls and FOF with mobility activity limitations.
CONCLUSION
The findings suggest that strategies to improve falls and FOF together could potentially help prevent functional limitations. Older adults who live with others and have falls or FOF should receive interventions to promote their mobility activities.
Topics: Humans; Aged; Home Environment; Fear; Aging; Independent Living
PubMed: 37124793
DOI: 10.3389/fpubh.2023.1007563 -
Schizophrenia Research. Cognition Mar 2020There is evidence that cognitive remediation (CR) is moderately effective in improving cognitive and functional difficulties in people with schizophrenia. However, there... (Review)
Review
BACKGROUND
There is evidence that cognitive remediation (CR) is moderately effective in improving cognitive and functional difficulties in people with schizophrenia. However, there is still a limited understanding of what influence different treatment responses.
AIM
To identify moderators influencing CR response in people with schizophrenia.
METHODS
This systematic review follows PRISMA guidelines. Searches were conducted up to January 2019 on PubMed and PsychInfo to identify randomized controlled trials of CR reporting analyses of moderators of treatment response. All papers were assessed for methodological quality and information on sample size, intervention and control condition, moderators, outcomes, effect of moderator on outcomes and demographic characteristics from each study was extracted and critically summarised.
RESULTS
Thirty-six studies were included, considering 2737 participants. Study participants consisted on average of people in their late-thirties, mostly men, with over 10 years of illness. The review identified moderators that could be grouped into five categories: demographics, biological, cognitive and functional, psychological, and illness-related characteristics. The assessment of methodological quality showed that many studies had a high risk of bias.
CONCLUSIONS
There was no high-quality replicated evidence which identifies reliable moderators of CR response. Many moderators were not replicated or presented in single, underpowered studies. Studies also investigated moderators independently despite their potential to overlap (e.g. age and education). Future research should concentrate on evaluating, with sound studies, the role moderators may play in affecting CR treatment response. This information can inform who will benefit most from the therapy and help to improve the benefits of CR.
PubMed: 31828023
DOI: 10.1016/j.scog.2019.100160 -
Journal of Clinical Medicine Sep 2021In patients with eating disorders (EDs), elevated dissociation may increase the risk of suicide. Bodily related disturbances, depression, and anxiety may intervene in...
In patients with eating disorders (EDs), elevated dissociation may increase the risk of suicide. Bodily related disturbances, depression, and anxiety may intervene in the association between dissociation and suicidality. In this study we aimed to examine the influence of bodily related disturbances, depression, anxiety, severity of ED symptoms, body mass index (BMI), and type and duration of the ED on the relationship between elevated dissociation and elevated suicidality. The study included 172 inpatients: 65 with anorexia nervosa restricting type, 60 with anorexia nervosa binge/purge type, and 37 with bulimia nervosa. Participants were assessed using self-rating questionnaires for dissociation, suicidality, bodily related parameters, and severity of ED symptomatology, depression, and anxiety. We found that dissociation and suicidality were directly associated. In addition, depression and anxiety moderated the mediating role of body image parameters in the association between increased dissociation and increased suicidality. Thus, only in inpatients with high depression and anxiety, i.e., above the median range, body image disturbances were found to mediate the association between dissociation and suicidality. ED-related parameters did not moderate these relationships. Our study demonstrates that in inpatients with EDs, increased dissociation may be significantly associated with increased suicidality, both directly and via the intervening influence of body image, depression, and anxiety.
PubMed: 34501475
DOI: 10.3390/jcm10174027 -
The Journal of Sexual Medicine May 2022Previous studies have demonstrated the deleterious effects of pain anxiety (ie, the degree to which one fears pain), stress, and solicitous partner responses (ie,...
BACKGROUND
Previous studies have demonstrated the deleterious effects of pain anxiety (ie, the degree to which one fears pain), stress, and solicitous partner responses (ie, expressions of sympathy and attention to one's partner's pain) on pain and pain-related disability, but little is known about whether these variables moderate the robust pain-pain-related disability relationship in individuals with provoked vestibulodynia (PVD).
AIM
We investigated whether pain anxiety, stress, and solicitous partner responses moderated the relationship between penetrative pain and pain-related sexual disability in women with PVD symptoms.
