An exploratory non-randomized study of a 3-month electronic nicotine delivery system (ENDS) intervention with people accessing a homeless supported temporary accommodation service (STA) in Ireland

Abstract Background Smoking is endemic amongst people accessing homeless services, and they are disproportionately affected by smoking-related diseases. This paper reports on the results of a 3-month small scale intervention which explored the efficacy, challenges and opportunities of using electronic nicotine delivery systems (ENDS) to support cessation of tobacco smoking with people accessing an Irish supported temporary accommodation (STA) homeless service. It considers the results of this intervention with reference to the balance of harms between the use of vaping to support smoking cessation and continued smoking. Methods Twenty-three participants were recruited. Demographic data, carbon monoxide (CO) measurements, homelessness status and smoking history were recorded. Participants were given an ENDS device and two 10-ml bottles containing e-liquid available in several flavours and at several strengths. Participants could pick up new bottles on a weekly basis. At weeks 1, 4, 8 and 12, the Fagerström Test and Mood and Physical Symptoms Scale (MPSS) were administered. Results Over 75% of the residents in the participating hostel were recruited (23/30). However, there was a substantial loss to follow-up (n = 14) as a result of data protection issues, the transient nature of the population of interest and non-compliance with the intervention. Self-reported reductions in cigarette consumption were found to be statistically significant (p < 0.001). However, reductions in carbon monoxide measurements were not statistically significant. Decreases in Fagerström Nicotine Dependence Test were statistically significant (p = 0.001), but decreases in MPSS “urge to smoke” and “strength of urges” composite scores were not. Reported side effects included coughing, runny nose, bleeding nose, slight sweating, dizziness, increased phlegm and a burning sensation at the back of the throat. Barriers to engagement were peer norms, vaping restrictions in accommodation and adverse life events. Positive effects reported included increased energy, less coughing, better breathing and financial benefits. An improvement in the domain “poor concentration” was also found to be statistically significant (p = 0.040). Conclusion ENDS-based interventions may be effective with this population. Future research should aim to improve follow-up, consider including behavioural components and monitor health effects in relation to ongoing concerns around risks and the balance of harms. Trial registration Registered retrospectively ISRCTN14767579

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Virtual Reality Technology Use in Cigarette Craving and Smoking Interventions (I “Virtually” Quit): Systematic Review (Preprint)

10.2196/preprints.24307 ◽

2020 ◽

Author(s):

Merel Keijsers ◽

Maria Cecilia Vega-Corredor ◽

Melanie Tomintz ◽

Simon Hoermann

Keyword(s):

Systematic Review ◽

Smoking Cessation ◽

Virtual Reality ◽

Technology Use ◽

Future Research ◽

Control Group ◽

Avoidance Task ◽

Nicotine Delivery ◽

Approach Avoidance

BACKGROUND Over the last 2 decades, virtual reality technologies (VRTs) have been proposed as a way to enhance and improve smoking cessation therapy. OBJECTIVE This systematic review aims to evaluate and summarize the current knowledge on the application of VRT in various smoking cessation therapies, as well as to explore potential directions for future research and intervention development. METHODS A literature review of smoking interventions using VRT was conducted. RESULTS Not all intervention studies included an alternative therapy or a placebo condition against which the effectiveness of the intervention could be benchmarked, or a follow-up measure to ensure that the effects were lasting. Virtual reality (VR) cue exposure therapy was the most extensively studied intervention, but its effect on long-term smoking behavior was inconsistent. Behavioral therapies such as a VR approach-avoidance task or gamified interventions were less common but reported positive results. Notably, only 1 study combined Electronic Nicotine Delivery Devices with VRT. CONCLUSIONS The inclusion of a behavioral component, as is done in the VR approach-avoidance task and gamified interventions, may be an interesting avenue for future research on smoking interventions. As Electronic Nicotine Delivery Devices are still the subject of much controversy, their potential to support smoking cessation remains unclear. For future research, behavioral or multicomponent interventions are promising avenues of exploration. Future studies should improve their validity by comparing their intervention group with at least 1 alternative or placebo control group, as well as incorporating follow-up measures. CLINICALTRIAL

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Correction to: An exploratory non-randomized study of a 3-month electronic nicotine delivery system (ENDS) intervention with people accessing a homeless supported temporary accommodation service (STA) in Ireland

Harm Reduction Journal ◽

10.1186/s12954-021-00549-6 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Florian Scheibein ◽

Kevin McGirr ◽

Andy Morrison ◽

Warren Roche ◽

John Stephen Gary Wells

Keyword(s):

Delivery System ◽

Randomized Study ◽

Nicotine Delivery ◽

Temporary Accommodation

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Midlife cardiovascular fitness and dementia

Neurology ◽

10.1212/wnl.0000000000005290 ◽

2018 ◽

Vol 90 (15) ◽

pp. e1298-e1305 ◽

Cited By ~ 40

Author(s):

Helena Hörder ◽

Lena Johansson ◽

XinXin Guo ◽

Gunnar Grimby ◽

Silke Kern ◽

...

