The Flash Technique in a Low-Intensity Group Trauma Intervention for Healthcare Providers Impacted by COVID-19 Patients

2021 ◽  
pp. EMDR-D-20-00053
Author(s):  
Philip E. Manfield ◽  
Lewis Engel ◽  
Ricky Greenwald ◽  
David G. Bullard
Keyword(s):  
Group Intervention ◽  
Healthcare Providers ◽  
Preliminary Evidence ◽  
Effect Sizes ◽  
Traumatic Memories ◽  
Low Intensity ◽  
Before And After ◽  
Flash Technique ◽  
Rapid Relief

The flash technique (FT) is a low-intensity individual or group intervention that appears to rapidly lessen the distress of disturbing and traumatic memories. This paper reports on the safety and effectiveness of group FT with 77 healthcare providers and 98 psychotherapists impacted by working with COVID-19 patients. One-hour webinars included 30 minutes of psychoeducation and two guided 15-minute FT interventions, focused on participants’ most distressing pandemic-related memory. Before and after each 15-minute FT intervention, they rated that memory using the 11-point zero-to-ten subjective units of disturbance (SUD) scale. Results from both interventions were highly significant with large effect sizes (p < .001, Hedges’ g = 2.01, Hedges’ g = 2.39). No adverse reactions were reported. For 35 participants who processed the same memory in both interventions, the pre–post SUD scores from the beginning of intervention #1 to the end of intervention #2 showed a significant reduction with a large effect size (p < .001, Hedges’ g = 3.80). For this group, both intervention #1 and intervention #2 showed significant reductions with large effect sizes (p < .001, Hedges’ g = 2.00) (p < .001, Hedges’ g = 1.18). Follow-up SUD scores were obtained from 58 participants, with the mean disturbance level showing a significant further decrease. These findings provide preliminary evidence that group FT appears to safely provide rapid relief from disturbing memories. FT merits further research.

The Feasibility and Effectiveness of Computer-Guided CBT (FearFighter) in a Rural Area

2007 ◽  
Vol 35 (4) ◽  
pp. 409-419 ◽  
Author(s):  
Linda Hayward ◽  
Alastair D. MacGregor ◽  
David F. Peck ◽  
Peter Wilkes
Keyword(s):  
Rural Area ◽  
Rural Areas ◽  
Independent Study ◽  
Effect Sizes ◽  
Self Help ◽  
Wide Range ◽  
Before And After ◽  
Unselected Sample ◽  
Closing The Gap

Evaluations of computer-guided CBT (CCBT) suggest that this is a promising approach to closing the gap between the demand for, and the supply of, CBT. However, additional studies are required that are conducted by researchers independent of the programme developers, and include a wider range of participants. This independent study examined the viability of CCBT for panic and phobic anxiety in an unselected sample of referrals in remote and rural areas of Scotland. Outcome was assessed by a wide range of outcome measures, completed before and after treatment, and at 4-month follow-up. Participants experienced few difficulties in using the programme, and GPs and participants regarded CCBT as acceptable and useful. Major improvements were obtained, with several large effect sizes, which remained at follow-up. It was concluded that computer-guided CBT can play a useful part in delivering CBT services in rural areas; and that self-help CBT may be the only treatment option available to some sufferers.

scholarly journals Long-Term Efficacy of Low-Intensity Single Donor Fecal Microbiota Transplantation in Ulcerative Colitis and Outcome-Specific Gut Bacteria

2021 ◽  
Vol 12 ◽  
Author(s):  
Rongrong Ren ◽  
Xuefeng Gao ◽  
Yichao Shi ◽  
Jianfeng Li ◽  
Lihua Peng ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Gut Microbiota ◽  
Fecal Microbiota Transplantation ◽  
Bacteroides Fragilis ◽  
Fecal Microbiota ◽  
Low Intensity ◽  
Single Donor ◽  
Before And After