METHODS
Participants with PVD symptoms (N = 65, age range = 18-73 years) completed an online survey assessing pain anxiety (Pain Anxiety Symptoms Scale-20), perceived stress (Perceived Stress Scale), solicitous partner responses (WHYMPI Solicitous Responses Scale), penetrative pain (Female Sexual Function Index), and pain-related sexual disability (Pain Disability Index). Moderated regression analyses were performed using pain anxiety, stress, and solicitous partner responses as moderators of the relationship between penetrative pain, and pain-related sexual disability.
OUTCOMES
Outcomes in the current study included the moderating effect of pain anxiety, perceived stress, and solicitous partner responses on the relationship between penetrative genital pain and pain-related disability in sexual behavior.
RESULTS
Higher genital pain from penetrative intercourse and higher pain anxiety significantly predicted higher pain-related sexual disability, but perceived stress was not significantly related to sexual disability. Solicitous partner responses were significantly positively correlated with pain-related sexual disability. None of the moderators significantly moderated the pain-pain-related sexual disability relationship.
CLINICAL IMPLICATIONS
For women with PVD, pain anxiety and solicitous partner responses to their pain may exacerbate their pain-related sexual disability, signifying that pain anxiety and solicitous partner responses represent important targets of therapeutic intervention for women with PVD.
STRENGTHS AND LIMITATIONS
The present study extended past research on the relationships between psychological and behavioral factors and pain in women with PVD symptoms by demonstrating the deleterious relationship between pain anxiety, solicitous responses, and pain-related sexual disability. However, the study was correlational in nature, which precludes conclusions about the effect of pain anxiety, and solicitous partner responses on pain-related sexual disability.
CONCLUSION
High pain anxiety and frequent solicitous partner responses to an individual's pain predicted higher pain-related sexual disability, suggesting that it may be possible to improve the quality of life of PVD sufferers through interventions that aim to decrease pain anxiety, and solicitous partner responses, in addition to interventions that aim to decrease pain per se. Maunder L, Dargie E, Pukall C. Moderators of the Relationship Between Pain and Pain-Related Sexual Disability in Women with Provoked Vestibulodynia Symptoms. J Sex Med 2022;19:809-822.
Topics: Adolescent; Adult; Aged; Female; Humans; Middle Aged; Pain; Quality of Life; Sexual Behavior; Sexual Partners; Surveys and Questionnaires; Vulvodynia; Young Adult
PubMed: 35370099
DOI: 10.1016/j.jsxm.2022.02.016 -
Frontiers in Sports and Active Living 2022The results from the physical training and cancer randomized controlled trial (Phys-Can RCT) indicate that high intensity (HI) strength and endurance training during...
Exploring Moderators of the Effect of High vs. Low-to-Moderate Intensity Exercise on Cardiorespiratory Fitness During Breast Cancer Treatment - Analyses of a Subsample From the Phys-Can RCT.
INTRODUCTION
The results from the physical training and cancer randomized controlled trial (Phys-Can RCT) indicate that high intensity (HI) strength and endurance training during (neo-)adjuvant cancer treatment is more beneficial for cardiorespiratory fitness (CRF, measured as peak oxygen uptake [VOpeak]) than low-to-moderate intensity (LMI) exercise. Adherence to the exercise intervention and demographic or clinical characteristics of patients with breast cancer undergoing adjuvant treatment may moderate the exercise intervention effect on VOpeak. In this study, the objective was to investigate whether baseline values of VOpeak, body mass index (BMI), time spent in moderate- to vigorous-intensity physical activity (MVPA), physical fatigue, age, chemotherapy treatment, and the adherence to the endurance training moderated the effect of HI vs. LMI exercise on VOpeak.
MATERIALS AND METHODS
We used data collected from a subsample from the Phys-Can RCT; women who were diagnosed with breast cancer and had a valid baseline and post-intervention VOpeak test were included ( = 255). The exercise interventions from the RCT included strength and endurance training at either LMI, which was continuous endurance training at 40-50% of heart rate reserve (HRR), or at HI, which was interval training at 80-90% of HRR, with similar exercise volume in the two groups. Linear regression analyses were used to investigate moderating effects using a significance level of < 0.10. Statistically significant interactions were examined further using the Johnson-Neyman (J-N) technique and regions of significance (for continuous variables) or box plots with adjusted means of post-intervention VOpeak (for binary variables).
