Internet-based treatment for PTSD reduces distress and facilitates the development of a strong therapeutic alliance: a randomized controlled clinical trial

BACKGROUND: The present study was designed to evaluate the efficacy of an internet-based therapy (Interapy) for Posttraumatic Stress Disorder (PTSD) in a German speaking population. Also, the quality of the online therapeutic relationship, its development and its relevance as potential moderator of the treatment effects was investigated. METHOD: Ninety-six patients with posttraumatic stress reactions were allocated at random to ten sessions of Internet-based cognitive behavioural therapy (CBT) conducted over a 5-week period or a waiting list control group. Severity of PTSD was the primary outcome. Secondary outcome variables were depression, anxiety, dissociation and physical health. Follow-up assessments were conducted at the end of treatment and 3 months after treatment. RESULTS: From baseline to post-treatment assessment, PTSD severity and other psychopathological symptoms were significantly improved for the treatment group (intent-to-treat group x time interaction effect size d = 1.40). Additionally, patients of the treatment condition showed significantly greater reduction of co-morbid depression and anxiety as compared to the waiting list condition. These effects were sustained during the 3-months follow-up period. High ratings of the therapeutic alliance and low drop-out rates indicated that a positive and stable therapeutic relationship could be established online. Significant improvement of the online working alliance in the course of treatment and a substantial correlation between the quality of the online relationship at the end of treatment and treatment outcome emerged. CONCLUSION: Interapy proved to be a viable treatment alternative for PTSD with large effect sizes and sustained treatment effects. A stable and positive online therapeutic relationship can be established through the Internet which improved during the treatment process. TRIAL REGISTRATION: Australian Clinical Trials Registry ACTRN012606000401550

3 × 3 Data Quality Assessment Tool Analysis for Electronic Health Records’ Secondary Use

This Delphi study includes an analysis of 3 × 3 data quality assessment (DQA), an electronic health records (EHR) DQA framework used for assessing the quality of EHR for use in secondary research. While the 3 × 3 DQA was developed and its creators received feedback, the level of feedback lacked numerous elements. This Delphi study includes a review of the 3 × 3 DQA as well as data quality assessments in the secondary use of EHR systems for research, examining how a data quality assessment tool creates a complete and accurate format for performing data quality assessments of EHR systems. The Delphi study includes a determination of how the implementation of a data quality assessment tool increases the quality and completeness of EHR data and an examination of how a data quality assessment tool improved the quality of clinical outcomes and research. Research was performed via a qualitative Delphi study, in which participants were asked to answer two rounds of questions. Each round contained a mixture of closed- and open-ended questions, and responses from the first round created the second round of questions. A panel of expert participants in the secondary use of EHR data who were published in at least one peer-reviewed journal was selected. Participants were located around the world, with most participants publishing peer-reviewed articles within the previous year. Although the 3 × 3 DQA was an easy-to-understand framework, the 3 × 3 DQA was a good starting point, particularly with more complicated EHR datasets. The Delphi study demonstrated that the DQA is one step in a larger process of data quality assessment and cleansing and highlights that practitioners must be prepared for this and build this into their processes when using EHR data. Findings included the need for standardizing EHR data fields and that concordance, the ability to match patient records across sources over time is an important often missing piece in EHR systems resulting in low data quality

ĮSA koncepcija ir numanomas jos įgyvendinimas Cišegrado šalių MVĮ versle

The papers' objective was to present essential factors of CSR conception, quantify their intensity and compare these factors within the countries of V4. The research was conducted through an online questionnaire in the countries of V4 (Czech Republic. Slovak Republic, Poland, and Hungary) from September 2019 to March 2020. The total amount of valid questionnaires was 1,585. Stated research hypotheses were tested by chi-square and Z-score Some interesting conclusions as low knowledge of CSR concept, low intensity of (SR implementation. low ability to identify positive effects of CSR were revealed by the research whereby the opinions differ in the Czech Republic and other countries of V4. Despite some research limitations, the study's findings should be considered in light of new trends and findings. It could be argued that the corona crisis would highly determine the results of the empirical research. On the other hand. it could be assumed that the economy will gradually recover and return to normal, which causes that these results will become relevant again

The Internet as a Mental Health Advisor in Germany—Results of a National Survey

The internet constitutes a popular source of health information. However, the use of the internet and other modern media in the domain of mental health remains widely unclear. This study aimed at exploring the readiness for seeking information online and making use of online counseling and media-assisted psychotherapy. A representative survey of N = 2411 Germans was conducted. Results indicated that more than one fourth of Germans would consider seeking help online in case of psychic strain. Participants reported that they would use the internet when needing to research about mental health topics and to communicate with persons concerned on internet forums. Only a small number of participants had already used psychological online-counseling. The majority of subjects reported not having known about the possibility of online counseling. However, the willingness to make use of this option in the future was in a medium range. Concerning the treatment of mental disorders, participants showed a clear preference toward conventional face-to-face treatment. Less than 10% of participants considered the use of treatment supported by mobile phones, the internet, or virtual realities as likely. Certainly, readiness was significantly higher in persons who were already using the relevant devices—mobile phones, computers, and the internet. In the future, there will presumably be an increasing demand for media-assisted psychological counseling and interventions. Members of the health care system should therefore prepare for current developments and help enlighten patients with regard to the possibilities, and also the potential risks of e-mental health

Sticks and Stones? Recognising and Optimally Responding to ‘eRage: A Growing Educational Challenge

Demand for online education, which provides students with the ability to study around their work and family commitments, has increased considerably in recent years and is expected to grow further. However, there are key differences between online and on-campus education that give rise to unique and complex challenges for online educators. One potential challenge is apparent greater volatility of online students that can see online educators experience greater levels of instructional dissent. We have termed this phenomenon ‘eRage’—students communicating electronically with staff in a rude, antisocial manner to express disagreement or contradictory opinions regarding classroom issues. This chapter will examine the challenges of online education that could contribute to eRage; briefly examine the literature pertaining to instructional dissent and provide recommendations for online educators to manage this somewhat overlooked and clandestine issue moving forward