Impact of guidance on intervention adherence in computerised interventions for mental health problems: A meta-analysis.

Web-based interventions are increasingly used for the prevention, treatment and aftercare of mental disorders. A crucial factor to the efficacy of such online programmes is adherence to the intervention content and procedure. It has been frequently suggested that adherence in web-based interventions is low and little is known about which factors influence adherence. To increase intervention uptake and completion, studies increasingly include interventions with some form of guidance. Guided interventions have been shown to have higher efficacy, however, evidence for the impact on adherence is limited and mixed. This meta-analysis explored the impact of human guidance on intervention completion in web-based mental health interventions. A total of 22 studies were included with interventions primarily targeting symptoms of depression and anxiety disorders. Results showed that guidance significantly increases the average amount of intervention completion [g = 0.29, 95% confidence interval (CI) 0.18-0.40] and the proportion of intervention completers [log odds ratio (OR) = 0.50, 95% CI 0.34-0.66] with small effects. On average, full completion rates were 12% higher in guided intervention groups. This meta-analysis demonstrated that guidance in web-based mental health interventions does increase adherence, but more research is required to better understand the specific mechanisms between guidance, adherence and outcomes.</p

From the Enlightenment to the Digital Sunlight System : realistic visualization of Count Potocki’s Laurentine Villa : progress of the works

Оver the last years new technologies have opened up countless opportunities for the world of science and building virtual (digital) worlds is one of most interesting among them. Methods employed in archaeological popularization may also be successfully used in research on monuments of a more complex character. Such an object is, undoubtedly, a drawing reconstruction of the Laurentine Villa of Pliny the Younger made by at least three skilful artists in the 1870s, commissioned by Stanisław К. Potocki and produced according to his instructions.Agnieszka Uziębł

Spatial and temporal variations of malaria epidemic risk in Ethiopia: factors involved and implications.

The aim of this study was to describe spatial and temporal variations in malaria epidemic risk in Ethiopia and to examine factors involved in relation to their implications for early warning and interpretation of geographical risk models. Forty-eight epidemic episodes were identified in various areas between September 1986 and August 1993 and factors that might have led to the events investigated using health facility records and weather data. The study showed that epidemics in specific years were associated with specific geographical areas. A major epidemic in 1988 affected the highlands whereas epidemics in 1991 and 1992 affected highland-fringe areas on the escarpments of the Rift Valley and in southern and north-western parts of the country. Malaria epidemics were significantly more often preceded by a month of abnormally high minimum temperature in the preceding 3 months than based on random chance, whereas frequency of abnormally low minimum temperature prior to epidemics was significantly lower than expected. Abnormal increases of maximum temperature and rainfall had no positive association with the epidemics. A period of low incidence during previous transmission seasons might have aggravated the events, possibly due to low level of immunity in affected populations. Epidemic risk is a dynamic phenomenon with changing geographic pattern based on temporal variations in determinant factors including weather and other eco-epidemiological characteristics of areas at risk. Epidemic early warning systems should take account of non-uniform effects of these factors by space and time and thus temporal dimensions need to be considered in spatial models of epidemic risks

Early warning systems for malaria in Africa: from blueprint to practice.

Although the development of early warning systems for malaria has been advocated by international agencies and academic researchers for many years, practical progress in this area has been relatively modest. In two recent articles, Thomson et al. provide new evidence that models of malaria incidence that incorporate monitored or predicted climate can provide early warnings of epidemics one to five months in advance in semi-arid areas. Although the potential benefits of these models in terms of improved management of epidemics are clear, several technical and practical hurdles still need to be overcome before the models can be widely integrated into routine malaria-control strategies

Approaches for Future Internet architecture design and Quality of Experience (QoE) Control

Researching a Future Internet capable of overcoming the current Internet limitations is a strategic investment. In this respect, this paper presents some concepts that can contribute to provide some guidelines to overcome the above-mentioned limitations. In the authors' vision, a key Future Internet target is to allow applications to transparently, efficiently and flexibly exploit the available network resources with the aim to match the users' expectations. Such expectations could be expressed in terms of a properly defined Quality of Experience (QoE). In this respect, this paper provides some approaches for coping with the QoE provision problem

The Influence of Human Support on the Effectiveness of Digital Mental Health Promotion Interventions for the General Population