Aims: To assess the long-term efficacy and safety of single-donor, low-intensity fecal microbiota transplantation (FMT) in treating ulcerative colitis (UC), and to identify the outcome-specific gut bacteria.Design: Thirty-one patients with active UC (Mayo scores ≥ 3) were recruited, and all received FMT twice, at the start of the study and 2∼3 months later, respectively, with a single donor and a long-term follow-up. The fecal microbiome profile was accessed via 16S rRNA sequencing before and after FMT.Results: After the first FMT, 22.58% (7/31) of patients achieved clinical remission and endoscopy remission, with the clinical response rate of 67.74% (21/31), which increased to 55% (11/20) and 80% (16/20), respectively, after the second FMT. No serious adverse events occurred in all patients. During 4 years of follow-up, the mean remission period of patients was 26.5 ± 19.98 m; the relapse rate in the 12 remission patients was 33.33% within 1 year, and 58.3% within 4 years. At baseline, UC patients showed an enrichment in some proinflammatory microorganisms compared to the donor, such as Bacteroides fragilis, Clostridium difficile, and Ruminococcus gnavus, and showed reduced amounts of short-chain fatty acid (SCFA) producing bacteria especially Faecalibacterium prausnitzii. FMT induced taxonomic compositional changes in the recipient gut microbiota, resulting in a donor-like state. Given this specific donor, UC recipients with different outcomes showed distinct gut microbial features before and after FMT. In prior to FMT, relapse was characterized by higher abundances of Bacteroides fragilis and Lachnospiraceae incertae sedis, together with lower abundances of Bacteroides massiliensis, Roseburia, and Ruminococcus; Prevotella copri was more abundant in the non-responders (NR); and the patients with sustained remission (SR) had a higher abundance of Bifidobacterium breve. After FMT, the NR patients had a lower level of Bifidobacterium compared to those with relapse (Rel) and SR, while a higher level of Bacteroides spp. was observed in the Rel group.Conclusion: Low-intensity single donor FMT could induce long remission in active UC. The gut microbiota composition in UC patients at baseline may be predictive of therapeutic response to FMT.

Low-intensity sleep intervention in a youth mental health service: a case series analysis

2020 ◽  
pp. 1-14
Author(s):  
Rebecca Rollinson ◽  
Isabel Price ◽  
Brioney Gee ◽  
Jonathan Lyons ◽  
Ben Carroll ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Young People ◽  
Secondary Care ◽  
Case Series ◽  
Youth Mental Health ◽  
Effect Sizes ◽  
Low Intensity ◽  
Series Analysis

Abstract Background: There is increasing evidence of a strong association between sleep and mental health in both adolescents and adults. CBT for insomnia is being applied to good effect with adults with mental health difficulties but there are few studies examining its applicability to adolescents within mental health services. Method: We carried out a case series analysis (n = 15) looking at the feasibility, accessibility and impact of a low-intensity sleep intervention for young people (14–25 years) being seen by a secondary care Youth Mental Health team in the UK. The intervention was based on cognitive behavioural therapy for insomnia (CBTi) and acceptance and commitment therapy (ACT) approaches and involved six individual sessions delivered on a weekly basis by a graduate psychologist. Routine outcome measures were used to monitor insomnia, psychological distress and functioning with assessments at baseline, session 3, session 6 and at 4 weeks after end of intervention. All participants scored in the clinical range for insomnia at the start of the study. Results: High uptake, attendance and measure completion rates were observed. Large effect sizes were observed for insomnia, psychological distress and functioning. Twelve of the fifteen participants (80%) no longer scored above threshold for insomnia at follow-up. All seven under-18s no longer met threshold for clinical ‘caseness’ on the Revised Child Anxiety and Depression Scale (RCADS) at follow-up. Discussion: The findings suggest that the intervention was well accepted by young people and feasible to apply within a secondary care setting. Strong effect sizes are encouraging but are probably inflated by the small sample size, uncontrolled design and unblinded assessments.

scholarly journals A Well-Structured Follow-Up Program is Required after Recovery from Coronavirus Disease 2019 (COVID-19); Release from Quarantine is Not the End of Treatment

2021 ◽  
Vol 10 (11) ◽  
pp. 2329
Author(s):  
Keun-Mi Lee ◽  
Hae-Jin Ko ◽  
Geon Ho Lee ◽  
A-Sol Kim ◽  
Dong-Wook Lee
Keyword(s):  
Psychological Stress ◽  
Psychological Symptoms ◽  
Healthcare Providers ◽  
Final Analysis ◽  
Physical Symptoms ◽  
Forward Selection ◽  
Phone Calls ◽  
Number Of Patients ◽  
Before And After

