Determination of anodal tDCS intensity threshold for reversal of corticospinal excitability: an investigation for induction of counter-regulatory mechanisms
- Hassanzahraee, Maryam, Nitsche, Michael, Zoghi, Maryam, Jaberzadeh, Shapour
- Authors: Hassanzahraee, Maryam , Nitsche, Michael , Zoghi, Maryam , Jaberzadeh, Shapour
- Date: 2020
- Type: Text , Journal article
- Relation: Scientific Reports Vol. 10, no. 1 (2020), p. 16108-16108
- Full Text:
- Reviewed:
- Description: Transcranial direct current stimulation is applied to modulate activity, and excitability of the brain. Basically, LTP-like plasticity is induced when anodal tDCS (a-tDCS) is applied over the primary motor cortex. However, it has been shown that specific parameters of a-tDCS can induce a plasticity reversal. We aimed to systematically assess the intensity threshold for reversal of the direction of plasticity induced by a-tDCS, monitored by corticospinal excitability (CSE), and explored mechanisms regulating this reversal. Fifteen healthy participants received a-tDCS in pseudo-random order for 26 min with four intensities of 0.3, 0.7, 1, and 1.5 mA. To measure CSE changes, single-pulse TMS was applied over the left M1, and motor evoked potentials of a contralateral hand muscle were recorded prior to a-tDCS, immediately and 30-min post-intervention. Paired-pulse TMS was used to evaluate intracortical excitation and inhibition. CSE increased significantly following a-tDCS with an intensity of 0.7 mA however, the expected effect decreased and even reversed at intensities of 1 and 1.5 mA. ICF was significantly increased while SICI and LICI decreased at 0.7 mA. On the other hand, a significant decrease of ICF, but SICI and LICI enhancement was observed at intensities of 1, and 1.5 mA. The present findings show an intensity threshold of ≥ 1 mA for 26 min a-tDCS to reverse LTP- into LTD-like plasticity. It is suggested that increasing stimulation intensity, with constant stimulation duration, activates counter-regulatory mechanisms to prevent excessive brain excitation. Therefore, stimulation intensity and plasticity induced by a-tDCS might non-linearly correlate in scenarios with prolonged stimulation duration.
- Authors: Hassanzahraee, Maryam , Nitsche, Michael , Zoghi, Maryam , Jaberzadeh, Shapour
- Date: 2020
- Type: Text , Journal article
- Relation: Scientific Reports Vol. 10, no. 1 (2020), p. 16108-16108
- Full Text:
- Reviewed:
- Description: Transcranial direct current stimulation is applied to modulate activity, and excitability of the brain. Basically, LTP-like plasticity is induced when anodal tDCS (a-tDCS) is applied over the primary motor cortex. However, it has been shown that specific parameters of a-tDCS can induce a plasticity reversal. We aimed to systematically assess the intensity threshold for reversal of the direction of plasticity induced by a-tDCS, monitored by corticospinal excitability (CSE), and explored mechanisms regulating this reversal. Fifteen healthy participants received a-tDCS in pseudo-random order for 26 min with four intensities of 0.3, 0.7, 1, and 1.5 mA. To measure CSE changes, single-pulse TMS was applied over the left M1, and motor evoked potentials of a contralateral hand muscle were recorded prior to a-tDCS, immediately and 30-min post-intervention. Paired-pulse TMS was used to evaluate intracortical excitation and inhibition. CSE increased significantly following a-tDCS with an intensity of 0.7 mA however, the expected effect decreased and even reversed at intensities of 1 and 1.5 mA. ICF was significantly increased while SICI and LICI decreased at 0.7 mA. On the other hand, a significant decrease of ICF, but SICI and LICI enhancement was observed at intensities of 1, and 1.5 mA. The present findings show an intensity threshold of ≥ 1 mA for 26 min a-tDCS to reverse LTP- into LTD-like plasticity. It is suggested that increasing stimulation intensity, with constant stimulation duration, activates counter-regulatory mechanisms to prevent excessive brain excitation. Therefore, stimulation intensity and plasticity induced by a-tDCS might non-linearly correlate in scenarios with prolonged stimulation duration.
The effect of an 8 week prescribed exercise and low-carbohydrate diet on cardiorespiratory fitness, body composition and cardiometabolic risk factors in obese individuals: A randomised controlled trial
- Perissiou, Maria, Borkoles, Erika, Kobayashi, Kent, Polman, Remco
- Authors: Perissiou, Maria , Borkoles, Erika , Kobayashi, Kent , Polman, Remco
- Date: 2020
- Type: Text , Journal article
- Relation: Nutrients Vol. 12, no. 2 (2020), p. 482
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- Reviewed:
- Description: Low-carbohydrate (LC) diets are an effective method for treating obesity and reducing cardiometabolic risk. However, exposure to LC diets is associated with reductions in muscle mass and increased osteoporosis risk in obese individuals. The combination of exercise with a LC diet appears to attenuate muscle mass loss induced by LC diets alone, and to further improve cardiometabolic profile. However, evidence to date in obese individuals is limited. We assessed the effect of LC diet in combination with supervised exercise on cardiorespiratory fitness, body composition and cardiometabolic risk factors in obese individuals. Male and female participants in the experimental (EX-LC structured supervised exercise program + low-carbohydrate meals n = 33 35.3 years) and control (EX-CO structured supervised exercise program + standard dietary advice n = 31 34.2 years) conditions underwent measurements of cardiorespiratory fitness ( O peak), body fat, lean muscle mass (LMM), and cardiometabolic biomarkers before and after an 8 week intervention. : Participants in the EX-LC condition demonstrated greater improvements in O peak ( = 0.002) and fat mass index (FMI, = 0.001) compared to the EX-CO condition. Achieving a ketogenic state (β-hydroxybutyrate, βHB ≥0.3 mmol/L) was associated with greater reductions in total body fat ( = 0.011), visceral adipose tissue ( = 0.025), FMI ( = 0.002) and C-reactive protein (CRP, = 0.041) but also with greater reductions in LMM ( = 0.042). : Short-term LC diet combined with prescribed exercise enhanced cardiorespiratory fitness and the cardiometabolic profile of obese individuals but was also associated with greater muscle mass loss compared to similar exercise training and standard dietary advice. The long-term effects of the LC diet should be further explored in future studies.
