Rational Reflection in the Post-epidemic Era: Institutional Advantages and Improvement of Governance Efficiency

Currently, the national epidemic prevention and control is still facing the challenges of secondary risk stacking, coordinated optimization of multi-party governance resources, and effective conversion of normal and abnormal conditions. Therefore, systematic thinking should be established in the normalized precision prevention and control and local emergency response, prevention and control should be implemented in accordance with the law, and source governance should be strengthened so as to overcome the risk challenges and improve governance efficiency.

Self-help Application for Obsessive-Compulsive Disorder Based on Exposure and Response Prevention Technique: Prototype Design and Usability Evaluation (Preprint)

BACKGROUND Obsessive-compulsive disorder (OCD) is a relatively common disorder that, due to its debilitating nature, significantly affects personal abilities, job performance, social adjustment, and interpersonal relationships. There are significant barriers to accessing evidence-based cognitive-behavioral therapy as a first-line treatment for obsessive-compulsive disorder. Mobile health applications (Apps) offer a promising way to improve access to evidence-based therapies while overcoming these barriers. OBJECTIVE This study aimed to design and evaluate a prototype of a self¬-help application for people with contamination OCD based on exposure and response prevention (ERP) technique. METHODS This work was developed in four different phases. 1) Needs assessment: Thorough literature review, reviewing existing related programs and apps, and interviewing patients and psychiatrists; 2) Create paper prototype: Considering the functional features identified in the previous phase using wireframe sketcher software. 3)Create digital prototype: developing an actual prototype using Axure RP software based on the information obtained from the evaluation of the paper prototype by expert panel. 4) Prototype usability evaluation: Through a heuristic evaluation with experts and a usability testing with patients using SUS questionnaire. RESULTS After requirement analysis, requirements were defined in the areas of information and educational elements and functional capabilities. Prototypes designed based on identified requirements include capabilities such as in-app online self-help group, assessing the severity of the symptoms of the disorder, psychological training, supportive treatment strategies, setting personalized treatment plan, tracking treatment progress through weekly reports provided, anxiety assessment, setting reminder. The results of heuristic evaluation of 5 experts showed that out of the total identified problems, the most problems are related to the” aesthetic and minimalist design” principle and the least problems are related to ”visibility of system status” and” flexibility and efficiency of use”. No problems were identified for “good error message”. Violated problem in the final application should be resolved and refinement can be made based on the experts' comments and suggestions. In usability testing with 10 patients, mean score of patients’ responses in the SUS questionnaire was 76.75 that indicates that the usability of the app prototype is good from the patient's perspective. CONCLUSIONS The results of heuristic evaluation with experts made it possible to identify how to provide information and to implement the capabilities in a way that can be more appropriate and easier for the user Furthermore, the results of the usability evaluation with potential prototype users showed the that implementing remote treatment with mobile app can be promising to help people with contamination OCD.

Self-help Application for Obsessive-Compulsive Disorder Based on Exposure and Response Prevention Technique: Prototype Design and Usability Evaluation (Preprint)

BACKGROUND Obsessive-compulsive disorder (OCD) is a relatively common disorder that, due to its debilitating nature, significantly affects personal abilities, job performance, social adjustment, and interpersonal relationships. There are significant barriers to accessing evidence-based cognitive-behavioral therapy as a first-line treatment for obsessive-compulsive disorder. Mobile health applications (Apps) offer a promising way to improve access to evidence-based therapies while overcoming these barriers. OBJECTIVE This study aimed to design and evaluate a prototype of a self¬-help application for people with contamination OCD based on exposure and response prevention (ERP) technique. METHODS This work was developed in four different phases. 1) Needs assessment: Thorough literature review, reviewing existing related programs and apps, and interviewing patients and psychiatrists; 2) Create paper prototype: Considering the functional features identified in the previous phase using wireframe sketcher software. 3)Create digital prototype: developing an actual prototype using Axure RP software based on the information obtained from the evaluation of the paper prototype by expert panel. 4) Prototype usability evaluation: Through a heuristic evaluation with experts and a usability testing with patients using SUS questionnaire. RESULTS After requirement analysis, requirements were defined in the areas of information and educational elements and functional capabilities. Prototypes designed based on identified requirements include capabilities such as in-app online self-help group, assessing the severity of the symptoms of the disorder, psychological training, supportive treatment strategies, setting personalized treatment plan, tracking treatment progress through weekly reports provided, anxiety assessment, setting reminder. The results of heuristic evaluation of 5 experts showed that out of the total identified problems, the most problems are related to the” aesthetic and minimalist design” principle and the least problems are related to ”visibility of system status” and” flexibility and efficiency of use”. No problems were identified for “good error message”. Violated problem in the final application should be resolved and refinement can be made based on the experts' comments and suggestions. In usability testing with 10 patients, mean score of patients’ responses in the SUS questionnaire was 76.75 that indicates that the usability of the app prototype is good from the patient's perspective. CONCLUSIONS The results of heuristic evaluation with experts made it possible to identify how to provide information and to implement the capabilities in a way that can be more appropriate and easier for the user Furthermore, the results of the usability evaluation with potential prototype users showed the that implementing remote treatment with mobile app can be promising to help people with contamination OCD.

The Hunt for “Perfect” Jolly Green (Cannabis)

Obsessive-compulsive disorder (OCD) and substance use disorders (SUDs) are clinically distinct disorders that share key features such as impulsivity, obsessive thoughts, compulsive behavior, and impaired attentional distraction. OCD sufferers may turn to substance use as a maladaptive coping strategy to reduce OCD-related distress, although research also suggests that varying substances may have differential effects on OCD symptoms (i.e., mitigating or even aggravating these symptoms). As individuals with comorbid OCD and SUDs demonstrate higher rates of suicidality and distress and lower treatment adherence compared to individuals with OCD alone, treatment considerations for this population are critical. Exposure and response prevention, the gold standard of OCD treatment, intentionally provokes OCD-related distress, which could inadvertently lead to an increased desire to use substances. While substance use and stress management may serve as beneficial precursors to exposure, further research is warranted on the interactions between OCD and SUDs and strategies to manage substance use in the context of OCD treatment.

Couple-Based Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder

For a number of reasons, it may be critical to involve a romantic partner or spouse in exposure and response prevention (ERP) for obsessive-compulsive disorder (OCD). Indeed, relationship stress focal to OCD is associated with greater symptom severity, a more severe course, and poor global functioning. Research also indicates that involving partners or spouses to serve as coaches for their OCD-affected partners during ERP improves the efficacy of this treatment. This chapter describes the nature and treatment of OCD, focusing on interpersonal dynamics, and outlines a couple-based ERP program for individuals with OCD who are in long-term relationships. Case examples are included to illustrate the techniques used in this program.