scholarly journals Examining the effects of safety behaviours on fear reduction during exposure

2021 ◽  
Author(s):  
Heather Hood
Keyword(s):  
Anxiety Disorders ◽  
Treatment Success ◽  
Cognitive Measures ◽  
Two Stage ◽  
Stage Design ◽  
Subjective Indicators ◽  
Fear Reduction ◽  
Approach Distance ◽  
Safety Behaviour

The use of safety behaviours has been considered one of the primary maintaining mechanisms of anxiety disorders; however, evidence suggests that they are not always detrimental to treatment success. This study examined the effects of safety behaviours on behavioural, cognitive, and subjective indicators of fear during exposure for fear of spiders. A two-stage design examined fear reduction and approach distance during an exposure task for participants (N = 43) assigned to either a safety behaviour use (SBU) or no safety behaviour use (NSB) condition. No differences were observed between the groups in subjective or cognitive measures at prettest, posttest, and one-week follow-up; however, unlike the NSB group, the SBU group did not maintain their gains in approach distance at follow-up, though this was no longer true after self-efficacy was covaried. These results call for a reconsideration of the practice of completely eliminating safety behaviours during exposure-based treatments for specific fears.

scholarly journals Examining the effects of safety behaviours on fear reduction during exposure

2021 ◽  
Author(s):  
Heather Hood
Keyword(s):  
Anxiety Disorders ◽  
Treatment Success ◽  
Cognitive Measures ◽  
Two Stage ◽  
Stage Design ◽  
Subjective Indicators ◽  
Fear Reduction ◽  
Approach Distance ◽  
Safety Behaviour

The use of safety behaviours has been considered one of the primary maintaining mechanisms of anxiety disorders; however, evidence suggests that they are not always detrimental to treatment success. This study examined the effects of safety behaviours on behavioural, cognitive, and subjective indicators of fear during exposure for fear of spiders. A two-stage design examined fear reduction and approach distance during an exposure task for participants (N = 43) assigned to either a safety behaviour use (SBU) or no safety behaviour use (NSB) condition. No differences were observed between the groups in subjective or cognitive measures at prettest, posttest, and one-week follow-up; however, unlike the NSB group, the SBU group did not maintain their gains in approach distance at follow-up, though this was no longer true after self-efficacy was covaried. These results call for a reconsideration of the practice of completely eliminating safety behaviours during exposure-based treatments for specific fears.

scholarly journals Promoting social distancing in a pandemic: Beyond the good intentions

2020 ◽  
Author(s):  
Paolo Falco ◽  
Sarah Zaccagni
Keyword(s):  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Two Stage ◽  
Stage Design ◽  
Social Distancing ◽  
Health Authorities ◽  
Ex Ante ◽  
Randomised Controlled ◽  
Shed Light

Do reminders to promote social distancing achieve the desired effects? Much of the existing literature analyses impacts on people's intentions to comply. We run a randomised controlled trial in Denmark to test different versions of a reminder to stay home at the beginning of the crisis. Using a two-stage design, we follow up with recipients and analyse their subsequent behaviour. We find that the reminder increases ex-ante intentions to comply when it emphasises the consequences of non-compliance for the subjects themselves and their families, while it has no effect when the emphasis is on other people or the country as a whole. We also find, however, that impacts on intentions do not translate into equivalent impacts on actions. This is despite the possibility that respondents may tend to over-report compliance. Only people in poor health react to the reminder by staying home more. Our results shed light on important gaps between people's intentions and their actions in responding to the recommendations of health authorities.

scholarly journals Promoting social distancing in a pandemic: Beyond good intentions

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260457
Author(s):  
Paolo Falco ◽  
Sarah Zaccagni
Keyword(s):  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Two Stage ◽  
Stage Design ◽  
Social Distancing ◽  
Health Authorities ◽  
Ex Ante ◽  
Randomised Controlled ◽  
Shed Light

Do reminders to promote social distancing achieve the desired effects on behavior? Much of the existing literature analyses impacts on people’s intentions to comply. We run a randomised controlled trial in Denmark to test different versions of a reminder to stay home at the beginning of the crisis. Using a two-stage design, we follow up with recipients and analyse their subsequent self-reported behaviour. We find that the reminder increases ex-ante intentions to comply when it emphasises the consequences of non-compliance for the subjects themselves and their families, while it has no effect when the emphasis is on other people or the country as a whole. We also find, however, that impacts on intentions do not translate into equivalent impacts on actions. Only people in poor health react to the reminder by staying home significantly more. Our results shed light on important gaps between people’s intentions and their actions in responding to the recommendations of health authorities.