- Authors: Perissiou, Maria , Borkoles, Erika , Kobayashi, Kent , Polman, Remco
- Date: 2020
- Type: Text , Journal article
- Relation: Nutrients Vol. 12, no. 2 (2020), p. 482
- Full Text:
- Reviewed:
- Description: Low-carbohydrate (LC) diets are an effective method for treating obesity and reducing cardiometabolic risk. However, exposure to LC diets is associated with reductions in muscle mass and increased osteoporosis risk in obese individuals. The combination of exercise with a LC diet appears to attenuate muscle mass loss induced by LC diets alone, and to further improve cardiometabolic profile. However, evidence to date in obese individuals is limited. We assessed the effect of LC diet in combination with supervised exercise on cardiorespiratory fitness, body composition and cardiometabolic risk factors in obese individuals. Male and female participants in the experimental (EX-LC structured supervised exercise program + low-carbohydrate meals n = 33 35.3 years) and control (EX-CO structured supervised exercise program + standard dietary advice n = 31 34.2 years) conditions underwent measurements of cardiorespiratory fitness ( O peak), body fat, lean muscle mass (LMM), and cardiometabolic biomarkers before and after an 8 week intervention. : Participants in the EX-LC condition demonstrated greater improvements in O peak ( = 0.002) and fat mass index (FMI, = 0.001) compared to the EX-CO condition. Achieving a ketogenic state (β-hydroxybutyrate, βHB ≥0.3 mmol/L) was associated with greater reductions in total body fat ( = 0.011), visceral adipose tissue ( = 0.025), FMI ( = 0.002) and C-reactive protein (CRP, = 0.041) but also with greater reductions in LMM ( = 0.042). : Short-term LC diet combined with prescribed exercise enhanced cardiorespiratory fitness and the cardiometabolic profile of obese individuals but was also associated with greater muscle mass loss compared to similar exercise training and standard dietary advice. The long-term effects of the LC diet should be further explored in future studies.
Traversing the funambulist's fine line between nursing and male identity : A systematic review of the factors that influence men as they seek to navigate the nursing profession
- Terry, Daniel, Peck, Blake, Carden, Clarissa, Perkins, Alicia, Smith, Andrew
- Authors: Terry, Daniel , Peck, Blake , Carden, Clarissa , Perkins, Alicia , Smith, Andrew
- Date: 2020
- Type: Text , Journal article , Review
- Relation: European Journal of Investigation in Health Psychology and Education Vol. 10, no. 3 (2020), p. 691-703
- Full Text:
- Reviewed:
- Description: Nursing has seen a dominance of women within the profession, and today, the presence of men in the role remains less understood and appreciated. Males considering or entering nursing face challenges concerning role misconception, marginalization, and gender bias. With a looming shortage of nurses on the horizon, it is more important now than ever before to find better ways of engaging males into nursing. The aim of the study was to examine the psychological constructs that influence male perceptions of nursing as they seek to navigate the profession, and what aspects influence men to consider nursing as a career. To achieve this, a systematic review and mixed research synthesis (integrated design) was conducted. English language research published between 1999 and 2019 was eligible. The methodological rigor of qualitative articles followed the Critical Appraisal Skills Program, while the Best Evidence Medical Education guided the quantitative review. Among the 24 publications identified, three sub-themes emerged from the overarching theme of the funambulist or tightrope walker. Sub-themes included societal, inner and collective voices that inform men's place in nursing or their decision making about entering the profession. There is a need to re-visit what it means to be a nurse in order to address the gendered stereotypes that impact men entering the nursing profession.
- Authors: Terry, Daniel , Peck, Blake , Carden, Clarissa , Perkins, Alicia , Smith, Andrew
- Date: 2020
- Type: Text , Journal article , Review
- Relation: European Journal of Investigation in Health Psychology and Education Vol. 10, no. 3 (2020), p. 691-703
- Full Text:
- Reviewed:
- Description: Nursing has seen a dominance of women within the profession, and today, the presence of men in the role remains less understood and appreciated. Males considering or entering nursing face challenges concerning role misconception, marginalization, and gender bias. With a looming shortage of nurses on the horizon, it is more important now than ever before to find better ways of engaging males into nursing. The aim of the study was to examine the psychological constructs that influence male perceptions of nursing as they seek to navigate the profession, and what aspects influence men to consider nursing as a career. To achieve this, a systematic review and mixed research synthesis (integrated design) was conducted. English language research published between 1999 and 2019 was eligible. The methodological rigor of qualitative articles followed the Critical Appraisal Skills Program, while the Best Evidence Medical Education guided the quantitative review. Among the 24 publications identified, three sub-themes emerged from the overarching theme of the funambulist or tightrope walker. Sub-themes included societal, inner and collective voices that inform men's place in nursing or their decision making about entering the profession. There is a need to re-visit what it means to be a nurse in order to address the gendered stereotypes that impact men entering the nursing profession.