Keyword(s):

Population Based ◽

Cardiovascular Fitness ◽

Future Research ◽

Positive Effects ◽

High Fitness ◽

Dementia Risk ◽

Dementia Incidence ◽

The Life Course ◽

Dementia Onset

ObjectiveTo investigate whether greater cardiovascular fitness in midlife is associated with decreased dementia risk in women followed up for 44 years.MethodsA population-based sample of 1,462 women 38 to 60 years of age was examined in 1968. Of these, a systematic subsample comprising 191 women completed a stepwise-increased maximal ergometer cycling test to evaluate cardiovascular fitness. Subsequent examinations of dementia incidence were done in 1974, 1980, 1992, 2000, 2005, and 2009. Dementia was diagnosed according to DSM-III-R criteria on the basis of information from neuropsychiatric examinations, informant interviews, hospital records, and registry data up to 2012. Cox regressions were performed with adjustment for socioeconomic, lifestyle, and medical confounders.ResultsCompared with medium fitness, the adjusted hazard ratio for all-cause dementia during the 44-year follow-up was 0.12 (95% confidence interval [CI] 0.03–0.54) among those with high fitness and 1.41 (95% CI 0.72–2.79) among those with low fitness. High fitness delayed age at dementia onset by 9.5 years and time to dementia onset by 5 years compared to medium fitness.ConclusionsAmong Swedish women, a high cardiovascular fitness in midlife was associated with a decreased risk of subsequent dementia. Promotion of a high cardiovascular fitness may be included in strategies to mitigate or prevent dementia. Findings are not causal, and future research needs to focus on whether improved fitness could have positive effects on dementia risk and when during the life course a high cardiovascular fitness is most important.

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Virtual Reality Technology Use in Cigarette Craving and Smoking Interventions (I “Virtually” Quit): Systematic Review

Journal of Medical Internet Research ◽

10.2196/24307 ◽

2021 ◽

Vol 23 (9) ◽

pp. e24307

Author(s):

Merel Keijsers ◽

Maria Cecilia Vega-Corredor ◽

Melanie Tomintz ◽

Simon Hoermann

Keyword(s):

Systematic Review ◽

Smoking Cessation ◽

Virtual Reality ◽

Technology Use ◽

Future Research ◽

Control Group ◽

Avoidance Task ◽

Nicotine Delivery ◽

Approach Avoidance

Background Over the last 2 decades, virtual reality technologies (VRTs) have been proposed as a way to enhance and improve smoking cessation therapy. Objective This systematic review aims to evaluate and summarize the current knowledge on the application of VRT in various smoking cessation therapies, as well as to explore potential directions for future research and intervention development. Methods A literature review of smoking interventions using VRT was conducted. Results Not all intervention studies included an alternative therapy or a placebo condition against which the effectiveness of the intervention could be benchmarked, or a follow-up measure to ensure that the effects were lasting. Virtual reality (VR) cue exposure therapy was the most extensively studied intervention, but its effect on long-term smoking behavior was inconsistent. Behavioral therapies such as a VR approach-avoidance task or gamified interventions were less common but reported positive results. Notably, only 1 study combined Electronic Nicotine Delivery Devices with VRT. Conclusions The inclusion of a behavioral component, as is done in the VR approach-avoidance task and gamified interventions, may be an interesting avenue for future research on smoking interventions. As Electronic Nicotine Delivery Devices are still the subject of much controversy, their potential to support smoking cessation remains unclear. For future research, behavioral or multicomponent interventions are promising avenues of exploration. Future studies should improve their validity by comparing their intervention group with at least 1 alternative or placebo control group, as well as incorporating follow-up measures.

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SHORT TERM DURABILITY OF A COGNITIVE BEHAVIOURAL INTERVENTION IN PSYCHOSIS: EFFECTS FROM A PILOT STUDY

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465804001092 ◽

2004 ◽

Vol 32 (1) ◽

pp. 117-121 ◽

Cited By ~ 12

Author(s):

Pauline L. Hall ◽

Nicholas Tarrier

Keyword(s):

Pilot Project ◽

Self Esteem ◽

Psychotic Symptoms ◽

Future Research ◽

Small Scale ◽

Behavioural Intervention ◽

Cognitive Behavioural ◽

Self Worth ◽

Cognitive Behavioural Intervention

Low self-esteem in psychosis is common and has been found to be significantly related to a number of clinical variables and to symptom severity. This report describes the follow-up evaluation of a simple time-limited cognitive behavioural intervention aimed to improve feelings of low self-worth in the treatment of psychotic symptoms. A previous small scale pilot project found encouraging results for the efficacy of the novel intervention following its delivery and at 3-month follow-up. This report examines the benefits of the technique at 12 months following delivery of the intervention. These preliminary results suggest that the intervention may promote improved levels of self-esteem, psychotic symptomatology and social functioning over the longer term. Implications for practice and future research are discussed.

