Exposure Therapy for Problem Gambling via Videoconferencing: A Case Report

This case report of a 31 year old woman who described her main problem as an uncontrollable urge to gamble on electronic gaming machines describes the application of exposure therapy (ET) by videoconferencing and the use of a clinical therapy assistant in the treatment of pathological gambling. The case study is used to demonstrate the effectiveness of this treatment with six sessions of therapy and 4 year follow up. The use of videoconferencing is discussed in relation to treatment effectiveness, ongoing follow up for the client and education and support for a community mental health nurse, therapy assistant, in a rural setting in South Australia. The implications of using this modality for the treatment of rural patients with problem gambling is discussed.     

Acquiring and Implementing Videoconferencing Technology to Enhance the Field Work Experience

Abstract

To facilitate connections between the curriculum and field, faculty members at one university have explored and experimented with the use of videoconferencing technology for increased faculty communication with students and field instructors. This paper describes the planning and equipment acquisition process, from beginning conceptualization to current implementation. Further, it provides practical information about videoconferencing systems and suggests ways to maximize their use.     

Direct Service Applications of Videoconferencing Technologies: Case Examples from Korea and the United States

SUMMARY

This paper describes practice applications of videoconferencing technologies in two settings. In Korea, people who live in areas which lack social welfare expertise receive services such as education, counseling, diagnostic assessment, and therapy through a system linking the central site with three service agencies in three different cities. In the United States, an interactive video breast cancer support group links women in three distant communities monthly. Evaluative feedback concerning these applications from professional and lay users will be reviewed in detail. Implications for the use of videoconferencing in social work practice will be discussed.     

Collaborative Care at a Distance: Student Therapists' Experiences of Learning and Delivering Relationally Focused Telemental Health

There is mounting evidence that telemental health is an effective delivery method for treating a variety of mental, emotional, behavioral, and relational health problems. While many of the therapeutic skills leading to the effectiveness of face-to-face treatments are transferable, the effectiveness of telemental health requires unique skills. The purpose of this phenomenological study was to determine the experience of learning how to use videoconferencing to deliver relationally focused mental health care. Participants included 10 graduates of a COAMFTE-accredited master's degree program emphasizing training in telemental health. Each student had practicum placements that required videoconferencing to deliver relationally based psychotherapy. Analysis of interview data revealed (a) personal reservations about distance delivery; (b) the importance of scaffolding student learning through curriculum, supervision, and mental health-care delivery protocols; (c) the technological barriers associated with this delivery method; and (d) overcoming technological barriers through intentionality.     

Psychologist and Physician Interest in Telehealth Training and Referral for Mental Health Services: An Exploratory Study

The current study explored psychological and medical professionals’ interest in videoconferencing telehealth training and mental health telehealth referral. An online survey assessed 782 participants comprised of 669 psychological (45% male, Mean Age = 47.01, SD = 16.82) and 113 medical professionals (58% male, Mean Age = 46.19, SD = 12.40). Z-test analyses indicated that although psychological professionals were statistically more interested in receiving telehealth training, both groups reported some interest. Ranked responses indicated efficacy data, ethical issues, and legal concerns as the most endorsed areas of training interest. Referral concerns were also found. Findings were discussed related to both statistical and clinical significance. Application of findings is discussed related to future work, practice, and program creation. The development of telehealth training programs will provide interested professionals with tools required for practice and may serve as an impetus to increase utilization and/or referral.     

Telehealth for Patients with Chronic Pain: Exploring a Successful and an Unsuccessful Outcome

Abstract

Cognitive-behavioral therapy (CBT) is effective for treating chronic pain, but little is known about the mechanisms that might facilitate or hinder its utility when delivered by videoconference. In a single-case experimental design, we explored the outcomes of two adults with chronic pain who were provided with videoconference-based CBT. The goal was to examine the relationship between therapeutic alliance as well as presence felt and clinical outcomes. Therapeutic alliance was high overall for both participants; however, only the successful case’s alliance ratings significantly increased over treatment. Levels of presence felt in videoconferencing were also high, but were not related to therapy outcome.     

Videoconferencing in Telepsychiatry

SUMMARY

Interactive videoconferencing is an easy, fast, and relatively inexpensive method of providing psychiatric services over long distances. The experiences of telepsychiatry practitioners have been promising in Finland, Norway, the United Kingdom, the USA, Canada, and Australia.