A feature agnostic approach for glaucoma detection in OCT volumes
- Maetschke, Stefan, Antony, Bhavna, Ishikawa, Hiroshi, Wollstein, Gadi, Schuman, Joel, Garnavi, Rahil
- Authors: Maetschke, Stefan , Antony, Bhavna , Ishikawa, Hiroshi , Wollstein, Gadi , Schuman, Joel , Garnavi, Rahil
- Date: 2019
- Type: Text , Journal article
- Relation: PLoS One Vol. 14, no. 7 (2019), p. e0219126
- Full Text:
- Reviewed:
- Description: Optical coherence tomography (OCT) based measurements of retinal layer thickness, such as the retinal nerve fibre layer (RNFL) and the ganglion cell with inner plexiform layer (GCIPL) are commonly employed for the diagnosis and monitoring of glaucoma. Previously, machine learning techniques have relied on segmentation-based imaging features such as the peripapillary RNFL thickness and the cup-to-disc ratio. Here, we propose a deep learning technique that classifies eyes as healthy or glaucomatous directly from raw, unsegmented OCT volumes of the optic nerve head (ONH) using a 3D Convolutional Neural Network (CNN). We compared the accuracy of this technique with various feature-based machine learning algorithms and demonstrated the superiority of the proposed deep learning based method. Logistic regression was found to be the best performing classical machine learning technique with an AUC of 0.89. In direct comparison, the deep learning approach achieved a substantially higher AUC of 0.94 with the additional advantage of providing insight into which regions of an OCT volume are important for glaucoma detection. Computing Class Activation Maps (CAM), we found that the CNN identified neuroretinal rim and optic disc cupping as well as the lamina cribrosa (LC) and its surrounding areas as the regions significantly associated with the glaucoma classification. These regions anatomically correspond to the well established and commonly used clinical markers for glaucoma diagnosis such as increased cup volume, cup diameter, and neuroretinal rim thinning at the superior and inferior segments.
- Authors: Maetschke, Stefan , Antony, Bhavna , Ishikawa, Hiroshi , Wollstein, Gadi , Schuman, Joel , Garnavi, Rahil
- Date: 2019
- Type: Text , Journal article
- Relation: PLoS One Vol. 14, no. 7 (2019), p. e0219126
- Full Text:
- Reviewed:
- Description: Optical coherence tomography (OCT) based measurements of retinal layer thickness, such as the retinal nerve fibre layer (RNFL) and the ganglion cell with inner plexiform layer (GCIPL) are commonly employed for the diagnosis and monitoring of glaucoma. Previously, machine learning techniques have relied on segmentation-based imaging features such as the peripapillary RNFL thickness and the cup-to-disc ratio. Here, we propose a deep learning technique that classifies eyes as healthy or glaucomatous directly from raw, unsegmented OCT volumes of the optic nerve head (ONH) using a 3D Convolutional Neural Network (CNN). We compared the accuracy of this technique with various feature-based machine learning algorithms and demonstrated the superiority of the proposed deep learning based method. Logistic regression was found to be the best performing classical machine learning technique with an AUC of 0.89. In direct comparison, the deep learning approach achieved a substantially higher AUC of 0.94 with the additional advantage of providing insight into which regions of an OCT volume are important for glaucoma detection. Computing Class Activation Maps (CAM), we found that the CNN identified neuroretinal rim and optic disc cupping as well as the lamina cribrosa (LC) and its surrounding areas as the regions significantly associated with the glaucoma classification. These regions anatomically correspond to the well established and commonly used clinical markers for glaucoma diagnosis such as increased cup volume, cup diameter, and neuroretinal rim thinning at the superior and inferior segments.
Belief in conspiracy theories : the predictive role of schizotypy, machiavellianism, and primary psychopathy
- Authors: March, Evita , Springer
- Date: 2019
- Type: Text , Journal article
- Relation: PLoS ONE Vol. 14, no. 12 (2019), p.
- Full Text:
- Reviewed:
- Description: A conspiracy theory refers to an alternative explanation of an event involving a conspirator plot organised by powerful people or organisations. Belief in conspiracy theories is related to negative societal outcomes such as poor medical decisions and a decrease in prosocial behaviour. Given these negative outcomes, researchers have explored predictors of belief in conspiracy theories in an attempt to understand and possibly manage these beliefs. In the current study, we explored the utility of personality in predicting belief in conspiracy theories. The aim of the current study was to explore the utility of the odd beliefs/magical thinking subtype of schizotypy, Machiavellianism, grandiose narcissism, vulnerable narcissism, primary psychopathy, and secondary psychopathy in predicting belief in conspiracy theories. Participants (N = 230; 44.7% male, 55.3% female) completed an anonymous, confidential online questionnaire which comprised demographics and measures of personality traits and belief in conspiracy theories. The total regression model indicated odd beliefs/magical thinking, trait Machiavellianism, and primary psychopathy were significant, positive predictors of belief in conspiracy theories. No other predictors reached significance. Results of the current study highlight individuals who might be more susceptible to believing conspiracy theories. Specifically, these results indicate that the individual more likely to believe in conspiracy theories may have unusual patterns of thinking and cognitions, be strategic and manipulative, and display interpersonal and affective deficits. © 2019 March, Springer. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
- Authors: March, Evita , Springer
- Date: 2019
- Type: Text , Journal article
- Relation: PLoS ONE Vol. 14, no. 12 (2019), p.