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Effects of Resonance Voice Therapy on Hormone-Related Vocal Disorders in Professional Singers: A Pilot Study

Clinical Medicine Insights Ear Nose and Throat ◽

10.1177/1179550618786934 ◽

2018 ◽

Vol 11 ◽

pp. 117955061878693 ◽

Cited By ~ 1

Author(s):

Laishyang (Melody) Ouyoung ◽

Brenda Capobres Villegas ◽

Changxing Liu ◽

Guy Talmor ◽

Uttam K Sinha

Keyword(s):

Randomized Study ◽

Voice Therapy ◽

Future Research ◽

Vocal Performance ◽

Level Of Evidence ◽

Pitch Range ◽

Maximum Phonation Time ◽

Female Singers ◽

Voice Data

Background: Menstruation-related hormonal alteration can be detrimental to the professional singing voice of women. Resonance Voice Therapy (RVT) has been proven to improve vocal production. However, no research to date has been conducted examining the subjective, acoustic, and stroboscopic effects of RVT on professional female singers having premenstrual or postmenopausal voice disorders. Aim: The aim of this study is to compare the vocal effects of RVT with a control cervical-thoracic intervention in healthy female singers during the premenstrual phase as well as in postmenopausal singers and to evaluate which intervention will allow singers to improve vocal performance regardless of changes in hormonal status. Design: A randomized study was designed for this research. The research subjects were 20 professional female singers from the Southern California area, USA, with 10 premenstrual subjects in one group and 10 postmenopausal subjects in the other group. Among each group, 5 subjects were randomly selected to receive RVT and the remaining subjects received cervical-thoracic–focused exercises. The therapies consisted of 1 month of daily 15-minute sessions. For premenstrual subjects, voice data were collected at days 25 to 27 of the premenstrual phase during a scheduled initial voice evaluation. Follow-up data were collected during the same phase of the menstrual cycle (days 25-27) after 1 month of exercises. For postmenopausal subjects, voice data were collected at an initial voice evaluation with follow-up after 1 month of the assigned voice treatment. Outcomes were assessed with the singer’s voice handicap index (VHI), laryngeal videostroboscopic examination, maximum phonation time (MPT), relative average perturbation (RAP), and pitch range before and following completion of therapies. Alleviation or deterioration percentages were used for statistical analysis. Student t test was used for statistical comparison between therapies. Results: The RVT decreased singer’s VHI for both premenstrual and postmenopausal subjects by an average of 67%, compared with 7.8% for the cervical-thoracic therapy. The RVT also effectively decreased RAP by an average of 57% when combining the premenstrual and postmenopausal groups. The RVT increased MPT and pitch range among both premenstrual and postmenopausal subjects. The stroboscopic examination did not detect any significant differences between the 2 interventions. Conclusions: The RVT is effective for professional female singers with hormone-related premenstrual and postmenopausal vocal changes. The RVT is suggested as one of the therapeutic approaches for vocal abnormalities in such a population. A larger cohort may be needed for future research. Level of Evidence: 1b

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The Daily Challenges of Caring for Grandchildren: A Daily Analysis of Emotional and Physical Reactivity to Stressors

Innovation in Aging ◽

10.1093/geroni/igab046.3439 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 962-962

Author(s):

Elizabeth Hahn Rickenbach ◽

Janelle Fassi

Keyword(s):

Physical Symptoms ◽

Future Research ◽

Daily Stressors ◽

Positive Events ◽

Levels Of Care ◽

Positive Effects ◽

Grandparent Caregivers ◽

Custodial Care ◽

Dual Income ◽

The Impact

Abstract Grandparents are increasingly providing extensive and custodial care for their grandchildren. Many factors have contributed to a societal rise in caregiving among grandparents, including addiction, incarceration, dual-income families, and the cost of childcare. Past work has highlighted positive effects of grandparenting (e.g. reduced dementia risk); however, research is limited that examines the day to day challenges grandparent caregivers experience. The goal of this research was to examine daily experiences of stressors, positive events, physical symptoms, and daily mood of grandparent caregivers. Participants (n=18 grandparent caregivers) filled out a diary survey for five consecutive days that measured daily stressors and positive events. A total of 90 diaries were completed. Stressors were reported on 97.6% of days. Multilevel analysis examining emotional and physical reactivity to daily events showed that, controlling for age and gender, on days when participants reported more stressors than average, they reported higher negative affect (p=.019), lower positive affect (p=.003) and more physical symptoms (p=.002). Positive events were not significantly associated with daily mood or daily physical symptoms. Overall, the findings supported the hypothesis that grandparent caregivers experience emotional and physical reactivity to the daily challenges they experience. Future research should examine resources and supports to reduce the impact of daily stressors, as well as the particular challenges among underrepresented groups, particularly Black and Latino grandparents, who provide disproportionate levels of care for their grandchildren. The current study highlights the potential vulnerability and daily needs for support among grandparents who provide regular and custodial care for their grandchildren.

