scholarly journals Therapy Processes Associated With Sudden Gains in Cognitive Therapy for Depression: Exploring Therapeutic Changes in the Sessions Surrounding the Gains

2021 ◽  
Vol 12 ◽  
Author(s):  
Lotte H. J. M. Lemmens ◽  
Robert J. DeRubeis ◽  
Tony Z. Tang ◽  
Julia C. C. Schulte-Strathaus ◽  
Marcus J. H. Huibers
Keyword(s):  
Therapeutic Alliance ◽  
Cognitive Therapy ◽  
Small Sample Size ◽  
Small Sample ◽  
Cognitive Behavioral ◽  
Future Research ◽  
Control Session ◽  
Sudden Gains ◽  
And Control

Background: The frequency and clinical impact of Sudden Gains—large symptom improvements during a single between-session interval—in psychotherapy for depression have been well established. However, there have been relatively few efforts to identify the processes that lead to sudden gains.Aim: To explore therapy processes associated with sudden gains in cognitive therapy for depression by examining changes in the sessions surrounding the gains, and the session preceding the gain in particular.Methods: Using ratings of video-recordings (n = 36), we assessed the content, frequency and magnitude of within-session cognitive-, behavioral-, and interpersonal change, as well as the quality of the therapeutic alliance in the session prior to the gain (pre-gain session), the session after the gain (post-gain session) and a control session. After that, we contrasted scores in the pre-gain session with those in the control session. In addition, we examined changes that occurred between the pre- and post-gain session (between-session changes) and explored patients' attributions of change.Results: Although not statistically significant, within-session changes were more frequent and stronger in the pre-gain session compared to the control session. The largest difference between the pre-gain and control session was found in the behavioral domain, and reached the level of trend-significance. There were more, and more impactful between-session changes in the interval during which the gain occurred as compared to a control interval. Exploratory analysis of attributions of change revealed eight subcategories, all corresponding with the cognitive-, behavioral- and interpersonal- domain. The quality of the therapeutic alliance was high and almost identical in all sessions.Conclusion: In spite of its small sample size, our study provides relevant descriptive information about potential precipitants of, themes related to, and attributions given for sudden gains. Furthermore, our study provides clear suggestions for future research. A better understanding of session content in the sessions surrounding sudden gains may provide insight into the mechanisms of change in psychotherapy, hereby suggesting treatment-enhancing strategies. We encourage researchers to conduct research that could clarify the nature of these mechanisms, and believe the methods used in this study could serve as a framework for further work in this area.

scholarly journals The Role of Dopamine Receptor D2 in Bridging the Intention-Behavior Gap in Sport Participation

2021 ◽  
Vol 18 (5) ◽  
pp. 2379
Author(s):  
Seiyeong Park ◽  
Junhye Kwon ◽  
Chiyoung Ahn ◽  
Hae-Sung Cho ◽  
Hyo Youl Moon ◽  
...  
Keyword(s):  
University Students ◽  
Dopamine Receptor ◽  
Sport Participation ◽  
Small Sample Size ◽  
Behavioral Model ◽  
Small Sample ◽  
Male Students ◽  
Future Research ◽  
Dopamine Receptor D2 ◽  
The Impact

Previous studies have identified that a behavior can occur through the strongest predictor intention, but there is a gap between intention and behavior. Dopamine receptor D2 (DRD2) is known to account for a variance in sporting behaviors in human and animal subjects. However, the relationship between DRD2 and sport participation has been poorly studied, and the limited available reports are inconsistent. The present study was performed to examine the impact of DRD2 on sport participation among Korean university students based on the integrated behavioral model (IBM). Data were collected from enrolled university students in Seoul (N = 45). Participants answered survey questions first, and then they gave investigators their hair to provide DNA information (i.e., the A1 allele of DRD2). DRD2 had a significant effect on sport participation, but only in male students. Male students who carried the A1 allele of DRD2 significantly participated in 105.10 min more sporting activities than male students who did not. Moreover, the effect of intention on sport participation was significantly decreased when considering DRD2. Despite the small sample size, the results of this study could be a preliminary case for a larger study and indicate the direction of future research. Our results suggest that DRD2 may have played an important role as the “actual skill” shown in the IBM.

scholarly journals The incidence and prevalence of cardiovascular diseases in gout: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Peter Cox ◽  
Sonal Gupta ◽  
Sizheng Steven Zhao ◽  
David M. Hughes
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
Small Sample Size ◽  
Meta Analysis ◽  
Random Effect ◽  
Small Sample ◽  
Future Research ◽  
Increased Risk