- Full Text:
- Reviewed:
- Description: A conspiracy theory refers to an alternative explanation of an event involving a conspirator plot organised by powerful people or organisations. Belief in conspiracy theories is related to negative societal outcomes such as poor medical decisions and a decrease in prosocial behaviour. Given these negative outcomes, researchers have explored predictors of belief in conspiracy theories in an attempt to understand and possibly manage these beliefs. In the current study, we explored the utility of personality in predicting belief in conspiracy theories. The aim of the current study was to explore the utility of the odd beliefs/magical thinking subtype of schizotypy, Machiavellianism, grandiose narcissism, vulnerable narcissism, primary psychopathy, and secondary psychopathy in predicting belief in conspiracy theories. Participants (N = 230; 44.7% male, 55.3% female) completed an anonymous, confidential online questionnaire which comprised demographics and measures of personality traits and belief in conspiracy theories. The total regression model indicated odd beliefs/magical thinking, trait Machiavellianism, and primary psychopathy were significant, positive predictors of belief in conspiracy theories. No other predictors reached significance. Results of the current study highlight individuals who might be more susceptible to believing conspiracy theories. Specifically, these results indicate that the individual more likely to believe in conspiracy theories may have unusual patterns of thinking and cognitions, be strategic and manipulative, and display interpersonal and affective deficits. © 2019 March, Springer. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
The henle fiber layer in albinism: Comparison to normal and relationship to outer nuclear layer thickness and foveal cone density
- Lee, Daniel, Woertz, Erica, Visotcky, Alexis, Wilk, Melissa, Heitkotter, Heather, Linderman, Rachel, Tarima, Sergey, Summers, C. Gail, Brooks, Brian, Brilliant, Murray, Antony, Bhavna, Lujan, Brandon, Carroll, Joseph
- Authors: Lee, Daniel , Woertz, Erica , Visotcky, Alexis , Wilk, Melissa , Heitkotter, Heather , Linderman, Rachel , Tarima, Sergey , Summers, C. Gail , Brooks, Brian , Brilliant, Murray , Antony, Bhavna , Lujan, Brandon , Carroll, Joseph
- Date: 2018
- Type: Text , Journal article
- Relation: Investigative Ophthalmology & visual science Vol. 59, no. 13 (2018), p. 5336-5348
- Full Text:
- Reviewed:
- Description: Directional optical coherence tomography (D-OCT) allows the visualization of the Henle fiber layer (HFL) in vivo. Here, we used D-OCT to characterize the HFL and outer nuclear layer (ONL) in albinism and examine the relationship between true foveal ONL and peak cone density. Horizontal D-OCT B-scans were acquired, registered, and averaged for 12 subjects with oculocutaneous albinism and 26 control subjects. Averaged images were manually segmented to extract HFL and ONL thickness. Adaptive optics scanning light ophthalmoscopy was used to acquire images of the foveal cone mosaic in 10 subjects with albinism, from which peak cone density was assessed. Across the foveal region, the HFL topography was different between subjects with albinism and normal controls. In particular, foveal HFL thickness was thicker in albinism than in normal controls (P < 0.0001), whereas foveal ONL thickness was thinner in albinism than in normal controls (P < 0.0001). The total HFL and ONL thickness was not significantly different between albinism and controls (P = 0.3169). Foveal ONL thickness was positively correlated with peak cone density in subjects with albinism (r = 0.8061, P = 0.0072). Foveal HFL and ONL topography are significantly altered in albinism relative to normal controls. Our data suggest that increased foveal cone packing drives the formation of Henle fibers, more so than the lateral displacement of inner retinal neurons (which is reduced in albinism). The ability to quantify foveal ONL and HFL may help further stratify grading schemes used to assess foveal hypoplasia.
- Authors: Lee, Daniel , Woertz, Erica , Visotcky, Alexis , Wilk, Melissa , Heitkotter, Heather , Linderman, Rachel , Tarima, Sergey , Summers, C. Gail , Brooks, Brian , Brilliant, Murray , Antony, Bhavna , Lujan, Brandon , Carroll, Joseph
- Date: 2018
- Type: Text , Journal article
- Relation: Investigative Ophthalmology & visual science Vol. 59, no. 13 (2018), p. 5336-5348
- Full Text:
- Reviewed:
- Description: Directional optical coherence tomography (D-OCT) allows the visualization of the Henle fiber layer (HFL) in vivo. Here, we used D-OCT to characterize the HFL and outer nuclear layer (ONL) in albinism and examine the relationship between true foveal ONL and peak cone density. Horizontal D-OCT B-scans were acquired, registered, and averaged for 12 subjects with oculocutaneous albinism and 26 control subjects. Averaged images were manually segmented to extract HFL and ONL thickness. Adaptive optics scanning light ophthalmoscopy was used to acquire images of the foveal cone mosaic in 10 subjects with albinism, from which peak cone density was assessed. Across the foveal region, the HFL topography was different between subjects with albinism and normal controls. In particular, foveal HFL thickness was thicker in albinism than in normal controls (P < 0.0001), whereas foveal ONL thickness was thinner in albinism than in normal controls (P < 0.0001). The total HFL and ONL thickness was not significantly different between albinism and controls (P = 0.3169). Foveal ONL thickness was positively correlated with peak cone density in subjects with albinism (r = 0.8061, P = 0.0072). Foveal HFL and ONL topography are significantly altered in albinism relative to normal controls. Our data suggest that increased foveal cone packing drives the formation of Henle fibers, more so than the lateral displacement of inner retinal neurons (which is reduced in albinism). The ability to quantify foveal ONL and HFL may help further stratify grading schemes used to assess foveal hypoplasia.
Anxiety online-A virtual clinic: Preliminary outcomes following completion of five fully automated treatment programs for anxiety disorders and symptoms
- Klein, Britt, Meyer, Denny, Austin, David, Kyrios, Michael
- Authors: Klein, Britt , Meyer, Denny , Austin, David , Kyrios, Michael
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Medical Internet Research Vol. 13, no. 4 (2011), p.
