scholarly journals Effectiveness of Computer-Assisted Therapy for Substance Dependence Using Breaking Free Online: Subgroup Analyses of a Heterogeneous Sample of Service Users

2015 ◽  
Vol 2 (2) ◽  
pp. e13 ◽  
Author(s):  
Sarah Elison ◽  
Glyn Davies ◽  
Jonathan Ward
Keyword(s):  
Psychosocial Functioning ◽  
Substance Dependence ◽  
Substance Misuse ◽  
Clinical Effectiveness ◽  
Computer Assisted ◽  
Service Users ◽  
Drug Of Choice ◽  
Wide Range ◽  
Other Substances ◽  
Computerized Treatment

Background Substance misuse services within the United Kingdom have traditionally been oriented to opiate and crack users, and attended predominantly by male service users. Groups who do not fit this demographic, such as women or those whose primary drug of choice is neither heroin nor crack, have tended to be underrepresented in services. In addition, there can be stigma associated with traditional opiate and crack-centric services. Therefore, the computerized treatment and recovery program, Breaking Free Online (BFO), was developed to enable service users to access confidential support for dependence on a wide range of substances. BFO is delivered as computer-assisted therapy (CAT), or, where appropriate, used as self-help. Objective The aim of this study was to report psychometric outcomes data from 393 service users accessing online support for substance misuse via BFO. Methods Following initial referral to substance misuse services, all participants were supported in setting up a BFO login by a practitioner or peer mentor, and, where required, assisted as they completed an online baseline assessment battery contained within the BFO program. Following a period of engagement with BFO, all participants completed the same battery of assessments, and changes in the scores on these assessments were examined. Results Significant improvements were found across the 393 service users in several areas of psychosocial functioning, including quality of life, severity of alcohol and drug dependence, depression, and anxiety (P=<.001 across all aspects of functioning). Additionally, significant improvements were found within specific subgroups of participants, including females (P=.001-<.001), males (P=.004-<.001), service users reporting alcohol dependence (P=.002-<.001), opiate and crack dependence (P=.014-<.001), and those seeking support for other substances that may be less well represented in the substance misuse sector (P=.001-<.001). Conclusions Data from this study indicates that BFO is an effective clinical treatment for a wide range of individuals requiring support for substance misuse. Further work is currently underway to examine more closely the clinical effectiveness of the program.

An outcomes study of eTherapy for dual diagnosis using Breaking Free Online

2014 ◽  
Vol 7 (2) ◽  
pp. 52-62 ◽  
Author(s):  
Sarah Elison ◽  
Jonathan Ward ◽  
Glyn Davies ◽  
Nicky Lidbetter ◽  
Daniel Hulme ◽  
...  
Keyword(s):  
Mental Health ◽  
Dual Diagnosis ◽  
Substance Dependence ◽  
Clinical Effectiveness ◽  
Outcome Data ◽  
Post Treatment ◽  
Service Users ◽  
Original Cohort ◽  
Content Type ◽  
Self Help

Purpose – In recent years there has been a proliferation of computer-based psychotherapeutic interventions for common mental health difficulties. Building on this, a small number of such interventions have now been developed to address substance dependence, one of which is Breaking Free Online (BFO). A new “eTherapy” self-help service, which was set up by the UK mental health charity Self-Help Services, has provided access to BFO to service users presenting with comorbid mental health and substance misuse difficulties. The purpose of this paper is to evaluate a range of clinical outcomes in the first cohort of service users accessing this dual diagnosis service. Design/methodology/approach – A number of standardised psychometric assessments were conducted with service users at baseline and post-treatment at discharge from the service. Outcome data were available for 47 service users out of an original cohort of 74. Findings – Statistically significant improvements were found in terms of measures of social functioning, depression, anxiety, alcohol and drug use and social anxiety. Clinically relevant gains were also identified, with fewer service users reaching threshold scores for depression and anxiety at post-treatment compared to baseline. Effect sizes also indicated that the identified improvements across the psychometric measures were robust and significant. Research limitations/implications – These findings provide further support for the clinical effectiveness of BFO, and also provide evidence that an eTherapy self-help service may be appropriate for some individuals presenting with dual diagnosis. Further research is underway with larger and alternative clinical populations to examine the effectiveness of BFO and also this novel eTherapy self-help approach. Originality/value – This paper has provided initial data to support effectiveness of a novel eTherapy service for dual diagnosis.

scholarly journals Syllabification of the Divine Comedy

2021 ◽  
Vol 14 (3) ◽  
pp. 1-26
Author(s):  
Andrea Asperti ◽  
Stefano Dal Bianco
Keyword(s):  
Text Processing ◽  
Solution Space ◽  
Generative Models ◽  
Divine Comedy ◽  
Point Of View ◽  
Computer Assisted ◽  
Wide Range ◽  
The Divine Comedy ◽  
Left And Right ◽  
Assisted Analysis