Mental wellbeing amongst the general population is languishing—exacerbated by the Coronavirus Disease 2019 (COVID-19) pandemic. Digital mental health promotion interventions, that improve mental health literacy and encourage adoption of evidence-informed practical strategies are essential. However, attrition and non-adherence are problematic in digital interventions. Human support is often applied as an antidote; yet, there is a paucity of randomized trials that compare different human support conditions amongst general population cohorts. Limited trials generally indicate that human support has little influence on adherence or outcomes in DMHPIs. However, providing participants autonomy to self-select automated support options may enhance motivation and adherence

The Influence of Three Modes of Human Support on Attrition and Adherence to a Web- and Mobile App–Based Mental Health Promotion Intervention in a Nonclinical Cohort: Randomized Comparative Study

Background: The escalating prevalence of mental health disorders necessitates a greater focus on web- and mobile app–based mental health promotion initiatives for nonclinical groups. However, knowledge is scant regarding the influence of human support on attrition and adherence and participant preferences for support in nonclinical settings. Objective: This study aimed to compare the influence of 3 modes of human support on attrition and adherence to a digital mental health intervention for a nonclinical cohort. It evaluated user preferences for support and assessed whether adherence and outcomes were enhanced when participants received their preferred support mode. Methods: Subjects participated in a 10-week digital mental health promotion intervention and were randomized into 3 comparative groups: standard group with automated emails (S), standard plus personalized SMS (S+pSMS), and standard plus weekly videoconferencing support (S+VCS). Adherence was measured by the number of video lessons viewed, points achieved for weekly experiential challenge activities, and the total number of weeks that participants recorded a score for challenges. In the postquestionnaire, participants ranked their preferred human support mode from 1 to 4 (S, S+pSMS, S+VCS, S+pSMS & VCS combined). Stratified analysis was conducted for those who received their first preference. Preintervention and postintervention questionnaires assessed well-being measures (ie, mental health, vitality, depression, anxiety, stress, life satisfaction, and flourishing). Results: Interested individuals (N=605) enrolled on a website and were randomized into 3 groups (S, n=201; S+pSMS, n=202; S+VCS, n=201). Prior to completing the prequestionnaire, a total of 24.3% (147/605) dropped out. Dropout attrition between groups was significantly different (P=.009): 21.9% (44/201) withdrew from the S group, 19.3% (39/202) from the S+pSMS group, and 31.6% (64/202) from the S+VCS group. The remaining 75.7% (458/605) registered and completed the prequestionnaire (S, n=157; S+pSMS, n=163; S+VCS, n=138). Of the registered participants, 30.1% (138/458) failed to complete the postquestionnaire (S, n=54; S+pSMS, n=49; S+VCS, n=35), but there were no between-group differences (P=.24). For the 69.9% (320/458; S, n=103; S+pSMS, n=114; S+VCS, n=103) who completed the postquestionnaire, no between-group differences in adherence were observed for mean number of videos watched (P=.42); mean challenge scores recorded (P=.71); or the number of weeks that challenge scores were logged (P=.66). A total of 56 participants (17.5%, 56/320) received their first preference in human support (S, n=22; S+pSMS, n=26; S+VCS, n=8). No differences were observed between those who received their first preference and those who did not with regard to video adherence (P=.91); challenge score adherence (P=.27); or any of the well-being measures including, mental health (P=.86), vitality (P=.98), depression (P=.09), anxiety (P=.64), stress (P=.55), life satisfaction (P=.50), and flourishing (P=.47). Conclusions: Early dropout attrition may have been influenced by dissatisfaction with the allocated support mode. Human support mode did not impact adherence to the intervention, and receiving the preferred support style did not result in greater adherence or better outcomes. Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR): 12619001009101; http://www.anzctr.org.au/ACTRN12619001009101.asp

Efficacy of transdiagnostic cognitive­-behavioral therapy for anxiety and depression in adults, children and adolescents: A meta­-analysis