- Full Text:
- Reviewed:
- Description: Background: The development of e-mental health interventions to treat or prevent mental illness and to enhance wellbeing has risen rapidly over the past decade. This development assists the public in sidestepping some of the obstacles that are often encountered when trying to access traditional face-to-face mental health care services. Objective: The objective of our study was to investigate the posttreatment effectiveness of five fully automated self-help cognitive behavior e-therapy programs for generalized anxiety disorder (GAD), panic disorder with or without agoraphobia (PD/A), obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and social anxiety disorder (SAD) offered to the international public via Anxiety Online, an open-access full-service virtual psychology clinic for anxiety disorders. Methods: We used a naturalistic participant choice, quasi-experimental design to evaluate each of the five Anxiety Online fully automated self-help e-therapy programs. Participants were required to have at least subclinical levels of one of the anxiety disorders to be offered the associated disorder-specific fully automated self-help e-therapy program. These programs are offered free of charge via Anxiety Online. Results: A total of 225 people self-selected one of the five e-therapy programs (GAD, n = 88; SAD, n = 50; PD/A, n = 40; PTSD, n = 30; OCD, n = 17) and completed their 12-week posttreatment assessment. Significant improvements were found on 21/25 measures across the five fully automated self-help programs. At postassessment we observed significant reductions on all five anxiety disorder clinical disorder severity ratings (Cohen d range 0.72-1.22), increased confidence in managing one's own mental health care (Cohen d range 0.70-1.17), and decreases in the total number of clinical diagnoses (except for the PD/A program, where a positive trend was found) (Cohen d range 0.45-1.08). In addition, we found significant improvements in quality of life for the GAD, OCD, PTSD, and SAD e-therapy programs (Cohen d range 0.11-0.96) and significant reductions relating to general psychological distress levels for the GAD, PD/A, and PTSD e-therapy programs (Cohen d range 0.23-1.16). Overall, treatment satisfaction was good across all five e-therapy programs, and posttreatment assessment completers reported using their e-therapy program an average of 395.60 (SD 272.2) minutes over the 12-week treatment period. Conclusions: Overall, all five fully automated self-help e-therapy programs appear to be delivering promising high-quality outcomes; however, the results require replication. © Britt Klein, Denny Meyer, David William Austin, Michael Kyrios.
- Authors: Klein, Britt , Meyer, Denny , Austin, David , Kyrios, Michael
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Medical Internet Research Vol. 13, no. 4 (2011), p.
- Full Text:
- Reviewed:
- Description: Background: The development of e-mental health interventions to treat or prevent mental illness and to enhance wellbeing has risen rapidly over the past decade. This development assists the public in sidestepping some of the obstacles that are often encountered when trying to access traditional face-to-face mental health care services. Objective: The objective of our study was to investigate the posttreatment effectiveness of five fully automated self-help cognitive behavior e-therapy programs for generalized anxiety disorder (GAD), panic disorder with or without agoraphobia (PD/A), obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and social anxiety disorder (SAD) offered to the international public via Anxiety Online, an open-access full-service virtual psychology clinic for anxiety disorders. Methods: We used a naturalistic participant choice, quasi-experimental design to evaluate each of the five Anxiety Online fully automated self-help e-therapy programs. Participants were required to have at least subclinical levels of one of the anxiety disorders to be offered the associated disorder-specific fully automated self-help e-therapy program. These programs are offered free of charge via Anxiety Online. Results: A total of 225 people self-selected one of the five e-therapy programs (GAD, n = 88; SAD, n = 50; PD/A, n = 40; PTSD, n = 30; OCD, n = 17) and completed their 12-week posttreatment assessment. Significant improvements were found on 21/25 measures across the five fully automated self-help programs. At postassessment we observed significant reductions on all five anxiety disorder clinical disorder severity ratings (Cohen d range 0.72-1.22), increased confidence in managing one's own mental health care (Cohen d range 0.70-1.17), and decreases in the total number of clinical diagnoses (except for the PD/A program, where a positive trend was found) (Cohen d range 0.45-1.08). In addition, we found significant improvements in quality of life for the GAD, OCD, PTSD, and SAD e-therapy programs (Cohen d range 0.11-0.96) and significant reductions relating to general psychological distress levels for the GAD, PD/A, and PTSD e-therapy programs (Cohen d range 0.23-1.16). Overall, treatment satisfaction was good across all five e-therapy programs, and posttreatment assessment completers reported using their e-therapy program an average of 395.60 (SD 272.2) minutes over the 12-week treatment period. Conclusions: Overall, all five fully automated self-help e-therapy programs appear to be delivering promising high-quality outcomes; however, the results require replication. © Britt Klein, Denny Meyer, David William Austin, Michael Kyrios.
Emotional functioning in children and adolescents with elevated depressive symptoms
- Hughes, Elizabeth, Gullone, Eleonora, Watson, Shaun
- Authors: Hughes, Elizabeth , Gullone, Eleonora , Watson, Shaun
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Psychopathology and Behavioral Assessment Vol. 33, no. 3 (2011), p. 335-345
- Full Text:
- Reviewed:
- Description: Difficulties with emotion and its regulation are of central importance to the etiology and course of depression. The current study investigated these constructs in relation to childhood and adolescence by comparing the emotional functioning of 170 9- to 15-year-olds reporting high levels of depressive symptoms (HD) to a matched sample of 170 children and adolescents reporting low levels of depressive symptoms (LD). Compared to LD, HD participants reported significantly greater shame proneness, poorer functioning on emotion regulation competencies (emotional control, self-awareness and situational responsiveness), less healthy emotion regulation strategy use (less reappraisal and greater suppression), and lower levels of guilt proneness. Empathic concern did not differ between the two groups. The findings enhance current knowledge by providing a more comprehensive profile of the emotional difficulties experienced by children and adolescents with elevated depressive symptoms. © 2011 Springer Science+Business Media, LLC.