During the Coronavirus Infection Disease-19 (COVID-19) pandemic, the number of patients released from quarantine is exceeding the number of newly diagnosed cases. This study is a retrospective cohort study in which consultation data were collected from a COVID-19 follow-up health consultation program. The studied population was selected from patients who recovered after quarantine and treatment for COVID-19 in Daegu City and in Gyeongsangbukdo province, Korea, from March to June 2020. The healthcare providers comprised 20 family-medicine specialists who consulted and educated the patients through phone calls in accordance with structured guidelines. Physical and mental status before and after recovery were compared among patients who received a single consultation and those who received two or more consultations. A total of 1604 subjects were selected for the final analysis. Of these, 1145 (71.4%) had one consultation and 459 (28.6%) had two or more. The group that had two or more consultations reported significantly more physical symptoms, more psychological symptoms (including depression), and more psychological stress. Multivariate forward selection logistic regression analysis showed that re-confirmed cases of COVID-19, physical symptoms after quarantine, feelings of depression, and psychological stress had a significant effect on the number of consultations received. In conclusion, COVID-19 has various physical and mental sequelae after discharge from quarantine. Therefore, a well-structured follow-up program is needed after recovery.

Impact of cognitive-psychoeducational interventions in bipolar patients and their relatives

2006 ◽  
Vol 21 (2) ◽  
pp. 81-86 ◽  
Author(s):  
Britta Bernhard ◽  
Annette Schaub ◽  
Petra Kümmler ◽  
Sandra Dittmann ◽  
Emanuel Severus ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Group Intervention ◽  
Bipolar Disorders ◽  
Warning Signs ◽  
Psychoeducational Group ◽  
Before And After ◽  
Expressed Emotions ◽  
Bipolar Patients ◽  
Psychoeducational Interventions

AbstractBackground.In recent years, several controlled studies could show that psychoeducational interventions have been effective for relapse prevention in bipolar disorders. We therefore established a cognitive-psychoeducational group intervention with 14 sessions providing information about the illness, early warning signs, cognitive and behavioural strategies for stress management and social rhythm. Additionally we offered a group intervention for the patients' relatives. The objective of this study was to describe the outcome associated with our psychoeducational intervention in bipolar patients and their relatives.Methods.Sixty-two bipolar patients attended 14 sessions (à 90 min) of cognitive-psychoeducational group therapy. Patients' knowledge of bipolar disorder and their satisfaction with the treatment were assessed using self-developed questionnaires before and after the group intervention. Additionally, 49 relatives of bipolar patients received two psychoeducational workshops of 4 hours each. We assessed demographic variables, burden, high expressed emotion and depressive symptoms of the relatives before and after the two workshops and at 1-year follow-up.Results.Patients significantly improved their knowledge of bipolar disorder. They also have benefited from the discussions and the exchange of useful coping strategies. Burden and high expressed emotions showed no significant reductions at post-assessment, however they were significantly reduced at 1-year follow-up. Relatives also felt significantly better informed about the illness.Conclusions.These findings show that psychoeducational interventions in bipolar patients and their relatives improve patients' and their relatives' knowledge of the illness and the burden of the disorder as well as high expressed emotions are reduced in relatives at 1-year follow-up.

scholarly journals A pre-post evaluation of oncology healthcare providers’ knowledge, attitudes, and practices following the implementation of a complementary medicine practice guideline

2021 ◽  
Author(s):  
Emilie N Hayward ◽  
Cody Z. Watling ◽  
Lynda G. Balneaves
Keyword(s):  
Cancer Patients ◽  
Complementary Medicine ◽  
Practice Guideline ◽  
Healthcare Providers ◽  
Clinical Practices ◽  
Education Session ◽  
Attitudes And Practices ◽  
Before And After ◽  
Knowledge Attitudes And Practices

