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A simulation-based framework for tracking decision-making development in youth basketball: operationalising Vygotsky's zone of proximal development through Bayesian multilevel modelling and verbal protocol analysis.

INTRODUCTION: Sports coaching research remains polarised between direct instruction approaches emphasising feedback and repetition vs. constraints-led approaches favouring athlete discovery through task design. This debate persists partly because existing methods cannot distinguish whether athletes are genuinely internalising tactical understanding or merely following external instructions. We present a methodological simulation study proposing a framework that operationalises Cultural-Historical Activity Theory-particularly Vygotsky's Zone of Proximal Development (ZPD)-through Bayesian multil

Validation of Strategic Memory Advanced Reasoning Training as an efficient and effective approach to treating warfighters with persistent cognitive complaints associated with mild traumatic brain injury.

INTRODUCTION: This study directly compared the relative effectiveness of Strategic Memory Advanced Reasoning Training (SMART), which focuses on metacognitive strategies, to a traditional cognitive rehabilitation (CR) program previously developed and validated for the Study of Cognitive Rehabilitation Effectiveness study (SCORE), in treating warfighters with a history of mild traumatic brain injury (mTBI) and persistent post-concussive symptoms (PCS). METHODS: A total of 148 active-duty service members (SMs) were recruited for this randomized controlled trial (RCT). Participants were randomly

Effects of reflection-through-action on collaborative clinical reasoning skills in an emergency dental simulation.

BACKGROUND: Simulation-based training is a central component of healthcare education. However, most current instructional designs emphasize post-simulation debriefing, while reflection during the simulation itself, termed reflection-through-action, remains understudied. Prior empirical evidence suggests that structured reflective pauses may enhance learners' metacognitive regulation and diagnostic and intervention clinical reasoning, though whether these learning gains transfer to subsequent, novel clinical scenarios is unknown. This study examined whether reflection-through-action during an i

Effectiveness and Cost-Effectiveness of the Tankevirus and Grubl Mental Health Apps Compared With a Placebo App-Mental Health Intervention With Digital Applications (MIND-APP): Protocol for a Randomized Controlled Researcher-Blinded Trial.

BACKGROUND: Anxiety and depression impose substantial clinical and economic burdens worldwide, with high prevalence, impaired functioning, and elevated health care costs. Digital self-help interventions offer scalable and potentially cost-effective strategies; however, evidence from rigorously controlled economic evaluations remains sparse. OBJECTIVE: This trial aims to evaluate the effectiveness and cost-effectiveness of 2 Norwegian mental health apps: Tankevirus (cognitive behavioral therapy-based) and Grubl (metacognitive therapy-based), compared with a digital placebo in reducing anxiety

AI literacy for self-regulated learning among pre-service teachers: development and validation of a scale of ethical use, monitoring, motivation, regulation, and evaluation.

INTRODUCTION: Existing AI-literacy measures often emphasize broad knowledge, attitudes, application, or ethical awareness rather than how learners use AI within self-regulated academic learning. This study developed and validated the Multidimensional Aspects of AI Literacy Scale for Pre-Service Teachers (MAILS-PT), which assesses Ethical Use, Metacognitive Monitoring (Monitor), Motivational Regulation (Motivate), Behavioral Regulation (Regulate), and Critical Evaluation (Evaluate). METHOD: An initial 60-item pool was reduced to 40 items through expert content review. The scale was administere

A Digital Cognitive-Physical Intervention for Attention-Deficit/Hyperactivity Disorder: Randomized Controlled Trial.

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders among children. Pharmacot … 95% CI -4.857 to -1.132; P=.002). The intervention was associated with significant reduction in the Metacognition Index (β=-6.312, 95% CI -10.973 to -1.650; P=.006) and Global Executive Composite (β=-5.952, 95% CI -10.214 to -1.690; P=.003) on the BRIEF. No severe intervention-related adverse events were reported. CONCLUSIONS: This novel digital cognitive-phys …

A Phase III, Randomized, Double-Blind, Placebo-Controlled Trial Assessing the Efficacy and Safety of Viloxazine Extended-Release Capsules in Adults with Attention-Deficit/Hyperactivity Disorder.

