Parental perceptions of participation in young adult-focused eating disorder treatment.

BACKGROUND: Eating disorders (ED) are serious mental illnesses affecting young adults (YA). Parent-supported treatment for this age cohort is an important consideration given the unique developmental needs and norms of familial social support, but more research is needed to understand parental perceptions of treatment involvement. METHODS: 33 parent-supports of YA with ED completed self-report assessments at admission and discharge of participation in brief, intensive, young-adult focused eating disorder treatment. Assessments measured programme satisfaction, parental self-efficacy, and parent and YA report of eating disorder-related psychopathology. Repeated measures ANOVAs were used to examine pre-post outcome differences and between group differences among parent-supports and their YA (i.e., the patients) on eating disorder psychopathology, clinical impairment, and family functioning using the EDEQ/P-EDEQ Global, P-CIA/CIA, and Family Assessment Device Family Functioning scales. Group differences across time points were examined with paired sample t-tests adjusted for multiple comparisons. Changes in parental self-efficacy were examined separately using two-tailed paired sample t-tests. RESULTS: Parents reported high acceptability and learning, improvements in self-efficacy, and significant reductions of YA psychopathology at post-treatment. Parents reported comparable reductions in ED psychopathology post-treatment, but significantly greater reductions in clinical impairment compared to YA. Measures of family functioning did not improve for either parent or YA at post-treatment. CONCLUSION: Results from this study suggest that parental involvement in a YA programme is feasible and acceptable from a parental perspective and improves parental self-efficacy.

Effects of Drug Physicochemical Properties on In-Situ Forming Implant Polymer Degradation and Drug Release Kinetics.

In-situ forming implants (ISFIs) represent a simple, tunable, and biodegradable polymer-based platform for long-acting drug delivery. However, drugs with different physicochemical properties and physical states in the polymer-solvent system exhibit different drug release kinetics. Although a few limited studies have been performed attempting to elucidate these effects, a large, systematic study has not been performed until now. The purpose of this study was to characterize the in vitro drug release of 12 different small molecule drugs with differing logP and pKa values from ISFIs. Drug release was compared with polymer degradation as measured by lactic acid (LA) release and change in poly(DL-lactide-co-glycolide) (PLGA) molecular weight (MW) measured by size exclusion chromatography with multi-angle laser light scattering (SEC-MALS). Drug physical state and morphology were also measured using differential scanning calorimetry (DSC) and scanning electron microscopy (SEM). Together, these results demonstrated that hydrophilic drugs have higher burst release at 24 h (22.8-68.4%) and complete drug release within 60 days, while hydrophobic drugs have lower burst release at 24 h (1.8-18.9%) and can sustain drug release over 60-285 days. Overall, drug logP and drug physical state in the polymer-solvent system are the most important factors when predicting the drug release rate in an ISFI for small-molecule drugs. Hydrophilic drugs exhibit high initial burst and less sustained release due to their miscibility with the aqueous phase, while hydrophobic drugs have lower initial burst and more sustained release due to their affinity for the hydrophobic PLGA. Additionally, while hydrophilic drugs seem to accelerate the degradation of PLGA, hydrophobic drugs on the other hand seem to slow down the PLGA degradation process compared with placebo ISFIs. Furthermore, drugs that were in a crystalline state within the ISFI drugs exhibited more sustained release compared with amorphous drugs.

Applying the cognitive theory of multimedia learning: an analysis of medical animations.

CONTEXT: Instructional animations play a prominent role in medical education, but the degree to which these teaching tools follow empirically established learning principles, such as those outlined in the cognitive theory of multimedia learning (CTML), is unknown. These principles provide guidelines for designing animations in a way that promotes optimal cognitive processing and facilitates learning, but the application of these learning principles in current animations has not yet been investigated. A large-scale review of existing educational tools in the context of this theoretical framework is necessary to examine if and how instructional medical animations adhere to these principles and where improvements can be made. METHODS: We conducted a comprehensive review of instructional animations in the health sciences domain and examined whether these animations met the three main goals of CTML: managing essential processing; minimising extraneous processing, and facilitating generative processing. We also identified areas for pedagogical improvement. Through Google keyword searches, we identified 4455 medical animations for review. After the application of exclusion criteria, 860 animations from 20 developers were retained. We randomly sampled and reviewed 50% of the identified animations. RESULTS: Many animations did not follow the recommended multimedia learning principles, particularly those that support the management of essential processing. We also noted an excess of extraneous visual and auditory elements and few opportunities for learner interactivity. CONCLUSIONS: Many unrealised opportunities exist for improving the efficacy of animations as learning tools in medical education; instructors can look to effective examples to select or design animations that incorporate the established principles of CTML.