Abstract PURPOSE Complementary medicine (CM) use is prevalent among cancer patients, yet it is often not assessed by oncology healthcare providers (HCPs). The purpose of this study was to evaluate oncology HCPs’ knowledge, attitudes, and practices surrounding CM use before and after the implementation of a practice guideline focusing on standardizing assessment and documentation of CM. METHODS Oncology HCPs across a provincial cancer agency were invited to participate in the study. The implementation strategy included an initial education session for HCPs and standardized CM assessment forms. Pre-post surveys assessing knowledge, attitudes, and practices related to CM were completed by HCPs prior to attending the education session and following the 4-month implementation period. Paired t-tests were conducted to determine differences between baseline and follow-up surveys. RESULTS A total of 31 oncology HCPs completed both baseline and follow-up surveys, with over 3,700 patient CM assessment forms being completed during the 4-month study period. At the end of the study, HCPs reported greater CM knowledge (p < 0.001), readiness to support cancer patients’ CM decisions (p = 0.002), and willingness to consult with another HCP about CM (p = 0.004). No significant change in HCPs’ reported attitudes towards CM, or clinical practices related to CM were observed. CONCLUSION Implementing a practice guideline, including a CM education session and a standardized assessment form was found to improve oncology HCPs’ self-reported CM knowledge and readiness to answer cancer patients’ questions about CM. The findings provide support for future knowledge translation research aimed at standardizing how CM is addressed within cancer care settings.

scholarly journals The Effect of the COVID-19 Lockdown on the Position-Specific Match Running Performance of Professional Football Players; Preliminary Observational Study

2021 ◽  
Vol 18 (22) ◽  
pp. 12221
Author(s):  
Damir Sekulic ◽  
Sime Versic ◽  
Andrew Decelis ◽  
Jose Castro-Piñero ◽  
Dejan Javorac ◽  
...  
Keyword(s):  
Physical Performance ◽  
High Intensity ◽  
Effect Sizes ◽  
Football Players ◽  
Professional Football ◽  
Running Performance ◽  
Low Intensity ◽  
Before And After ◽  
National Competition ◽  
Physical Performances

The COVID-19 pandemic interrupted professional football in the 2019/2020 season, and football experts anticipate that the consequences of lockdown measures will negatively affect the physical performance of players once competition restarts. This study aimed to evaluate position-specific match running performance (MRP) to determine the effect of COVID-19 lockdowns on the physical performance of professional football players. Players’ MRPs (n = 124) were observed in matches before and after the COVID-19 lockdown in the 2019/2020 season of the highest level of national competition in Croatia and were classified according to player position: central defenders (CD; n = 42), fullbacks (FB; n = 20), midfielders (MF; n = 46), and forwards (FW; n = 16). The MRPs were measured using Global Positioning System, and included the total distance covered, low-intensity running (≤14.3 km/h), running (14.4–19.7 km/h), high-intensity running (≥19.8 km/h), total accelerations (>0.5 m/s2), high-intensity accelerations (>3 m/s2), total decelerations (less than –0.5 m/s2), and high-intensity decelerations (less than –3 m/s2). The results indicated that, in matches after the COVID-19 lockdown, (i) CDs and FBs featured lower running and high-intensity running (t-value: from 2.05 to 3.51; all p < 0.05; moderate to large effect sizes), (ii) MFs covered a greater distance in low-intensity running and achieved a lower number of total accelerations, and total and high-intensity decelerations (t-value: from –3.54 to 2.46; all p < 0.05, moderate to large effect sizes), and (iii) FWs featured lower high-intensity running (t-value = 2.66, p = 0.02, large effect size). These findings demonstrate that the physical performances of football players from the Croatian first division significantly decreased in matches after the COVID-19 lockdown. A combination of inadequate adaptation to football-specific match demands and a crowded schedule after the competition was restarted most likely resulted in such an effect.

scholarly journals A pilot study of the feasibility of a Swedish multimodal group intervention for severe migraine—The migraine patient school

2021 ◽  
Vol 4 ◽  
pp. 251581632110204
Author(s):  
Birgitta Helmerson ◽  
Anna Sundholm ◽  
Kerstin Hedborg ◽  
Elisabet Waldenlind ◽  
Marie Kierkegaard ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Group Intervention ◽  
Migraine Patient ◽  
Intervention Program ◽  
Body Awareness ◽  
Before And After ◽  
Behavioral Group ◽  
Relaxation Exercises ◽  
The Impact