A phase II study investigating biological effects of maintenance usage of hydroxychloroquine on Par-4 levels in patients with resected tumors.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 3085-3085
Author(s):  
Peng Wang ◽  
Ravshan Burikhanov ◽  
Heidi Weiss ◽  
Rani Jayswal ◽  
Susanne M. Arnold ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Disease Progression ◽  
Phase Ii ◽  
Interim Analysis ◽  
Phase Ii Study ◽  
Biological Effects ◽  
Fold Increase ◽  
Two Stage ◽  
Stage Design

3085 Background: Hydroxychloroquine (HCQ) is an inducer of the tumor suppressor Par-4 (prostate apoptosis response-4) secretion from normal cells. Secreted Par-4 causes paracrine apoptosis of tumor cells in mice. Established dosing of HCQ 200 mg bid induces Par-4 secretion but not the autophagy-inhibition marker p62 and correlates with apoptosis induction in patients' tumors. Methods: This is a single-arm, single institute phase II study to characterize the biological effects of 3-months of HCQ at fixed-dose (200 mg p.o. twice a day) on plasma Par-4 levels in adults with resected solid tumors. The primary endpoint is proportion of patients who will exhibit a two-fold increase in Par-4 levels from baseline compared to 3 months of follow-up. 12-month progression free survival (PFS) is one of the secondary endpoints. A Simon's two-stage design was used to test the null hypothesis that the proportion of patients exhibiting a two-fold increase in Par-4 is equal to 50% compared to 70% using a one-sided alternative. These hypothesized assumptions are based on a small pilot human data and from a phase I clinical trial on a small number of patients (n = 9). The first stage of interim analysis will be performed after a total of 15 patients have been accrued. If there are eight or fewer responses occurred, the study will be stopped. Otherwise, 28 additional patients will be accrued for a total of 43 subjects. Results: A total of 19 patients were enrolled in the trial. Per protocol, the interim analysis and stopping boundary is based on the first 15 patients. A total of 4 out of 15 patients (26.7%) 95% CI: 8% - 55% exhibited a >2-fold increase in Par-4 levels at 3 months. This did not surpass the stopping bound for futility and thus indicates stopping of patient accrual based on the assumptions used for the Simon's two-stage design. 7 out of 19 patients (36.8%) 95% CI: 16% - 62% who exhibited at least a 2-fold increase at either 2 or 3 months of follow-up, 50% (95% CI: 26% - 74%) and 56% (95% CI: 31% -79%) exhibited a 1.5-fold and 1.25-fold increase respectively. To date, 10/19 patients finished 12-month follow-up, 4/19 and 5/19 finished 6-month and 3-month follow up respectively. 2 of 12 patients with less than 2-fold increase of Par-4 developed disease progression. None of 7 patients with 2-fold increase of Par-4 showed disease progression. Conclusions: Despite that the study was terminated prematurely, to our knowledge this is the first study in human to identify dynamic changes of serum Par-4 while on long-term of usage of HCQ. We also demonstrate trend of PFS benefit especially for subjects having 2-fold increase of Par-4 induction. Identification of tumors more Par-4 sensitive and predictive biomarkers of Par-4 induction are necessary to continue our investigation. Clinical trial information: NCT02232243.

The Link Between Verbal Short-Term Memory and Anomia Treatment Gains

2019 ◽  
Vol 28 (3) ◽  
pp. 1039-1052
Author(s):  
Reva M. Zimmerman ◽  
JoAnn P. Silkes ◽  
Diane L. Kendall ◽  
Irene Minkina
Keyword(s):  
Short Term Memory ◽  
Controlled Trial ◽  
Treatment Success ◽  
Linear Regression Models ◽  
Language Performance ◽  
Short Term ◽  
Term Memory ◽  
Treatment Gains ◽  
Post Hoc

Purpose A significant relationship between verbal short-term memory (STM) and language performance in people with aphasia has been found across studies. However, very few studies have examined the predictive value of verbal STM in treatment outcomes. This study aims to determine if verbal STM can be used as a predictor of treatment success. Method Retrospective data from 25 people with aphasia in a larger randomized controlled trial of phonomotor treatment were analyzed. Digit and word spans from immediately pretreatment were run in multiple linear regression models to determine whether they predict magnitude of change from pre- to posttreatment and follow-up naming accuracy. Pretreatment, immediately posttreatment, and 3 months posttreatment digit and word span scores were compared to determine if they changed following a novel treatment approach. Results Verbal STM, as measured by digit and word spans, did not predict magnitude of change in naming accuracy from pre- to posttreatment nor from pretreatment to 3 months posttreatment. Furthermore, digit and word spans did not change from pre- to posttreatment or from pretreatment to 3 months posttreatment in the overall analysis. A post hoc analysis revealed that only the less impaired group showed significant changes in word span scores from pretreatment to 3 months posttreatment. Discussion The results suggest that digit and word spans do not predict treatment gains. In a less severe subsample of participants, digit and word span scores can change following phonomotor treatment; however, the overall results suggest that span scores may not change significantly. The implications of these findings are discussed within the broader purview of theoretical and empirical associations between aphasic language and verbal STM processing.