BACKGROUND AND OBJECTIVE: Attention-deficit/hyperactivity disorder is a neurodevelopmental disorder that typically begins in childhood and o … 380) subscales, the CGI-I (p = 0.0076), and the BRIEF-A Global Executive Composite (p = 0.0468) and Metacognition Index (p = 0.0100). Analysis of categorical secondary endpoints revealed that the viloxazine ER group had a significantly higher AISRS 30% response rate compared with placebo (p = 0.0395); all other comparisons were not significant. Many treatment e …

Aging of Nonhuman Primate Eyes Is Sexually Dimorphic.

IMPORTANCE: Traumatic brain injury (TBI) is known to cause widespread neural disruption in the cerebrum. However, less is known about the as … ioning Global Executive Composite score (β = -208.9 mm3; 95% CI, -319.0 to -98.0 mm3; P = .008) and Metacognition Index score (β = -202.5 mm3; 95% CI, -319.0 to -85.0 mm3; P = .02). In a subset of 185 participants with longitudinal data, younger msTBI participants exhibited cerebellum volume reductions (β = 0.0052 mm3; 95% CI, 0.0013 to 0.0090 mm3; P = .01), an …

iCogCA to Promote Cognitive Health Through Digital Group Interventions for Individuals Living With a Schizophrenia Spectrum Disorder: Protocol for a Nonrandomized Concurrent Controlled Trial.

BACKGROUND: Cognitive impairments are a key aspect of schizophrenia spectrum disorders (SSDs), significantly affecting clinical and functional outcomes. The COVID-19 pandemic has heightened concerns about mental health services and cognitive stimulation opportunities. Despite evidence-based interventions like action-based cognitive remediation (ABCR) and metacognitive training (MCT), a research-to-practice gap exists in their application across mental health settings. OBJECTIVE: The iCogCA study aims to address this gap by implementing digital ABCR and MCT through a national Canadian collabor

A Self-Guided Internet-Based Intervention for the Reduction of Gambling Symptoms: A Randomized Clinical Trial.

IMPORTANCE: Most individuals with problem gambling or gambling disorder remain untreated due to barriers to treatment. Limited research exists on alternative treatments. OBJECTIVE: To investigate the efficacy of a self-guided internet-based intervention for individuals with gambling problems and to identify potential outcome moderators. DESIGN, SETTING, AND PARTICIPANTS: This single-center randomized clinical trial was conducted from July 13, 2021, to December 31, 2022, at the University Medical Center Hamburg-Eppendorf. Participants were recruited across Germany for 2 assessments (before in

Fenfluramine treatment is associated with improvement in everyday executive function in preschool-aged children (<5 years) with Dravet syndrome: A critical period for early neurodevelopment.

OBJECTIVE: To evaluate whether fenfluramine (FFA) is associated with improvement in everyday executive function (EF)-self-regulation-in pres … o T-scores and summarized in Inhibitory Self-Control Index (ISCI), Flexibility Index (FI), Emergent Metacognition Index (EMI), and Global Executive Composite (GEC). Clinically meaningful improvement and worsening were defined using RCI ≥ 90% and RCI ≥ 80% certainty, respectively. The associations between placebo vs FFA combined (0.2, 0.4, and 0.7 mg/kg/day) or …

Comparison of GPT-5 and GPT-4o in Solving the Polish Centre for Medical Examinations (CEM) Gastroenterology Examination.

INTRODUCTION: Large language models (LLMs) are increasingly explored as tools for medical education and assessment. While prior studies have demonstrated strong performance of LLMs on undergraduate and general medical examinations, their reliability and calibration on specialty-level certification exams remain insufficiently characterized. In particular, little is known about how model-reported confidence aligns with correctness in high-stakes medical testing. OBJECTIVE: The aim of this study was to compare the accuracy of responses and the calibration of self-reported confidence of GPT-4o an

Older Adults' Motivators and Barriers to Using Mindfulness Apps for Stress Management in Brain Health Interventions: Interview Study.