AbstractThe aims of this systematic review and meta-analysis were to describe prevalence of cardiovascular disease in gout, compare these results with non-gout controls and consider whether there were differences according to geography. PubMed, Scopus and Web of Science were systematically searched for studies reporting prevalence of any cardiovascular disease in a gout population. Studies with non-representative sampling, where a cohort had been used in another study, small sample size (< 100) and where gout could not be distinguished from other rheumatic conditions were excluded, as were reviews, editorials and comments. Where possible meta-analysis was performed using random-effect models. Twenty-six studies comprising 949,773 gout patients were included in the review. Pooled prevalence estimates were calculated for five cardiovascular diseases: myocardial infarction (2.8%; 95% confidence interval (CI)s 1.6, 5.0), heart failure (8.7%; 95% CI 2.9, 23.8), venous thromboembolism (2.1%; 95% CI 1.2, 3.4), cerebrovascular accident (4.3%; 95% CI 1.8, 9.7) and hypertension (63.9%; 95% CI 24.5, 90.6). Sixteen studies reported comparisons with non-gout controls, illustrating an increased risk in the gout group across all cardiovascular diseases. There were no identifiable reliable patterns when analysing the results by country. Cardiovascular diseases are more prevalent in patients with gout and should prompt vigilance from clinicians to the need to assess and stratify cardiovascular risk. Future research is needed to investigate the link between gout, hyperuricaemia and increased cardiovascular risk and also to establish a more thorough picture of prevalence for less common cardiovascular diseases.

scholarly journals Community intervention strategies to reduce the impact of financial strain and promote financial well-being: a comprehensive rapid review

2021 ◽  
Vol 28 (1) ◽  
pp. 42-50
Author(s):  
Nicole M. Glenn ◽  
Lisa Allen Scott ◽  
Teree Hokanson ◽  
Karla Gustafson ◽  
Melissa A. Stoops ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Community Intervention ◽  
Well Being ◽  
Small Sample ◽  
Financial Strain ◽  
Rapid Review ◽  
Research Centre ◽  
Future Research ◽  
The Impact

Financial well-being describes when people feel able to meet their financial obligations, feel financially secure and are able to make choices that benefit their quality of life. Financial strain occurs when people are unable to pay their bills, feel stressed about money and experience negative impacts on their quality of life and health. In the face of the global economic repercussions of the COVID-19 pandemic, community-led approaches are required to address the setting-specific needs of residents and reduce the adverse impacts of widespread financial strain. To encourage evidence-informed best practices, a provincial health authority and community-engaged research centre collaborated to conduct a rapid review. We augmented the rapid review with an environmental scan and interviews. Our data focused on Western Canada and was collected prior to the pandemic (May–September 2019). We identified eight categories of community-led strategies to promote financial well-being: systems navigation and access; financial literacy and skills; emergency financial assistance; asset building; events and attractions; employment and educational support; transportation; and housing. We noted significant gaps in the evidence, including methodological limitations of the included studies (e.g. generalisability, small sample size), a lack of reporting on the mechanisms leading to the outcomes and evaluation of long-term impacts, sparse practice-based data on evaluation methods and outcomes, and limited intervention details in the published literature. Critically, few of the included interventions specifically targeted financial strain and/or well-being. We discuss the implications of these gaps in addition to possibilities and priorities for future research and practice. We also consider the results in relation to the COVID-19 pandemic and its economic consequences.

The quality of research exploring in-session measures of CBT competence: a systematic review

2021 ◽  
pp. 1-17
Author(s):  
Kathryn Rayson ◽  
Louise Waddington ◽  
Dougal Julian Hare
Keyword(s):  
English Language ◽  
Research Training ◽  
Evidence Base ◽  
Small Sample ◽  
Measurement Properties ◽  
Future Research ◽  
Sample Sizes ◽  
Fidelity Assessment ◽  
Quality Of Research

Abstract Background: Cognitive behavioural therapy (CBT) is in high demand due to its strong evidence base and cost effectiveness. To ensure CBT is delivered as intended in research, training and practice, fidelity assessment is needed. Fidelity is commonly measured by assessors rating treatment sessions, using CBT competence scales (CCSs). Aims: The current review assessed the quality of the literature examining the measurement properties of CCSs and makes recommendations for future research, training and practice. Method: Medline, PsychINFO, Scopus and Web of Science databases were systematically searched to identify relevant peer-reviewed, English language studies from 1980 onwards. Relevant studies were those that were primarily examining the measurement properties of CCSs used to assess adult 1:1 CBT treatment sessions. The quality of studies was assessed using a novel tool created for this study, following which a narrative synthesis is presented. Results: Ten studies met inclusion criteria, most of which were assessed as being ‘fair’ methodological quality, primarily due to small sample sizes. Construct validity and responsiveness definitions were applied inconsistently in the studies, leading to confusion over what was being measured. Conclusions: Although CCSs are widely used, we need to pay careful attention to the quality of research exploring their measurement properties. Consistent definitions of measurement properties, consensus about adequate sample sizes and improved reporting of individual properties are required to ensure the quality of future research.