scholarly journals An empirical example of analysis using a two-stage modeling approach: within-subject association of outdoor context and physical activity predicts future daily physical activity levels

2020 ◽  
Author(s):  
Chih-Hsiang Yang ◽  
Jaclyn P Maher ◽  
Aditya Ponnada ◽  
Eldin Dzubur ◽  
Rachel Nordgren ◽  
...  
Keyword(s):  
Physical Activity ◽  
Vigorous Physical Activity ◽  
Wearable Sensors ◽  
Activity Levels ◽  
Two Stage ◽  
Modeling Approach ◽  
Source Program ◽  
Modeling Strategy ◽  
Stage Modeling

Abstract People differ from each other to the extent to which momentary factors, such as context, mood, and cognitions, influence momentary health behaviors. However, statistical models to date are limited in their ability to test whether the association between two momentary variables (i.e., subject-level slopes) predicts a subject-level outcome. This study demonstrates a novel two-stage statistical modeling strategy that is capable of testing whether subject-level slopes between two momentary variables predict subject-level outcomes. An empirical case study application is presented to examine whether there are differences in momentary moderate-to-vigorous physical activity (MVPA) levels between the outdoor and indoor context in adults and whether these momentary differences predict mean daily MVPA levels 6 months later. One hundred and eight adults from a multiwave longitudinal study provided 4 days of ecological momentary assessment (during baseline) and accelerometry data (both at baseline and 6 month follow-up). Multilevel data were analyzed using an open-source program (MixWILD) to test whether momentary strength between outdoor context and MVPA during baseline was associated with average daily MVPA levels measured 6 months later. During baseline, momentary MVPA levels were higher in outdoor contexts as compared to indoor contexts (b = 0.07, p < .001). Participants who had more momentary MVPA when outdoors (vs. indoors) during baseline (i.e., a greater subject-level slope) had higher daily MVPA at the 6 month follow-up (b = 0.09, p < .05). This empirical example shows that the subject-level momentary association between specific context (i.e., outdoors) and health behavior (i.e., physical activity) may contribute to overall engagement in that behavior in the future. The demonstrated two-stage modeling approach has extensive applications in behavioral medicine to analyze intensive longitudinal data collected from wearable sensors and mobile devices.

scholarly journals Evaluation of adherence monitoring system using evriMED with a differentiated response compared to standard of care among drug-sensitive TB patients in three provinces in South Africa: a protocol for a cluster randomised control trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Noriah Maraba ◽  
Catherine Orrell ◽  
Candice M. Chetty-Makkan ◽  
Kavindhran Velen ◽  
Rachel Mukora ◽  
...  
Keyword(s):  
South Africa ◽  
Treatment Success ◽  
Standard Of Care ◽  
Treatment Completion ◽  
Phone Call ◽  
Randomised Control Trial ◽  
Improve Medication Adherence ◽  
Tb Treatment ◽  
Differentiated Care

Abstract Background South Africa has achieved drug-susceptible TB (DS-TB) treatment success of only 77% among people with new and previously treated TB. Alternative approaches are required to improve medication adherence and treatment completion to limit transmission, TB relapse and the development of resistance. This study aims to implement and evaluate the use of adherence medication monitors (Wisepill evriMED 1000) with a differentiated response to patient care, among DS-TB patients in three provinces of South Africa. Methods In total, 18 public health clinics across three provinces were selected. Clinics were randomised to intervention or standard of care clinics. In each clinic, approximately 145 DS-TB patients are being enrolled to reach a total of 2610. All patients have their daily adherence monitored using medication monitors. In the intervention arm, patients are receiving medication monitor reminders and differentiated care in response to adherence data. This weekly review of daily real-time monitoring will be undertaken from a central database. The differentiated care model includes automated SMS reminders with a missed dose, research staff-initiated phone call to the patient with a second or third missed dose, a home visit if four or more doses are missed, and motivational counselling if four or more doses are missed repeatedly. Fidelity of the intervention will be measured through process evaluation. Patients in control clinics will receive medication monitors for adherence tracking, standard of care TB education, and normal clinic follow-up procedures. The primary outcome is the proportion of patients by arm with >80% adherence, as measured by the medication monitor. The feasibility and acceptability of the intervention will be assessed by in-depth interviews with patients, stakeholders, and study staff. A cost effectiveness analysis of the intervention and standard of care clinics will be conducted. Significance This trial will provide evidence for the use of an intervention, including medication monitors and differentiated care package, to improve adherence to TB treatment. Improved adherence should also improve TB treatment completion rates, thus reducing loss to follow-up rates, and TB relapse among people with TB. The intervention is intended to ultimately improve overall TB control and reduce TB transmission in South Africa. Trial registration Pan African Trial Registry PACTR201902681157721. Registered on 11 February 2019.

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