The first practical telepsychiatry experiments in Finland were carried out at the Department of Psychiatry of the University of Oulu, where videoconferencing has been used for family therapy, psychiatric supervision, consultation, patient negotiations, and teaching. During 1998, out of a total of 400 hours, 35% of the online time was used for teaching, 24% for occupational counseling, 21% for consultations and patient negotiations, and 20% for methodological development and other activities (mainly testing the connections). The costs of inpatient negotiations via teleconferencing is half those of conventional negotiations. In general, cost analyses have also shown that telepsychiatric services are economically cost-effective in most European countries and in Australia, where a relatively small number of connections exists, while in the USA and Canada, high telecommunications costs make telemedicine more prohibitive compared to conventional care.     

Socioeconomic evaluation of a correctional programme in Sweden—long-term effects Samhällsekonomisk utvärdering av ett kriminalvårdsprogram i Sverige—långsiktiga effekter

The present article focuses on the long-term socioeconomic outcome of a correctional programme in Sweden, called KrAmi (n=62), using a systematic comparison with a control group of probation clients (n=51). The evaluation, which had a quasi-experimental design, was based on actual costs for each client (n=113) for a period of five years, from 1995 to 1999. The follow-up period was two years, during which the socioeconomic costs decreased step-wise for both groups, probation groups more so than programme groups. The deteriorations were 70–80% compared to the period before treatment. Rehabilitation to labour market, measured in pension points, was more successful for programme groups than for control groups. Thanks to this, as well as lower costs during the treatment period, the programme groups’ socioeconomic profitability, measured with a 15-year cost–benefit analysis (CBA), was greater than that of the control groups. The cost–effectiveness analysis (CEA) shows that the KrAmi groups are better off in work rehabilitation, depreciation time (one year compared with two and a half years for probation groups) and repayment ratio (14 SEK compared to 6 SEK for probation groups) although cost savings are greater for probation groups.     

The effects of orchidectomy and supraphysiological testosterone administration on trabecular bone structure and gene expression in rats

Abstract

Objective: This study aimed to determine the effects of orchidectomy and supraphysiological testosterone replacement on trabecular structure and gene expression in the bone.

Methods: Twenty-four 3-month old male rats were randomized into sham (SH), orchidectomized (ORX) and testosterone-treated (TE) groups. Orchidectomy was performed on the ORX and TE group. Weekly testosterone enanthate intramuscular injection at 7?mg/kg body weight was administered to the TE group for 8 weeks while the other groups received peanut oil as vehicle. Blood was collected before and after treatment for serum testosterone analysis. The femora and tibiae were harvested after the treatment period for trabecular structure and gene expression analysis.

Results: The trabecular bone volume decreased significantly and the porosity increased significantly in the ORX group compared to the SH group (p?<?0.05). Testosterone treatment prevented all these changes (p?<?0.05). The expression of osteogenic genes decreased significantly in the ORX group compared to the SH group (p?<?0.05). Testosterone treatment decreased the expressions of RANKL and OPG genes significantly (p?<?0.05).

Conclusion: Orchidectomy-induced degeneration in trabecular structure is caused by a decrease in the expressions of osteogenic genes. Supraphysiological testosterone replacement is able to prevent these degenerative changes in the bone despite the modest changes in gene expression.     

Testofen,a specialised Trigonella foenum-graecum seed extract reduces age-related symptoms of androgen decrease,increases testosterone levels and improves sexual function in healthy aging males in a double-blind randomised clinical study

This study examined the effect of Testofen, a specialised Trigonella foenum-graecum seed extract on the symptoms of possible androgen deficiency, sexual function and serum androgen concentrations in healthy aging males. This was a double-blind, randomised, placebo-controlled trial involving 120 healthy men aged between 43 and 70 years of age. The active treatment was standardised Trigonella foenum-graecum seed extract at a dose of 600?mg/day for 12 weeks. The primary outcome measure was the change in the Aging Male Symptom questionnaire (AMS), a measure of possible androgen deficiency symptoms; secondary outcome measures were sexual function and serum testosterone. There was a significant decrease in AMS score over time and between the active and placebo groups. Sexual function improved, including number of morning erections and frequency of sexual activity. Both total serum testosterone and free testosterone increased compared to placebo after 12 weeks of active treatment. Trigonella foenum-graecum seed extract is a safe and effective treatment for reducing symptoms of possible androgen deficiency, improves sexual function and increases serum testosterone in healthy middle-aged and older men.     