scholarly journals Sexual Orientation Provisions in Canadian Collective Agreements

2004 ◽  
Vol 58 (4) ◽  
pp. 644-666 ◽  
Author(s):  
Travor Brown
Keyword(s):  
Sexual Orientation ◽  
Public Sector ◽  
Small Sample Size ◽  
Small Sample ◽  
Future Research ◽  
Empirical Testing ◽  
Collective Agreements ◽  
The Past ◽  
Workplace Needs ◽  
Public Sector Bargaining

Abstract The past decade has been marked by increased awareness concerning employment discrimination against gays and lesbians. Yet, to the author’s knowledge, there has been limited research regarding the response of Canadian labour organizations to the workplace needs of gay and lesbian members. Limitations of these previous studies include small sample size, lack of theoretical framework, and the absence of empirical testing of hypotheses. The present study builds on these works through the use of Craig’s model, the inclusion of multi-disciplinary research, and the empirical testing of data collected from more than 240 Canadian collective agreements. Key findings include that larger, public sector bargaining units with equality clauses in their collective agreements were most likely also to contain clauses that prohibited discrimination based on sexual orientation. The paper concludes with suggestions for future research.

What women want: the effect of health agency advertising on patient-doctor communication

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Cynthia Morton ◽  
Sabrina Habib ◽  
Jon Morris
Keyword(s):  
Sexual Health ◽  
Small Sample Size ◽  
Health Agency ◽  
Small Sample ◽  
Communication Strategy ◽  
Future Research ◽  
Health Communications ◽  
Content Type ◽  
Women’S Sexual Health ◽  
Doctor Communication

Purpose The purpose of this study is to investigate the relationship between women’s sexual health agency and their intent to initiate communications with their doctors. The research questions examined the effect sexual health agency has on patient-doctor communication, women’s emotional responses to health advertisements encouraging patient communication with their doctors, attitude toward the message and behavioral intentions after exposure to the advertising message. Design/methodology/approach An experimental design was implemented via an online questionnaire instrument to test the differences between younger-aged women (25 to 45 years) and mature-aged women (46 to 70 years). It was observed that 188 women who reported their status as single and sexually active in the past 12 months were exposed to a health advertisement that encouraged patient-doctor communication. Analyses were conducted to compare between-group measures on sexual health agency, emotional response and attitude toward the ad and behavioral intention. Findings No statistical difference existed between younger and older women. In general, women expect their doctor to lead conversations about sexual health but are positively reinforced by health messages that encourage their assertiveness as patients. Research limitations/implications The small sample size also may have limited the study’s potential to evaluate differences between age segments. Future research should explore this further. Practical implications The study provides evidence that sexual health advertising can reinforce women’s intent to initiate conversations with doctors regardless of age. Social implications Health communications can bolster women’s sexual health agency and improve patient-initiated conversations with doctors. Originality/value The study is the first to explore advertising messaging’s potential for applying health agency as a communication strategy for encouraging sexual health communications between women and their doctors.

scholarly journals Congenital Micropenis: Aetiology And Management

2021 ◽  
Author(s):  
Marianna Rita Stancampiano ◽  
Kentaro Suzuki ◽  
Stuart O’Toole ◽  
Gianni Russo ◽  
Gen Yamada ◽  
...  
Keyword(s):  
Racial Differences ◽  
Small Sample Size ◽  
Small Sample ◽  
Long Term Outcomes ◽  
Penile Length ◽  
Appearance Quality ◽  
Wide Range ◽  
The Impact

Abstract In the newborn, penile length is determined by a number of androgen dependent and independent factors. The current literature suggests that there are inter-racial differences in stretched penile length in the newborn and although congenital micropenis should be defined as a stretched penile length of less than 2.5SDS of the mean for the corresponding population and gestation, a pragmatic approach would be to evaluate all boys with a stretched penile length below 2 cm, as congenital micropenis can be a marker for a wide range of endocrine conditions. However, it remains unclear as to whether the state of micropenis, itself, is associated with any long-term consequences. There is a lack of systematic studies comparing the impact of different therapeutic options on long-term outcomes, in terms of genital appearance, quality of life and sexual satisfaction. To date, research has been hampered by a small sample size and inclusion of a wide range of heterogeneous diagnoses; for these reasons, condition specific outcomes have been difficult to compare between studies. Lastly, there is a need for a greater collaborative effort in collecting standardized data so that all real-world or experimental interventions performed at an early age can be studied systematically into adulthood.

