Transanal endoscopic microsurgery versus endoscopic mucosal resection for large rectal adenomas (TREND-study)

Background: Recent non-randomized studies suggest that extended endoscopic mucosal resection (EMR) is equally effective in removing large rectal adenomas as transanal endoscopic microsurgery (TEM). If equally effective, EMR might be a more cost-effective approach as this strategy does not require expensive equipment, general anesthesia and hospital admission. Furthermore, EMR appears to be associated with fewer complications. The aim of this study is to compare the cost-effectiveness and cost-utility of TEM and EMR for the resection of large rectal adenomas. Methods/design. Multicenter randomized trial among 15 hospitals in the Netherlands. Patients with a rectal adenoma 3 cm, located between 115 cm ab ano, will be randomized to a TEM- or EMR-treatment strategy. For TEM, patients will be treated under general anesthesia, adenomas will be dissected en-bloc by a full-thickness excision, and patients will be admitted to the hospital. For EMR, no or conscious sedation is used, lesions will be resected through the submucosal plane i

Self-Talk and Sports Performance: A Meta-Analysis

Based on the premise that what people think influences their actions, self-talk strategies have been developed to direct and facilitate human performance. In this article, we present a meta-analytic review of the effects of self-talk interventions on task performance in sport and possible factors that may moderate the effectiveness of self-talk. A total of 32 studies yielding 62 effect sizes were included in the final meta-analytic pool. The analysis revealed a positive moderate effect size (ES = .48). The moderator analyses showed that self-talk interventions were more effective for tasks involving relatively fine, compared with relatively gross, motor demands, and for novel, compared with well-learned, tasks. Instructional self-talk was more effective for fine tasks than was motivational self-talk; moreover, instructional self-talk was more effective for fine tasks rather than gross tasks. Finally, interventions including self-talk training were more effective than those not including self-talk training. The results of this study establish the effectiveness of self-talk in sport, encourage the use of self-talk as a strategy to facilitate learning and enhance performance, and provide new research directions