A pilot study of CBT versus escitalopram combined with CBT in the treatment of pathological gamblers

We conducted a randomised controlled trial pilot study (N = 30) with two treatment groups: (1) Manualised cognitive behavioural therapy (CBT) (n = 15) and (2) escitalopram combined with CBT (n = 15). Treatment was administered individually and the CBT included weekly sessions for eight consecutive weeks. The treatment with escitalopram lasted for a minimum of 16 weeks (20 mg/day), with an optional continuation for a 6-month follow-up period. Repeated measures ANOVA with modified intent-to-treat analyses were conducted. Results showed significant time effects on all measures for both treatment conditions, although no significant group or time × group effects. The results indicated that both treatments were effective in the short term (effect sizes (ES) ranging from 0.45 to 0.91 for the CBT group and 0.27 to 0.72 for the escitalopram+CBT group), and that adding CBT to escitalopram had no additional statistically significant effect (between-group ES of 0.11 and 0.29 for primary outcome measures at 16-weeks post-treatment).     

Self-Esteem,Locus of Control,and Suicide Risk

Abstract

Past research suggests that African American clients in need of mental health services are less likely to be properly diagnosed and receive appropriate treatment compared to White Americans. It has been further suggested that this may be even a greater problem for those who are both African American and female. In the current study, 2 groups of hospitalized clinically depressed females (92 African American females; 99 White females) were administered the Self-Esteem Rating Scale, Internal Control Index, and Suicide Risk Scale. Results indicated more similarities than differences between the two groups. For instance, there were no differences in locus of control or suicide risk between groups. In addition, although there were differences in self-esteem between groups, self-esteem was the best predictor of suicide risk within groups (White, R² =42%; African American, R² = 19%). African American females possessed higher self-esteem than White females (p = .05). For African American females age and self-esteem were positively correlated (r = .27, p =.01). Clinically depressed females could benefit from treatment focusing on improving self-esteem within a context of multicultural sensitivity.     

Examining the Efficacy of a Brief Mindfulness-Based Stress Reduction (Brief MBSR) Program on Psychological Health

Abstract

Objective: The purpose of the study was to examine potential psychological health benefits of participating in a brief (5-week) mindfulness-based stress reduction (brief MBSR) program integrated into an academic course. Participants: Participants were 119 undergraduate students (treatment: n = 72; control: n = 47) enrolled in elective academic courses on addictive behaviors, between January 2010 and May 2012. Methods: This study employed a quasi-experimental pretest/posttest design comparing changes in psychological health between brief MBSR treatment and parallel control groups. Baseline and follow-up data were collected synchronously across semesters for both groups. Results: Analysis of covariance revealed significant improvements in psychological health, measured by mindfulness (Philadelphia Mindfulness Scale: p ≤ .001; Kentucky Inventory of Mindfulness Scale: p ≤ .001) and self-compassion (Self-compassion Scale: p ≤ .001), among brief MBSR participants compared with the parallel control cohort. Significant reductions in trait anxiety were not evident. Conclusions: Brief MBSR programs can improve psychological health; however, longer MBSR programs may be needed to improve psychological distress, such as trait anxiety.     

Does age affect the efficacy and safety of GreenLight HPS™ laser photoselective vaporization prostatectomy?

Background: To evaluate the efficacy and safety of GreenLight HPS^? (High Performance System) laser photoselective vaporization prostatectomy (PVP) for the treatment of benign prostatic hyperplasia (BPH) in patients of different age groups. Methods: 164 consecutive patients were stratified into two groups: age <70 (group I, n?=?93) and age ≥70 (group II, n?=?71) years. Transurethral PVP was performed using a GreenLight HPS? side-firing laser system. Voiding parameters were measured preoperatively and at 1 and 4 weeks and 3, 6, 12, 18, 24 and 36 months postoperatively. Results: Among the preoperative parameters evaluated, there were significant differences (p?<?0.05) in prostate volume (I: 58.7; II: 73.6?mL) and serum prostate-specific antigen (I: 1.9; II: 2.9?ng/mL), while American Urological Association Symptom Score (AUASS), Quality of Life (QoL), maximum flow rate (Qmax), Sexual Health Inventory for Men (SHIM) and post void residual (PVR) were similar (p?>?0.05) between groups. No significant differences in laser utilization, energy usage and operating time were noted. Clinical outcomes (AUASS, QoL, Qmax, PVR) showed immediate and stable improvement from baseline (p?<?0.05) within each group, but no significant differences between the two groups were observed during the follow-up period. The incidence of adverse events was low and similar in both groups. Conclusions: The results suggest that age has little effect on the efficacy and safety of GreenLight HPS? laser PVP.     