- Authors: Hughes, Elizabeth , Gullone, Eleonora , Watson, Shaun
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Psychopathology and Behavioral Assessment Vol. 33, no. 3 (2011), p. 335-345
- Full Text:
- Reviewed:
- Description: Difficulties with emotion and its regulation are of central importance to the etiology and course of depression. The current study investigated these constructs in relation to childhood and adolescence by comparing the emotional functioning of 170 9- to 15-year-olds reporting high levels of depressive symptoms (HD) to a matched sample of 170 children and adolescents reporting low levels of depressive symptoms (LD). Compared to LD, HD participants reported significantly greater shame proneness, poorer functioning on emotion regulation competencies (emotional control, self-awareness and situational responsiveness), less healthy emotion regulation strategy use (less reappraisal and greater suppression), and lower levels of guilt proneness. Empathic concern did not differ between the two groups. The findings enhance current knowledge by providing a more comprehensive profile of the emotional difficulties experienced by children and adolescents with elevated depressive symptoms. © 2011 Springer Science+Business Media, LLC.
The relationship between physical capacity and match performance in elite Australian football : A mediation approach
- Mooney, Mitchell, O'Brien, Brendan, Cormack, Stuart, Coutts, Aaron, Berry, Jason, Young, Warren
- Authors: Mooney, Mitchell , O'Brien, Brendan , Cormack, Stuart , Coutts, Aaron , Berry, Jason , Young, Warren
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 14, no. 5 (2011), p. 447-452
- Full Text:
- Reviewed:
- Description: The aim of this study was to verify if yo-yo intermittent recovery test (level 2) (yo-yo IR2) score is linked to Australian football (AF) performance through match exercise intensity. Six week prospective study design. Twenty-one data sets were recorded from nine individual players that completed the yo-yo IR2, and played an Australian Football League match in the first five rounds of the 2010 season wearing a global positioning system (GPS) unit. Simple mediation modelling was used to analyse the inter-relationship between yo-yo IR2 score, match exercise intensity and AF performance. Playing position and experience were also incorporated into the model to identify conditional affects. A significant direct relationship was observed between yo-yo IR2 and number of ball disposals (p<0.1) and a significant indirect relationship was observed between yo-yo IR2 and number of ball disposals through distance travelled at high intensity (HIR mmin-1) (p<0.1). Moderation analysis showed that playing position affected the relationship between of yo-yo IR2 and HIR mmin-1 (p<0.1) and HIR mmin-1 and total ball disposals (p<0.1). Playing experience also significantly affected the relationship between HIR mmin-1 and total ball disposals. This study is the first to identify the effects of yo-yo IR2 on total ball disposals through HIR mmin-1 performed during AF matches, and that playing position and playing experience affect these interactions. © 2011 Sports Medicine Australia.
- Authors: Mooney, Mitchell , O'Brien, Brendan , Cormack, Stuart , Coutts, Aaron , Berry, Jason , Young, Warren
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 14, no. 5 (2011), p. 447-452
- Full Text:
- Reviewed:
- Description: The aim of this study was to verify if yo-yo intermittent recovery test (level 2) (yo-yo IR2) score is linked to Australian football (AF) performance through match exercise intensity. Six week prospective study design. Twenty-one data sets were recorded from nine individual players that completed the yo-yo IR2, and played an Australian Football League match in the first five rounds of the 2010 season wearing a global positioning system (GPS) unit. Simple mediation modelling was used to analyse the inter-relationship between yo-yo IR2 score, match exercise intensity and AF performance. Playing position and experience were also incorporated into the model to identify conditional affects. A significant direct relationship was observed between yo-yo IR2 and number of ball disposals (p<0.1) and a significant indirect relationship was observed between yo-yo IR2 and number of ball disposals through distance travelled at high intensity (HIR mmin-1) (p<0.1). Moderation analysis showed that playing position affected the relationship between of yo-yo IR2 and HIR mmin-1 (p<0.1) and HIR mmin-1 and total ball disposals (p<0.1). Playing experience also significantly affected the relationship between HIR mmin-1 and total ball disposals. This study is the first to identify the effects of yo-yo IR2 on total ball disposals through HIR mmin-1 performed during AF matches, and that playing position and playing experience affect these interactions. © 2011 Sports Medicine Australia.