Effectiveness of Directional Microphones and Noise Reduction Schemes in Hearing Aids: A Systematic Review of the Evidence

2005 ◽  
Vol 16 (07) ◽  
pp. 473-484 ◽  
Author(s):  
Ruth A. Bentler
Keyword(s):  
Systematic Review ◽  
Noise Reduction ◽  
Hearing Aids ◽  
Small Sample Size ◽  
Careful Consideration ◽  
Small Sample ◽  
Experimental Conditions ◽  
Directional Microphones ◽  
Directional Microphone

A systematic review of the literature was undertaken to find evidence of real-world effectiveness of directional microphone and digital noise reduction features in current hearing aids. The evidence was drawn from randomized controlled trials, nonrandomized intervention studies, and descriptive studies. The quality of each study was evaluated for factors such as blinding, power of statistical analyses, and use of psychometrically strong outcome measures. Weaknesses in the identified studies included small sample size, resultant poor power to detect potentially worthwhile differences, and overlapping experimental conditions. Nine studies were identified for directional microphones, and the evidence (albeit weak) supports effectiveness. Two studies were identified for the noise reduction feature, and the evidence was equivocal. For the researcher, such a systematic review should encourage the careful consideration of appropriate methodologies for assessing feature effectiveness. For the clinician, the outcomes reported herein should encourage use of such a systematic review to drive clinical practice.

‘There is no sincerer love than the love of food’ (George Bernard Shaw, 1903): The meaning of food and its uses in prison subculture

2018 ◽  
Vol 16 (2) ◽  
pp. 127-146 ◽  
Author(s):  
Tomer Einat ◽  
Moran Davidian
Keyword(s):  
Small Sample Size ◽  
Food Products ◽  
Analysis Data ◽  
Small Sample ◽  
Structured Interviews ◽  
Maximum Security ◽  
Maximum Security Prison ◽  
The Social ◽  
Bernard Shaw

This study examines the ways in which the prison service handles food and analyses the uses and meanings of food in prison subculture. Using semi-structured interviews and content analysis, data were collected and analysed from 20 ex-prisoners who were incarcerated in maximum-security prison facilities for a period of three years or more. Our main findings are that, according to the interviewees’ testimonies, (a) the Israel Prison Service (IPS) makes manipulative and abusive use of food in order to perpetuate its power; and (b) food serves as a means to determine the relationship between prisoners and staff, govern social status or rejection in the prison subculture, or pass the time. We have four main conclusions. First, the IPS nutrition policy differentiates and discriminates among prisoners and clearly violates the basic human rights of prisoners, thus suggesting an abuse of power. Second, the IPS’s use of food as a tool for punishing or rewarding introduces and perpetuates inequalities and encourages the illegal prison trade in food and food products. Third, cooking in prison, especially in light of its illegality, constitutes a symbolic expression of resistance to the institution and a meaningful way of coping with boredom. Lastly, food and its possession in prison serve as very powerful tools for constructing and perpetuating exploitation and unequal power relations among prisoners. Although the study suffers from two limitations – the validity of the adolescents’ responses and the small sample size – its findings lead us to propose that an improvement in the food products that are accessible to prisoners and permission to cook in their cells are inexpensive and legitimate means of bettering both the prisoners’ quality of life and the social atmosphere in prison.

An initial validation of a new quality of life measure for adults with intellectual disability: The Mini-MANS-LD

2018 ◽  
Vol 24 (2) ◽  
pp. 177-193
Author(s):  
Roman Raczka ◽  
Kate Theodore ◽  
Janice Williams
Keyword(s):  
Quality Of Life ◽  
Intellectual Disability ◽  
Small Sample Size ◽  
Initial Study ◽  
Small Sample ◽  
Self Report ◽  
Life Measure ◽  
Acceptable Internal Consistency ◽  
Report Measure

There is an appropriate increasing focus on the need to ensure the voices of people with intellectual disability are captured as part of assessing individuals’ quality of life; however, there remains a lack of a consensus on ways to achieve this. This article describes the development of a self-report measure of quality of life for people with intellectual disability, the ‘Mini-MANS-LD’, based on the concepts of Maslow’s hierarchy of needs. Following use with 33 individuals with intellectual disability, the Mini-MANS-LD was found to have acceptable psychometric properties, including moderate congruent validity and acceptable internal consistency. Administrators’ feedback suggested good acceptability and feasibility, and the measure was relatively quick to administer, easy to use and acceptable to service users. Despite a small sample size, this initial study suggests that the Mini-MANS-LD may present a conceptually relevant, feasible and acceptable self-report measure of quality of life for people with intellectual disability.

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