RESULTS
Age, as a continuous variable, and adherence, dichotomized into < or > 58% based on median, moderated the effect of HI vs. LMI on CRF ( = -0.08, 95% CI [-0.16, 0.01], = 0.06, and = 1.63, 95% CI [-0.12, 3.38], = 0.07, respectively). The J-N technique and regions of significance indicated that the intervention effect (HI vs. LMI) was positive and statistically significant in participants aged 61 years or older. Baseline measurement of CRF, MVPA, BMI, physical fatigue, and chemotherapy treatment did not significantly moderate the intervention effect on CRF.
CONCLUSION
Women with breast cancer who are older and who have higher adherence to the exercise regimen may have larger effects of HI exercise during (neo-)adjuvant cancer treatment on CRF.
PubMed: 35903402
DOI: 10.3389/fspor.2022.902124 -
PloS One 2020This study examined the mediating or moderating relationship of social health on physical health and post-traumatic stress symptoms among displaced Syrians and...
OBJECTIVES
This study examined the mediating or moderating relationship of social health on physical health and post-traumatic stress symptoms among displaced Syrians and Jordanians at high risk for physical and mental health ailments. Frequency of mental health symptoms stratified by demographic factors was also explored. We hypothesized social health would mediate and/or moderate the relationship between physical and post-traumatic stress symptoms (PTSS).
METHODS
This cross-sectional study includes 598 adults between 18 and 75 years old recruited from three health centers in the city of Irbid, Jordan, 20 km away from the Syrian border. Post-traumatic stress symptoms (PTSS) were measured through the primary care post-traumatic stress disorder checklist. Physical and social health were assessed through the Duke Health Profile. One-way ANOVA and independent samples T-tests examined mean scores of social health, PTSS, physical health stratified by age, gender, nationality, education level, and trauma exposure. Bivariate correlations explored the relationship between social health, PTSS, and physical health. PROCESS macro tested social health as a moderator and mediator on the association of the physical health and PTSS.
RESULTS
Social health moderated and mediated the relationship between physical health and PTSS. Males reported (t = 2.53, p < .05) better physical health scores than females. Those who had less than a high school education reported lower social health (F = 13.83, p < .001); higher PTSS (F = 5.83, p < .001); and lower physical health (F = 5.76, p < .01) than more educated individuals. Syrians reported significantly higher PTSS (F = 4.13, p < .05) than Jordanians, however, there was no significant differences between nationality for physical or social health. Social health was positively associated with better physical health (r = 0.10, p < .01) and negatively with PTSS (r = -.293, p < .01).
CONCLUSIONS
Our results support our primary hypothesis suggesting social health mediates and moderates PTSS and physical health. Secondary findings illustrate gender, educational, and income differences in physical health and PTSS.
CLINICAL TRIALS REGISTRY
NCT03721848.
Topics: Adaptation, Psychological; Adolescent; Adult; Aged; Cross-Sectional Studies; Depression; Female; Health Status; Humans; Jordan; Male; Mental Health; Middle Aged; Psychological Distance; Refugees; Residence Characteristics; Stress Disorders, Post-Traumatic; Syria; Young Adult
PubMed: 33095832
DOI: 10.1371/journal.pone.0241036 -
Ear and Hearing 2020There are very limited data regarding the spoken language and academic outcomes of children with mild to severe hearing loss (HL) during the elementary school years, and...
OBJECTIVES
There are very limited data regarding the spoken language and academic outcomes of children with mild to severe hearing loss (HL) during the elementary school years, and the findings of these studies are inconsistent. None of these studies have examined the possible role of aided hearing in these outcomes. This study used a large cohort of children to examine these outcomes and in particular to examine whether aided hearing moderates the effect of HL with regard to these outcomes.
DESIGN
The spoken language, reading, writing, and calculation abilities were measured after second and fourth grades in children with mild to severe HL (children who are hard of hearing; CHH, n = 183) and a group of children with normal hearing (CNH, n = 91) after the completion of second and fourth grades. Also, among the CHH who wore hearing aids, aided better-ear speech intelligibility index values at the age of school entry were obtained.