Online alcohol interventions: A systematic review
- White, Angela, Kavanagh, David, Stallman, Helen, Klein, Britt, Kay-Lambkin, Frances, Proudfoot, Judith, Drennan, Judy, Connor, Jason, Baker, Amanda, Hines, Emily, Young, Ross
- Authors: White, Angela , Kavanagh, David , Stallman, Helen , Klein, Britt , Kay-Lambkin, Frances , Proudfoot, Judith , Drennan, Judy , Connor, Jason , Baker, Amanda , Hines, Emily , Young, Ross
- Date: 2010
- Type: Text , Journal article , Review
- Relation: Journal of Medical Internet Research Vol. 12, no. 5 (2010), p. e62p.1-e62p.12
- Full Text:
- Reviewed:
- Description: Background: There has been a significant increase in the availability of online programs for alcohol problems. A systematic review of the research evidence underpinning these programs is timely. Objectives: Our objective was to review the efficacy of online interventions for alcohol misuse. Systematic searches of Medline, PsycINFO, Web of Science, and Scopus were conducted for English abstracts (excluding dissertations) published from 1998 onward. Search terms were: (1) Internet, Web*; (2) online, computer *; (3) alcohol*; and (4) Eeffect *, trial*, random* (where * denotes a wildcard). Forward and backward searches from identified papers were also conducted. Articles were included if (1) the primary intervention was delivered and accessed via the Internet, (2) the intervention focused on moderating or stopping alcohol consumption, and (3) the study was a randomized controlled trial of an alcohol-related screen, assessment, or intervention. Results: The literature search initially yielded 31 randomized controlled trials (RCTs), 17 of which met inclusion criteria. Of these 17 studies, 12 (70.6%) were conducted with university students, and 11 (64.7%) specifically focused on at-risk, heavy, or binge drinkers. Sample sizes ranged from 40 to 3216 (median 261), with 12 (70.6%) studies predominantly involving brief personalized feedback interventions. Using published data, effect sizes could be extracted from 8 of the 17 studies. In relation to alcohol units per week or month and based on 5 RCTs where a measure of alcohol units per week or month could be extracted, differential effect sizes to posttreatment ranged from 0.02 to 0.81 (mean 0.42, median 0.54). Pre-post effect sizes for brief personalized feedback interventions ranged from 0.02 to 0.81, and in 2 multi-session modularized interventions, a pre-post effect size of 0.56 was obtained in both. Pre-post differential effect sizes for peak blood alcohol concentrations (BAC) ranged from 0.22 to 0.88, with a mean effect size of 0.66. Conclusions: The available evidence suggests that users can benefit from online alcohol interventions and that this approach could be particularly useful for groups less likely to access traditional alcohol-related services, such as women, young people, and at-risk users. However, caution should be exercised given the limited number of studies allowing extraction of effect sizes, the heterogeneity of outcome measures and follow-up periods, and the large proportion of student-based studies. More extensive RCTs in community samples are required to better understand the efficacy of specific online alcohol approaches, program dosage, the additive effect of telephone or face-to-face interventions, and effective strategies for their dissemination and marketing.
- Description: Background: There has been a significant increase in the availability of online programs for alcohol problems. A systematic review of the research evidence underpinning these programs is timely. Objectives: Our objective was to review the efficacy of online interventions for alcohol misuse. Systematic searches of Medline, PsycINFO, Web of Science, and Scopus were conducted for English abstracts (excluding dissertations) published from 1998 onward. Search terms were: (1) Internet, Web*; (2) online, computer *; (3) alcohol*; and (4) E\effect *, trial*, random* (where * denotes a wildcard). Forward and backward searches from identified papers were also conducted. Articles were included if (1) the primary intervention was delivered and accessed via the Internet, (2) the intervention focused on moderating or stopping alcohol consumption, and (3) the study was a randomized controlled trial of an alcohol-related screen, assessment, or intervention. Results: The literature search initially yielded 31 randomized controlled trials (RCTs), 17 of which met inclusion criteria. Of these 17 studies, 12 (70.6%) were conducted with university students, and 11 (64.7%) specifically focused on at-risk, heavy, or binge drinkers. Sample sizes ranged from 40 to 3216 (median 261), with 12 (70.6%) studies predominantly involving brief personalized feedback interventions. Using published data, effect sizes could be extracted from 8 of the 17 studies. In relation to alcohol units per week or month and based on 5 RCTs where a measure of alcohol units per week or month could be extracted, differential effect sizes to posttreatment ranged from 0.02 to 0.81 (mean 0.42, median 0.54). Pre-post effect sizes for brief personalized feedback interventions ranged from 0.02 to 0.81, and in 2 multi-session modularized interventions, a pre-post effect size of 0.56 was obtained in both. Pre-post differential effect sizes for peak blood alcohol concentrations (BAC) ranged from 0.22 to 0.88, with a mean effect size of 0.66. Conclusions: The available evidence suggests that users can benefit from online alcohol interventions and that this approach could be particularly useful for groups less likely to access traditional alcohol-related services, such as women, young people, and at-risk users. However, caution should be exercised given the limited number of studies allowing extraction of effect sizes, the heterogeneity of outcome measures and follow-up periods, and the large proportion of student-based studies. More extensive RCTs in community samples are required to better understand the efficacy of specific online alcohol approaches, program dosage, the additive effect of telephone or face-to-face interventions, and effective strategies for their dissemination and marketing.
- Authors: White, Angela , Kavanagh, David , Stallman, Helen , Klein, Britt , Kay-Lambkin, Frances , Proudfoot, Judith , Drennan, Judy , Connor, Jason , Baker, Amanda , Hines, Emily , Young, Ross
- Date: 2010
- Type: Text , Journal article , Review
- Relation: Journal of Medical Internet Research Vol. 12, no. 5 (2010), p. e62p.1-e62p.12
- Full Text:
- Reviewed:
- Description: Background: There has been a significant increase in the availability of online programs for alcohol problems. A systematic review of the research evidence underpinning these programs is timely. Objectives: Our objective was to review the efficacy of online interventions for alcohol misuse. Systematic searches of Medline, PsycINFO, Web of Science, and Scopus were conducted for English abstracts (excluding dissertations) published from 1998 onward. Search terms were: (1) Internet, Web*; (2) online, computer *; (3) alcohol*; and (4) Eeffect *, trial*, random* (where * denotes a wildcard). Forward and backward searches from identified papers were also conducted. Articles were included if (1) the primary intervention was delivered and accessed via the Internet, (2) the intervention focused on moderating or stopping alcohol consumption, and (3) the study was a randomized controlled trial of an alcohol-related screen, assessment, or intervention. Results: The literature search initially yielded 31 randomized controlled trials (RCTs), 17 of which met inclusion criteria. Of these 17 studies, 12 (70.6%) were conducted with university students, and 11 (64.7%) specifically focused on at-risk, heavy, or binge drinkers. Sample sizes ranged from 40 to 3216 (median 261), with 12 (70.6%) studies predominantly involving brief personalized feedback interventions. Using published data, effect sizes could be extracted from 8 of the 17 studies. In relation to alcohol units per week or month and based on 5 RCTs where a measure of alcohol units per week or month could be extracted, differential effect sizes to posttreatment ranged from 0.02 to 0.81 (mean 0.42, median 0.54). Pre-post effect sizes for brief personalized feedback interventions ranged from 0.02 to 0.81, and in 2 multi-session modularized interventions, a pre-post effect size of 0.56 was obtained in both. Pre-post differential effect sizes for peak blood alcohol concentrations (BAC) ranged from 0.22 to 0.88, with a mean effect size of 0.66. Conclusions: The available evidence suggests that users can benefit from online alcohol interventions and that this approach could be particularly useful for groups less likely to access traditional alcohol-related services, such as women, young people, and at-risk users. However, caution should be exercised given the limited number of studies allowing extraction of effect sizes, the heterogeneity of outcome measures and follow-up periods, and the large proportion of student-based studies. More extensive RCTs in community samples are required to better understand the efficacy of specific online alcohol approaches, program dosage, the additive effect of telephone or face-to-face interventions, and effective strategies for their dissemination and marketing.