We provide a syllabification algorithm for the Divine Comedy using techniques from probabilistic and constraint programming. We particularly focus on the synalephe , addressed in terms of the "propensity" of a word to take part in a synalephe with adjacent words. We jointly provide an online vocabulary containing, for each word, information about its syllabification, the location of the tonic accent, and the aforementioned synalephe propensity, on the left and right sides. The algorithm is intrinsically nondeterministic, producing different possible syllabifications for each verse, with different likelihoods; metric constraints relative to accents on the 10th, 4th, and 6th syllables are used to further reduce the solution space. The most likely syllabification is hence returned as output. We believe that this work could be a major milestone for a lot of different investigations. From the point of view of digital humanities it opens new perspectives on computer-assisted analysis of digital sources, comprising automated detection of anomalous and problematic cases, metric clustering of verses and their categorization, or more foundational investigations addressing, e.g., the phonetic roles of consonants and vowels. From the point of view of text processing and deep learning, information about syllabification and the location of accents opens a wide range of exciting perspectives, from the possibility of automatic learning syllabification of words and verses to the improvement of generative models, aware of metric issues, and more respectful of the expected musicality.

scholarly journals Service user and clinician perspectives on the use of outcome measures in psychological therapy

2015 ◽  
Vol 8 ◽  
Author(s):  
Graham R. Thew ◽  
Louise Fountain ◽  
Paul M. Salkovskis
Keyword(s):  
Clinical Practice ◽  
Service User ◽  
Outcome Measurement ◽  
Psychological Therapy ◽  
Service Development ◽  
Service Users ◽  
Routine Outcome Measurement ◽  
Episode Of Care ◽  
Wide Range ◽  
Clinician Perspectives

AbstractWhile the benefits of routine outcome measurement have been extolled and to some degree researched, it is surprising that service user opinions on this common therapy practice have largely not been investigated. This study aimed to assess service users’ experiences of completing measures during psychological therapy, with a view to exploring how therapists can maximize how helpful measures are in therapy. Fifteen participants completed surveys about the use of measures in their current episode of care. Ten clinicians also completed a survey about their use of, and views about, measures. Results showed that despite mixed experiences in how measures were explained and used, service users showed generally favourable attitudes towards their use in therapy, with them being perceived as most helpful when well integrated into sessions by their therapists. Clinicians reported using a wide range of measures, and generally endorsed positive beliefs about measures more strongly than negative ones. Implications for clinical practice, service development, and further research are discussed.

scholarly journals Opiate dependence and pregnancy: 20-year follow-up study

2007 ◽  
Vol 31 (12) ◽  
pp. 450-453 ◽  
Author(s):  
Marie Whitty ◽  
John O'Connor
Keyword(s):  
Psychosocial Functioning ◽  
Substance Misuse ◽  
Opiate Dependence ◽  
Drug Misuse ◽  
Clinical Implications ◽  
Follow Up Study ◽  
Treatment Centre ◽  
Long Term Follow Up

AIMS AND METHODThis study examined the 20-year outcome of 55 women who were pregnant and using opiates in 1985 and were attending the Drug Treatment Centre and Advisory Board, Dublin. We established outcome across a number of variables, including mortality, psychiatric and physical morbidity, psychosocial functioning, ongoing drug misuse and outcome of offspring.RESULTSAt 20-year follow-up 29 women (53%) were deceased. HIV was the commonest cause of death, accounting for 17 deaths (59%). Those who were alive at follow-up displayed high rates of unemployment (84%), illicit substance misuse (74%) and most were dependent on state-subsidised accommodation (78%).CLINICAL IMPLICATIONSMortality was higher in our group compared with other long-term follow-up samples. These findings suggest that such participants and their offspring require intensive long-term support and treatment.

Achieving digital health sustainability: Breaking Free and CGL

2017 ◽  
Vol 22 (2) ◽  
pp. 72-82 ◽  
Author(s):  
Jonathan Ward ◽  
Glyn Davies ◽  
Stephanie Dugdale ◽  
Sarah Elison ◽  
Prun Bijral
Keyword(s):  
Free Group ◽  
Substance Misuse ◽  
Digital Health ◽  
Health Sector ◽  
Third Sector ◽  
Computer Assisted ◽  
Behavioural Science ◽  
Content Type ◽  
Health And Social Care ◽  
The Uk

Purpose Multiple challenges remain in achieving sustainability of digital health innovations, with many failing to realise their potential due to barriers to research, development and implementation. Finding an approach that overcomes these challenges is important if society is to derive benefit from these new approaches to healthcare. Having been commissioned by local authorities, NHS Trusts, prisons, charities, and third sector providers across the UK, Breaking Free Group, who in 2010 launched Breaking Free Online (BFO), a computer-assisted therapy programme for substance misuse, have overcome many of these challenges. This has been possible through close collaborative working with partner organisations, to overcome barriers to implementation and sustainability. The paper aims to discuss these issues. Design/methodology/approach This paper synthesises findings from a series of qualitative studies conducted by Breaking Free Group in collaboration with health and social care charity, Change, Grow, Live (CGL), which explore barriers and facilitators of implementation and sustainability of BFO at CGL. Data are analysed using thematic analyses with findings conceptualised using behavioural science theory. Findings This partnership has resulted in UK wide implementation of BFO at CGL, enhanced focus on digital technologies in substance misuse recovery, and a growing body of published collaborative research. Originality/value Valuable lessons have been learnt through the partnership between Breaking Free Group and CGL, which will be of interest to the wider digital health community. This paper outlines those lessons, in the hope that they will provide guidance to other digital health developers and their partners, to contribute to the continued evolution of a sustainable digital health sector.