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Association of study type, sample size, and follow-up length with type of recommendation produced by the National Institute for Health and Clinical Excellence Interventional Procedures Programme

International Journal of Technology Assessment in Health Care ◽

10.1017/s026646230705163x ◽

2007 ◽

Vol 23 (1) ◽

pp. 101-107 ◽

Cited By ~ 12

Author(s):

William Bruce Campbell ◽

Steven J. Barnes ◽

Rebecca A. Kirby ◽

Sarah L. Willett ◽

Sally Wortley ◽

...

Keyword(s):

Interventional Procedures ◽

Randomized Study ◽

Case Series ◽

Clinical Excellence ◽

Future Research ◽

Relevant Evidence ◽

Number Of Patients ◽

Evidence Type ◽

To Receive

Objectives:The association between type and amount of clinical evidence and type of National Institute for Health and Clinical Excellence recommendations for interventional procedures was examined.Methods:The evidence about 736 studies (including 183,729 patients) relating to 130 different interventional procedures and about relevant recommendations was analyzed. Associations were examined between type of recommendation (“normal arrangements” or “cautionary guidance”) and evidence type, total number of treated patients, and mean follow-up length. Evidence type was categorized as (a) randomized, (b) nonrandomized controlled, and (c) case series/reports. The main outcome measures were frequency of evidence type, total number of patients treated, and mean follow-up length, by type of recommendation.Results:“Normal arrangements” recommendations were made for 70 (54 percent) procedures and “cautionary guidance” was issued for 60 (46 percent) procedures. Procedures supported by at least one randomized study (34 percent,n= 44) were more likely to receive a “normal arrangements” recommendation (relative risk 1.38,p= .063). Overall, there were 85 (12 percent), 135 (18 percent), and 516 (70 percent) studies in categories a–c, respectively. The number of treated patients was significantly larger among procedures with “normal arrangements” (median, 605; range, 26–6,842) than among those with “cautionary guidance” (median, 240; range, 1–3,261;p< .001) recommendation. Mean follow-up length was longer in studies relating to procedures with “normal arrangements” recommendation (median, 16.7; range, 0–84 months) compared with those with “cautionary guidance” (median, 14.6; range, 0–67 months;p= .160).Conclusions:Procedures supported by randomized studies, and with larger numbers of patients and longer follow-up length, were more likely to receive positive guidance. Future research and development on interventional procedures should aim to produce better and more relevant evidence to optimize the possibility of such procedures being accepted by policy makers.

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Clinical Success Using the Audio-Visual Feedback Training for Cluttering

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig17-2019-0018 ◽

2019 ◽

Vol 4 (6) ◽

pp. 1589-1594

Author(s):

Yvonne van Zaalen ◽

Isabella Reichel

Keyword(s):

Visual Feedback ◽

Clinical Success ◽

Pause Duration ◽

Digital Audio ◽

Male Adolescents ◽

Feedback Training ◽

Positive Effects ◽

Speech Monitoring ◽

Adolescents And Adults

Purpose Among the best strategies to address inadequate speech monitoring skills and other parameters of communication in people with cluttering (PWC) is the relatively new but very promising auditory–visual feedback (AVF) training ( van Zaalen & Reichel, 2015 ). This study examines the effects of AVF training on articulatory accuracy, pause duration, frequency, and type of disfluencies of PWC, as well as on the emotional and cognitive aspects that may be present in clients with this communication disorder ( Reichel, 2010 ; van Zaalen & Reichel, 2015 ). Methods In this study, 12 male adolescents and adults—6 with phonological and 6 with syntactic cluttering—were provided with weekly AVF training for 12 weeks, with a 3-month follow-up. Data was gathered on baseline (T0), Week 6 (T1), Week 12 (T2), and after follow-up (T3). Spontaneous speech was recorded and analyzed by using digital audio-recording and speech analysis software known as Praat ( Boersma & Weenink, 2017 ). Results The results of this study indicated that PWC demonstrated significant improvements in articulatory rate measurements and in pause duration following the AVF training. In addition, the PWC in the study reported positive effects on their ability to retell a story and to speak in more complete sentences. PWC felt better about formulating their ideas and were more satisfied with their interactions with people around them. Conclusions The AVF training was found to be an effective approach for improving monitoring skills of PWC with both quantitative and qualitative benefits in the behavioral, cognitive, emotional, and social domains of communication.

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