Families of Children with Serious Emotional Disturbances: Parent Perceptions of Family Resources and Stressors

This study addresses the dearth of research on families of children with serious emotional disturbances (SEDs) by examining parents’ perceptions of their families’ resources and stressors. Parent and/or guardian responses on the Family Inventory of Resources and Stressors (FIRST) whose children were receiving treatment for SEDs (n = 80) were compared to those with children without SEDs (n = 48). One-way ANCOVA analyses revealed that, when controlling for income and education level, families of children with SEDs reported significantly greater stress levels than families of children without SEDs, but both groups reported similar levels of resources. The principles derived from this study provide critical information for treatment providers and researchers seeking to develop an in-depth understanding of the resources and stressors of families of children with SEDs so as to more effectively collaborate with them in treatment planning.     

The effects of daily alendronate,daily calcitonin and alendronate every other day on bone mineral density in osteoporotic men

Objectives. Biphosphonates have been widely used in the treatment of osteoporosis, but there is not enough data on their use in men. The aim of this study is to investigate the effects of twelve months' treatment with daily 10 mg alendronate, every other day 10 mg alendronate and daily 200 IU calcitonin on bone mineral density (BMD) in men with osteoporosis.

Materials and methods. 46 men with osteoporosis were randomly allocated to three groups: 15 patients in the first group received daily 10 mg alendronate and calcium (1000 mg/day), 14 patients in the second group used every other day 10 mg alendronate and calcium and 17 patients in the third group were given intranasal salmon calcitonin and calcium. At the baseline, sixth and twelfth months, BMD was measured at lumbar spine (L_2–4), femoral neck and Ward's triangle zone by means of dual energy X-ray absorptiometry (LUNAR).

Results. In daily and every other day alendronate and calcitonin groups there was a significant increase in BMD at lumbar spine (p = 0.004, p = 0.001, p = 0.04), but no difference at the femoral neck (p > 0.05) at the end of twelve months. When the groups were compared with each other, no significant differences in BMD levels at lumbar spine, femoral neck and Ward's triangle were found (p > 0.05).     

Effects of testosterone administration on liver structure and function in aging rats

Aging males have a decrease in testosterone levels, by which the testosterone treatment may influence in a negatively fashion the liver.

Aim: This study aimed to analyze the effects of aging with or without testosterone administration on the liver components of animals.

Methods: Wistar rats were divided into three groups: 20 months’ group (G20), 24 months’ group (G24), group treated with testosterone for 16 weeks (GT). All groups were sacrificed at 24 months except for G20 that was sacrificed at 20 months.

Results: Aging and testosterone treatment alters the body weight (BW), liver weight (LW) and relative liver weight. Besides, testosterone increased the mitogen capacity of hepatocytes. Nonetheless, we reinforce the negative effects of testosterone on old animals’ liver as chronic hepatic congestion and/or cholestasis. In addition, we observed that testosterone plays an important role on hepatic glycogen stores.

Conclusions: Our study showed many implications for the knowledge about the effects of aging with or without testosterone administration on old animals’ liver.     

Web-Assisted Instruction for Changing Social Cognitive Variables Related to Physical Activity

The authors examined the efficacy of Web-assisted instruction for promoting the use of social cognitive theory (SCT) strategies related to physical activity. They recruited college students attending health courses. The authors created 3 groups (Web-assisted, comparison, and control) based on the course structure. The Web-assisted group received information on exercise and fitness and a Web-based program (treatment, n = 127); 7 sections received the same exercise and fitness information as the treatment condition, but no Web-based program (comparison, n = 118); and 6 sections received information in unrelated areas (control, n = 178). The Web-based program consisted of 9 Web assignments (1 per week) that targeted key SCT variables. Satisfaction with the Web-based program was high. Use of self-regulation strategies was significantly higher at posttest in the treatment group than it was in the other groups. Knowledge concerning the skills taught by the Web assignments was significantly greater in the treatment group than it was in the comparison group. The results of this study demonstrate that a Web-based instructional program has a positive impact on knowledge and skills related to SCT strategies for changing physical activity behavior.     

‘Making it relevant’: a rural teacher’s integration of an international studies program

This paper presents a case study in which a series of international programs was delivered via interactive videoconferencing technology to a middle school classroom in a small rural town in the USA. Despite positive reactions to the international programs, a deeper look at the use of the programs pointed to some reason for concern regarding the manner in which the international program was used to motivate students. The danger of ethnocentric interpretation was clearly present.