RESULTS
Oral language abilities of the CHH with mild and moderate HL were similar to the CNH at each grade. Children with moderately-severe HL (better-ear pure tone threshold >59 but <76 dB HL) had significantly poorer oral language and reading skills than the CNH at each grade. The children with mild and moderate HL did not differ from the CNH in oral language or reading. No differences were found between the CHH regardless of severity and CNH with regard to spelling, passage writing, or calculation. The degree to which hearing aids provided audible speech information played a moderating role in the oral language outcomes of CHH and this moderation of language mediated the relationship between the unaided hearing ability of the CHH and their academic outcomes.
CONCLUSIONS
As a group, children with mild and moderate HL have good outcomes with regard to language and academic performance. Children with moderately-severe losses were less skilled in language and reading than the CNH and CHH children with mild and moderate losses. Audibility provided by hearing aids was found to moderate the effects of HL with respect to these outcomes. These findings emphasize the importance of including the effects of clinical interventions such as aided hearing when examining outcomes of CHH.
Topics: Child; Hearing; Hearing Aids; Hearing Loss; Hearing Tests; Humans; Language Development
PubMed: 32032223
DOI: 10.1097/AUD.0000000000000823 -
International Journal of Environmental... Oct 2022Research has documented that adverse childhood experiences (ACEs) significantly impact young people's risky behaviors. Yet, few studies have explored if individuals'...
Research has documented that adverse childhood experiences (ACEs) significantly impact young people's risky behaviors. Yet, few studies have explored if individuals' perceived stress mediates the association between ACEs and risky behaviors; also if social support moderates the pathways from ACEs to risky behaviors through perceived stress. This study aimed to assess the mediation effect of perceived stress and the moderation effect of social support in the study of ACEs and risky behaviors. This study sample includes 1091 Chinese rural young people. A web-based survey was used to assess demographic information, ACEs, perceived stress, social support, and seven types of risky behaviors. Multivariate regression models were run to test associations between ACEs and different risky behaviors while controlling for confounding variables. The mediation model (Model 4) and the moderated mediation model (Model 58) were also performed using the PROCESS macro. Multivariate regression results showed that, with increasing ACEs values, there was an increased likelihood of all risky behaviors. The moderated mediation analysis confirmed that perceived stress mediated the linkage between ACEs and risky behaviors. However, no significant moderating effect of social support was found. The study findings indicate that ACEs, risky behaviors, and perceived stress are significant public health problems among rural Chinese young people. Culturally appropriate prevention and intervention programs and services need to be implemented to address these issues and promote rural Chinese young people's wellbeing and development.
Topics: Humans; Young Adult; Adolescent; Adverse Childhood Experiences; Risk-Taking; Social Support; Stress, Psychological; China
PubMed: 36293775
DOI: 10.3390/ijerph192013194 -
Psychologica Belgica 2021In the present study, we investigated the relationship between friendship quality (dimensions) and non-suicidal self-injury (NSSI) as well as the moderating role of...
In the present study, we investigated the relationship between friendship quality (dimensions) and non-suicidal self-injury (NSSI) as well as the moderating role of gender and age in this relationship. The sample consisted of 463 children and adolescents (50.10% female, age range: 9-17 years). Friendship quality and NSSI were measured using the Friendship Qualities Scale (FQS; Bukowski, Hoza, & Boivin, 1994) and the Self Harm Inventory (SHI; Sansone, Wiederman, & Sansone, 1998), respectively. Overall, total friendship quality and NSSI were significantly and negatively related. Additionally, the relationship between total friendship quality and NSSI was moderated by gender and age. Specifically, girls with low friendship quality reported more NSSI; whereas for boys an opposite effect was found. As for age, friendship quality and NSSI were positively related in older participants. In younger participants, a relationship between friendship quality and NSSI seemed rather absent. This study highlights the important association between friendship quality and NSSI, as well as gender- and age-related differences in this association, which should be taken into account in the prevention and treatment of NSSI.
PubMed: 34824862
DOI: 10.5334/pb.1067