BACKGROUND: Population aging is driving a rapid rise in dementia cases worldwide, posing a major challenge for health care systems around the globe, including in the Netherlands. Digital multidomain lifestyle interventions, which target multiple lifestyle domains simultaneously, can protect against cognitive decline in at-risk older adults but struggle to sustain engagement. Addressing stress in these interventions is crucial, as it can directly increase dementia risk and may promote unhealthy behaviors in other domains targeted in these interventions, including physical activity, diet, and sl

[Cognitive-behavioral therapy at the Pavillon Albert-Prévost's specialized outpatient clinics during the last 50 years: innovations and evolution].

The Pavillon Albert-Prévost (PAP) has played a leading role in the development of modern psychiatry in the province of Québec. It has also been, in the francophone milieu, the teaching hospital that was the most deeply influenced by psychoanalytic theories. The arrival of somatic approaches, particularly biofeedback and relaxation, in the Psychosomatic medicine and consultation-liaison service, as introduced by Dr. Jacques Monday in the 1970s, was initially greeted with great scepticism by the majority of his colleagues at PAP. In the 1980s and 1990s, Dr. Camille Laurin, then head of the depar

[Three Essential Shared Capabilities for Young Psychiatrists: Brain, Real-world, and Life-course Principles toward Values-based Psychiatry].

The discipline of psychiatry promotes well-being and recovery based on a comprehensive understanding of the patient from the perspectives of … table to reductionist models of the brain. That is, human mental functioning forms a foundation for metacognition and sophisticated language functions, and through interactions with others and society, one's mental functioning allows for further brain transformation and development (self-regulation of mental functions). Humans develop their own brain and mental …

Exploring Immersive Multimodal Virtual Reality Training, Affective States, and Ecological Validity in Healthy Firefighters: Quasi-Experimental Study.

BACKGROUND: Firefighters face stressful life-threatening events requiring fast decision-making. To better prepare for those situations, training is paramount, but errors in real-life training can be harmful. Virtual reality (VR) simulations provide the desired realism while enabling practice in a secure and controlled environment. Firefighters' affective states are also crucial as they are a higher-risk group. OBJECTIVE: To assess the impact on affective states of 2 simulated immersive experiences in a sample of healthy firefighters (before, during, and after the simulation), we pursued a mul

[Preventing violence in schizophrenia with cognitive remediation].

OBJECTIVES: The association between schizophrenia and violence represents an important issue in psychiatry. Often highly publicized, violent acts raise the question of their detection, prevention, management and treatment. There is no single, direct and exclusive link between aggressiveness and the underlying psychiatric disorder. On the contrary, the processes underlying this violence are multiple and interlinked. In addition to static and dynamic risk factors, cognitive deficits play an important role in the genesis and maintenance of violent and aggressive behavior. METHODS: Using recent d

User Experience and Satisfaction With a Web-Based Application to Improve Intelligibility in Parkinson's Disease.

BACKGROUND/OBJECTIVES: Motor speech impairments, such as hypokinetic dysarthria, are highly prevalent among individuals with Parkinson's disease (PD). These voice and speech deficits may significantly impact speech intelligibility, leading many individuals with PD to withdraw socially. Digital platforms may provide a feasible way to address motor speech impairments in this population while also fostering patients' self-management skills through independent home-based practice. The objective of this preliminary one-group pre-post treatment study is to provide a qualitative examination of partic

Randomized controlled trial of emotion regulation therapy versus cognitive behavioral therapy to address distress in cancer caregivers

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Interconnectivity of fear of progression and generalized anxiety - Network analysis among a sample of hematological cancer survivors.

PurposeFear of cancer progression and recurrence (FoP) and generalized anxiety disorder (GAD) are syndromes commonly seen in cancer patients. This study applied network analysis to investigate how symptoms of both concepts are interconnected.MethodsWe used cross-sectional data from hematological cancer survivors. A regularized Gaussian graphical model including symptoms of FoP (FoP-Q) and GAD (GAD-7) was estimated. We investigated (i) the overall network structure and (ii) tested on pre-selected items whether both syndromes could be differentiated based on their worry content (cancer related v

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… A recent transdiagnostic FoP model emphasizes the importance of intrusive thoughts, death anxiety, threat appraisals, intolerance of uncertainty and metacognitions [ 19 ]. … For example, metacognitions and intolerance of anxiety seem to play crucial roles in the etiology and maintenance of FoP and GAD. This should be considered when selecting instruments in future studies [ 7 , 36 ]. …