Abstract: This meta-­analysis examined the effect of transdiagnostic cognitive­-behavioral therapy (T­-CBT) in adults, children,  and adolescents with emotional disorders, exploring the effects of possible moderator variables on efficacy. In contrast with previous reviews, only studies employing transdiagnostic theory­-based protocols were included. A total of 48 studies reporting on 6291 participants were identified. Treatment efficacy was examined using a random effects model and taking into account pre­- and post­-treatment data. Results within the adult population showed large overall effect sizes on anxiety (randomized con­trolled trials [RCTs]: g = 0.80; Uncontrolled studies: g = 1.02) and depression (RCTs: g = 0.72; Uncontrolled studies: g = 1.08) that were stable at follow up. Preliminary analysis with children and adolescents showed medium effect sizes on anxiety (g = 0.45) and depression (g = 0.50). No significant differences between T­-CBT and disorder­-specific CBT were found. Overall, results support the efficacy of T­-CBT for emotional disorders.Resumen: Eficacia de la terapia cognitivo conductual transdiagnóstica en el tratamiento de la ansiedad y la depresión en adultos, niños y adolescentes: Un meta-análisis. El presente meta­-análisis examina el efecto de la terapia cognitivo conductual transdiagnóstica (TCC­-T) en adultos, niños y adolescentes con trastornos emocionales, explorando los efectos de posibles variables moderadoras en su eficacia. A diferencia de los meta­-análisis previos, sólo se incluyeron los estudios que emplearon protocolos basados explícitamente en el enfoque transdiagnóstico. Se identificaron 48 estudios que informaron sobre 6291 participantes. La eficacia del tratamiento se examinó utilizando un modelo de efectos aleatorios y teniendo en cuenta los datos pre y post­-tratamiento. Los resultados sobre población adulta muestran tamaños del efecto elevados para la ansiedad (ensayos controlados aleatorizados [ECAs]: g = 0.80; Estudios no controlados: g = 1.02) y la depresión (ECAs: g = 0.72; Estudios no controlados: g = 1.08), que permanecieron esta­bles durante el seguimiento. El análisis preliminar con población de niños y adolescentes mostró tamaños del efecto medios en ansiedad (g = 0.45) y depresión (g = 0.50). No encontramos diferencias significativas entre la TCC­-T y la TCC para trastornos específicos. En general, los resultados apoyan la eficacia de la TCC­-T para los trastornos  emocionales. Abstract: This meta-­analysis examined the effect of transdiagnostic cognitive­-behavioral therapy (T­-CBT) in adults, children,  and adolescents with emotional disorders, exploring the effects of possible moderator variables on efficacy. In contrast with previous reviews, only studies employing transdiagnostic theory­-based protocols were included. A total of 48 studies reporting on 6291 participants were identified. Treatment efficacy was examined using a random effects model and taking into account pre­- and post­-treatment data. Results within the adult population showed large overall effect sizes on anxiety (randomized con­trolled trials [RCTs]: g = 0.80; Uncontrolled studies: g = 1.02) and depression (RCTs: g = 0.72; Uncontrolled studies: g = 1.08) that were stable at follow up. Preliminary analysis with children and adolescents showed medium effect sizes on anxiety (g = 0.45) and depression (g = 0.50). No significant differences between T­-CBT and disorder­-specific CBT were found. Overall, results support the efficacy of T­-CBT for emotional disorders.Resumen: Eficacia de la terapia cognitivo conductual transdiagnóstica en el tratamiento de la ansiedad y la depresión en adultos, niños y adolescentes: Un meta-análisis. El presente meta­-análisis examina el efecto de la terapia cognitivo conductual transdiagnóstica (TCC­-T) en adultos, niños y adolescentes con trastornos emocionales, explorando los efectos de posibles variables moderadoras en su eficacia. A diferencia de los meta­-análisis previos, sólo se incluyeron los estudios que emplearon protocolos basados explícitamente en el enfoque transdiagnóstico. Se identificaron 48 estudios que informaron sobre 6291 participantes. La eficacia del tratamiento se examinó utilizando un modelo de efectos aleatorios y teniendo en cuenta los datos pre y post­-tratamiento. Los resultados sobre población adulta muestran tamaños del efecto elevados para la ansiedad (ensayos controlados aleatorizados [ECAs]: g = 0.80; Estudios no controlados: g = 1.02) y la depresión (ECAs: g = 0.72; Estudios no controlados: g = 1.08), que permanecieron esta­bles durante el seguimiento. El análisis preliminar con población de niños y adolescentes mostró tamaños del efecto medios en ansiedad (g = 0.45) y depresión (g = 0.50). No encontramos diferencias significativas entre la TCC­-T y la TCC para trastornos específicos. En general, los resultados apoyan la eficacia de la TCC­-T para los trastornos  emocionales