Objectives: To evaluate a multidisciplinary group intervention, the migraine patient school (MPS), for patients with severe, mostly chronic migraine. Method: A 13-week group intervention program including seven sessions of patient education, practical body awareness and relaxation exercises, and home assignments was performed in small groups with 5–11 participants. Four groups were consecutively included from spring 2014 to fall 2015. Headache diaries and standardized and study-specific questionnaires were used for evaluation at baseline before MPS (pre-interventional phase), and at follow-up. Results: Twenty-four of 30 included patients completed the study, i.e. attended ≥ four sessions. Most participants found it rewarding to participate in the MPS and easy to take part in, understand and complete home assignments. Validated standardized questionnaires delivered before, and after (follow-up) MPS showed that the impact on life (HIT-6) and avoidance behavior (PIPS-A) were significantly improved whereas quality of life (MSQL), anxiety and depression (HAD) and perceived stress (PSS-14) did not show a statistically significant change. Conclusion: The Migraine patient school with a multimodal educational and behavioral group intervention program was feasible to perform and seem to benefit patients with severe (high-frequency or chronic) migraine.

Moving Forward Four Words at a Time: Effects of a Supplemental Preschool Vocabulary Intervention

2020 ◽  
Vol 51 (1) ◽  
pp. 165-175 ◽  
Author(s):  
Lindsey A. Peters-Sanders ◽  
Elizabeth S. Kelley ◽  
Christa Haring Biel ◽  
Keri Madsen ◽  
Xigrid Soto ◽  
...  
Keyword(s):  
Group Intervention ◽  
Single Case ◽  
Single Case Design ◽  
Vocabulary Intervention ◽  
Iterative Development ◽  
At Risk Children ◽  
Before And After ◽  
Child Friendly ◽  
Interactive Lessons ◽  
Case Design

Purpose This study evaluated the effects of an automated, small-group intervention designed to teach preschoolers challenging vocabulary words. Previous studies have provided evidence of efficacy. In this study, we evaluated the effects of the program after doubling the number of words taught from 2 to 4 words per book. Method Seventeen preschool children listened to 1 prerecorded book per week for 9 weeks. Each storybook had embedded, interactive lessons for 4 target vocabulary words. Each lesson provided repeated exposures to words and their definitions, child-friendly contexts, and multiple opportunities for children to respond verbally to instructional prompts. Participants were asked to define the weekly targeted vocabulary before and after intervention. A repeated acquisition single-case design was used to examine the effects of the books and embedded lessons on learning of target vocabulary words. Results Treatment effects were observed for all children across many of the books. Learning of at least 2 points (i.e., 1 word) was replicated for 74.5% of 149 books tested across the 17 participants. On average, children learned to define 47% of the target vocabulary words (17 out of 36). Conclusions Results support including 4 challenging words per book, as children learned substantially more words when 4 words were taught, in comparison to previous studies. Within an iterative development process, results of the current study take us 1 step closer to creating an optimal vocabulary intervention that supports the language development of at-risk children.

Clinically Meaningful Change

Methodology ◽  
2019 ◽  
Vol 15 (3) ◽  
pp. 97-105
Author(s):  
Rodrigo Ferrer ◽  
Antonio Pardo
Keyword(s):  
Effect Size ◽  
False Negative ◽  
False Negative Rate ◽  
Point Of View ◽  
Skewed Distribution ◽  
Effect Sizes ◽  
False Negatives ◽  
Large Size ◽  
Before And After ◽  
Post Test

Abstract. In a recent paper, Ferrer and Pardo (2014) tested several distribution-based methods designed to assess when test scores obtained before and after an intervention reflect a statistically reliable change. However, we still do not know how these methods perform from the point of view of false negatives. For this purpose, we have simulated change scenarios (different effect sizes in a pre-post-test design) with distributions of different shapes and with different sample sizes. For each simulated scenario, we generated 1,000 samples. In each sample, we recorded the false-negative rate of the five distribution-based methods with the best performance from the point of view of the false positives. Our results have revealed unacceptable rates of false negatives even with effects of very large size, starting from 31.8% in an optimistic scenario (effect size of 2.0 and a normal distribution) to 99.9% in the worst scenario (effect size of 0.2 and a highly skewed distribution). Therefore, our results suggest that the widely used distribution-based methods must be applied with caution in a clinical context, because they need huge effect sizes to detect a true change. However, we made some considerations regarding the effect size and the cut-off points commonly used which allow us to be more precise in our estimates.

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