26 research outputs found

    Relative effectiveness and adverse effects of cervical manipulation, mobilisation and the activator instrument in patients with sub-acute non-specific neck pain: results from a stopped randomised trial

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    <p>Abstract</p> <p>Background</p> <p>Neck pain of a mechanical nature is a common complaint seen by practitioners of manual medicine, who use a multitude of methods to treat the condition. It is not known, however, if any of these methods are superior in treatment effectiveness. This trial was stopped due to poor recruitment. The purposes of this report are (1) to describe the trial protocol, (2) to report on the data obtained from subjects who completed the study, (3) to discuss the problems we encountered in conducting this study.</p> <p>Methods</p> <p>A pragmatic randomised clinical trial was undertaken. Patients who met eligibility criteria were randomised into three groups. One group was treated using specific segmental high velocity low amplitude manipulation (diversified), another by specific segmental mobilisation, and a third group by the Activator instrument. All three groups were also treated for any myofascial distortions and given appropriate exercises and advice. Participants were treated six times over a three-week period or until they reported being pain free. The primary outcome measure for the study was Patient Global Impression of Change (PGIC); secondary outcome measures included the Short-Form Health Survey (SF-36v<sub>2</sub>), the neck Bournemouth Questionnaire, and the numerical rating scale for pain intensity. Participants also kept a diary of any pain medication taken and noted any perceived adverse effects of treatment. Outcomes were measured at four points: end of treatment, and 3, 6, and 12 months thereafter.</p> <p>Results</p> <p>Between January 2007 and March 2008, 123 patients were assessed for eligibility, of these 47 were considered eligible, of which 16 were allocated to manipulation, 16 to the Activator instrument and 15 to the mobilisation group. Comparison between the groups on the PGIC adjusted for baseline covariants did not show a significant difference for any of the endpoints. Within group analyses for change from baseline to the 12-month follow up for secondary outcomes were significant for all groups on the Bournemouth Questionnaire and for pain, while the mobilisation group had a significant improvement on the PCS and MCS subscales of the SF-36<sub>v2</sub>. Finally, there were no moderate, severe, or long-lasting adverse effects reported by any participant in any group.</p> <p>Conclusions</p> <p>Although the small sample size must be taken into consideration, it appears that all three methods of treating mechanical neck pain had a long-term benefit for subacute neck pain, without moderate or serious adverse events associated with any of the treatment methods. There were difficulties in recruiting subjects to this trial. This pragmatic trial should be repeated with a larger sample size.</p

    Patterns of math and English self-concepts as motivation for college major selection

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    A variable and person-centered approach was applied to understand the development of cross domain self-concepts of ability, patterns of math and English self-concepts of ability throughout adolescence, and their associations with college major. An expectancy-value perspective was integrated with dimensional comparison theory to understand how math and English self-concepts of ability relate to one another over time and within a person. Regression analysis identified a positive association of math self-concept throughout adolescence with math-related majors and a negative association of English self-concept with math-related majors. Cluster analysis classified students into six to seven patterns of varying math and English self-concepts of ability. Stereotypical gender differences were observed in cluster membership, with women overrepresented in high English clusters and males over represented in high math clusters. Cluster membership was predictive of the math-related college majors. Students who were higher in math self concept of ability relative to English were overrepresented in math intensive majors. Findings support the importance of considering intraindividual hierarchies and ipsative relationships when studying the development of self-concept of ability and academic choices

    Selective importance in self-enhancement : Patterns of feedback adolescents use to improve math self-concept

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    We illustrate how early adolescents use different patterns of ability feedback to promote a positive self-concept of ability (SCA) in mathematics. Students can simultaneously use ability appraisals from parents and teachers, while also drawing information from peer, dimensional, and temporal comparisons. Although we find these five sources are equally important for promoting students’ positive SCA, on average, we use a pattern-centered approach to show that students who believe they are good at math often select certain feedback sources as more important to develop this belief. We find that students’ patterns of ability feedback are unstable, with evidence suggesting different patterns may emerge depending on the availability of ability feedback. Findings suggest early adolescents attempting to promote their own positive SCA in mathematics may know to seek different feedback sources depending on their individual circumstances. Implications are discussed through the lens of social comparison theory

    Success with EASE: Who benefits from a STEM learning community?