- Description: Background: There has been a significant increase in the availability of online programs for alcohol problems. A systematic review of the research evidence underpinning these programs is timely. Objectives: Our objective was to review the efficacy of online interventions for alcohol misuse. Systematic searches of Medline, PsycINFO, Web of Science, and Scopus were conducted for English abstracts (excluding dissertations) published from 1998 onward. Search terms were: (1) Internet, Web*; (2) online, computer *; (3) alcohol*; and (4) E\effect *, trial*, random* (where * denotes a wildcard). Forward and backward searches from identified papers were also conducted. Articles were included if (1) the primary intervention was delivered and accessed via the Internet, (2) the intervention focused on moderating or stopping alcohol consumption, and (3) the study was a randomized controlled trial of an alcohol-related screen, assessment, or intervention. Results: The literature search initially yielded 31 randomized controlled trials (RCTs), 17 of which met inclusion criteria. Of these 17 studies, 12 (70.6%) were conducted with university students, and 11 (64.7%) specifically focused on at-risk, heavy, or binge drinkers. Sample sizes ranged from 40 to 3216 (median 261), with 12 (70.6%) studies predominantly involving brief personalized feedback interventions. Using published data, effect sizes could be extracted from 8 of the 17 studies. In relation to alcohol units per week or month and based on 5 RCTs where a measure of alcohol units per week or month could be extracted, differential effect sizes to posttreatment ranged from 0.02 to 0.81 (mean 0.42, median 0.54). Pre-post effect sizes for brief personalized feedback interventions ranged from 0.02 to 0.81, and in 2 multi-session modularized interventions, a pre-post effect size of 0.56 was obtained in both. Pre-post differential effect sizes for peak blood alcohol concentrations (BAC) ranged from 0.22 to 0.88, with a mean effect size of 0.66. Conclusions: The available evidence suggests that users can benefit from online alcohol interventions and that this approach could be particularly useful for groups less likely to access traditional alcohol-related services, such as women, young people, and at-risk users. However, caution should be exercised given the limited number of studies allowing extraction of effect sizes, the heterogeneity of outcome measures and follow-up periods, and the large proportion of student-based studies. More extensive RCTs in community samples are required to better understand the efficacy of specific online alcohol approaches, program dosage, the additive effect of telephone or face-to-face interventions, and effective strategies for their dissemination and marketing.
Prospective application of a five-step regulatory assessment model to a proposed federal sperm donor registry in Australia: Is it in the public interest?
- Authors: Sawyer, Neroli
- Date: 2010
- Type: Text , Journal article
- Relation: Journal of law and medicine Vol. 17, no. 4 (2010), p. 608-616
- Full Text:
- Description: It has been proposed that a nationally mandated donor registry be established in Australia to provide data for estimating the possible number of inadvertent half-sibling matings resulting from the multiple use of anonymous donors in donor insemination and to assist identity-release donors and their donor-inseminated children to establish contact. A five-step regulatory assessment model, as described by Johnson and Petersen in 2008, was applied prospectively to the proposed donor registry to identify public interest issues. The resultant issues concern the public ethical interest in child welfare; the public health interest in avoiding genetic abnormalities/disease; public socio-political and legal interests in avoiding inadvertent consanguineous relationships; public ethical and health interests in avoiding identity issues in the donor-inseminated child; and public socio-ethical interests in providing nationally mandated, comprehensive records of donor insemination outcomes. These results provide a basis for further discussion in regard to donor insemination legislation at the federal level.
- Authors: Sawyer, Neroli
- Date: 2010
- Type: Text , Journal article
- Relation: Journal of law and medicine Vol. 17, no. 4 (2010), p. 608-616
- Full Text:
- Description: It has been proposed that a nationally mandated donor registry be established in Australia to provide data for estimating the possible number of inadvertent half-sibling matings resulting from the multiple use of anonymous donors in donor insemination and to assist identity-release donors and their donor-inseminated children to establish contact. A five-step regulatory assessment model, as described by Johnson and Petersen in 2008, was applied prospectively to the proposed donor registry to identify public interest issues. The resultant issues concern the public ethical interest in child welfare; the public health interest in avoiding genetic abnormalities/disease; public socio-political and legal interests in avoiding inadvertent consanguineous relationships; public ethical and health interests in avoiding identity issues in the donor-inseminated child; and public socio-ethical interests in providing nationally mandated, comprehensive records of donor insemination outcomes. These results provide a basis for further discussion in regard to donor insemination legislation at the federal level.
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