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    During the past few decades, there has been a nationwide push to improve performance and persistence outcomes for STEM undergraduates. As part of this effort, recent research has emphasized the need for focus on not only improving the delivery of course content, but also addressing the social-psychological needs of students. One promising intervention type that has been proposed as a multifaceted way to address both cognitive and social-psychological aspects of the learning process is the learning community. Learning communities provide students with opportunities to build a strong support system in college and are generally associated with increased student engagement and integration with campus systems and cultures. In this study, we examine the impact of a learning community intervention for first-year biological sciences majors, the Enhanced Academic Success Experience (EASE) program. Incoming freshmen are assigned to EASE based on their SAT (or ACT equivalent) Math score, a metric demonstrated to be a key predictor of student success in the program. We find that enrollment in EASE is correlated with higher STEM course grades; an increase of 0.25 (on a 0-4 point scale) in cumulative first-year GPA; and gains in non-academic outcomes, such as measures of sense of belonging and academic integration. Further, these outcomes are more pronounced for particular subgroup populations. For example, whereas surveyed male students seemed to benefit academically from participating in a learning community, female students reported a greater sense of belonging in regard to the biological sciences major and reported higher values for behavioral indicators of academic integration. Lastly, we find that the EASE program is positively correlated with students' intention to stay in the biological sciences major. And, among the three race-oriented groups, this impact is most pronounced for under-represented students. In light of these findings, we discuss the potential of discipline-specific learning community programs to improve academic outcomes for students most at risk of leaving STEM majors, such as students underprepared for college level coursework

    STEM learning communities promote friendships but risk academic segmentation.

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    Universities are increasingly using learning communities (LCs) to promote the academic and social integration of entering students, especially within STEM majors. Examining the causal effect of LCs on student networks is necessary to understand the nature and scope of their impact. This study combines a regression discontinuity design with social network analysis to estimate the effect of a simple LC design on the size, strength, structure, and composition of friendship networks among students within the same biological sciences freshman cohort. Results of the quasi-experimental analysis indicate that LC participants acquired one additional friend in the major and increased their share of friends in the LC by 54 percentage-points. Exponential random-graph models that test mediation and alternative friendship mechanisms provide support for the theoretical argument that the LC promoted friendship development by structuring opportunities for interaction through block-registration into courses. Thus, this study shows that even simple LCs can shape the development of friendships through relatively low-cost administrative means. The increased access to resources and support facilitated by the LC is likely beneficial for participating students. However, there is a potential downside when eligibility for participation is determined using academic metrics that separate the student population into distinct classroom environments

    Components of engagement in saying-is-believing exercises.

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    The saying-is-believing effect is an important step for changing students' attitudes and beliefs in a wise intervention. However, most studies have not closely examined the process of the saying-is-believing effect when individuals are engaged in the activity. Using a qualitative approach, the present study uses an engagement framework to investigate (a) components of engagement in the saying-is-believing effect; and (b) how differently students may engage in a saying-is-believing exercise. Semi-structured interviews were conducted with 14 undergraduates in a scholarship program for low-income transfer students from community college. Analysis using inductive and deductive approaches found that students varied on the extent to which they experienced the effectiveness of the saying-is-believing effect through affective, cognitive, and behavioral experiences. The study offers examples of how people can indeed differ in the extent to which they experience the saying-is-believing effect, and the implications for designing more effective interventions. Specifically, students' positive affective experiences from seeing the larger goal of creating videos may be important components for the saying-is-believing effect to work. Behavioral experiences, such as learning soft skills, academic skills learned indirectly from the intervention, and academic skills learned directly from the intervention were accompanied by both positive affective and cognitive experiences. Findings show the importance of students' differential engagement in saying-is-believing exercises both for building more effective wise interventions and interpreting heterogeneity in intervention effectiveness
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