Implementation of computer-assisted therapy for substance misuse: a qualitative study of Breaking Free Online using Roger's diffusion of innovation theory

2014 ◽  
Vol 14 (4) ◽  
pp. 207-218 ◽  
Author(s):  
Sarah Elison ◽  
Jonathan Ward ◽  
Glyn Davies ◽  
Mark Moody
Keyword(s):  
Diffusion Of Innovation ◽  
Social System ◽  
Substance Misuse ◽  
Social Care ◽  
Computer Assisted ◽  
Innovation Theory ◽  
Diffusion Of Innovation Theory ◽  
Content Type ◽  
Adoption And Implementation ◽  
The Social

Purpose – The purpose of this paper is to explore the adoption and implementation of computer-assisted therapy (CAT) using Breaking Free Online (BFO) in a social care and health charity working with people affected by drugs and alcohol dependence, Crime Reduction Initiatives (CRI). Design/methodology/approach – Semi-structured interviews were conducted with service managers, practitioners, peer mentors and service users. Data were thematically analysed and themes conceptualised using Roger's Diffusion of Innovation Theory (Rogers, 1995, 2002, 2004). Findings – A number of perceived barriers to adoption of BFO throughout CRI were identified within the social system, including a lack of IT resources and skills. However, there were numerous perceived benefits of adoption of BFO throughout CRI, including broadening access to effective interventions to support recovery from substance dependence, and promoting digital inclusion. Along with the solutions that were found to the identified barriers to implementation, intentions around longer-term continuation of adoption of the programme were reported, with this process being supported through changes to both the social system and the individuals within it. Research limitations/implications – The introduction of innovations such as BFO within large organisations like CRI can be perceived as being disruptive, even when individuals within the organisation recognise its benefits. For successful adoption and implementation of such innovations, changes in the social system are required, at organisational and individual levels. Practical implications – The learning points from this study may be relevant to the substance misuse sector, and more widely to criminal justice, health and social care organisations. Originality/value – This study is the first of its kind to use a qualitative approach to examine processes of implementation of CAT for substance misuse within a large treatment and recovery organisation.

scholarly journals Rapid prototyping of a complex model for the manufacture of plaster molds for slip casting ceramic

Cerâmica ◽  
2014 ◽  
Vol 60 (356) ◽  
pp. 465-470 ◽  
Author(s):  
D. P. C. Velazco ◽  
E. F. Sancet ◽  
F. Urbaneja ◽  
M. Piccico ◽  
M. F. Serra ◽  
...  
Keyword(s):  
Rapid Prototyping ◽  
New Technologies ◽  
Slip Casting ◽  
Complex Model ◽  
Computer Assisted ◽  
Plaster Mold ◽  
Digital Format ◽  
Wide Range ◽  
3D Scanners ◽  
Ceramic Manufacturing

Computer assisted designing (CAD) is well known for several decades and employed for ceramic manufacturing almost since the beginning, but usually employed in the first part of the projectual ideation processes, neither in the prototyping nor in the manufacturing stages. The rapid prototyping machines, also known as 3D printers, have the capacity to produce in a few hours real pieces using plastic materials of high resistance, with great precision and similarity with respect to the original, based on unprecedented digital models produced by means of modeling with specific design software or from the digitalization of existing parts using the so-called 3D scanners. The main objective of the work is to develop the methodology used in the entire process of building a part in ceramics from the interrelationship between traditional techniques and new technologies for the manufacture of prototypes. And to take advantage of the benefits that allow us this new reproduction technology. The experience was based on the generation of a complex piece, in digital format, which served as the model. A regular 15 cm icosahedron presented features complex enough not to advise the production of the model by means of the traditional techniques of ceramics (manual or mechanical). From this digital model, a plaster mold was made in the traditional way in order to slip cast clay based slurries, freely dried in air and fired and glazed in the traditional way. This experience has shown the working hypothesis and opens up the possibility of new lines of work to academic and technological levels that will be explored in the near future. This technology provides a wide range of options to address the formal aspect of a part to be performed for the field of design, architecture, industrial design, the traditional pottery, ceramic art, etc., which allow you to amplify the formal possibilities, save time and therefore costs when drafting the necessary and appropriate matrixes to each requirement.

scholarly journals Clinical benefits and adverse effects of siwak (S. persica) use on periodontal health: a scoping review of literature

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Haslinda Ramli ◽  
Tuti Ningseh Mohd-Dom ◽  
Shahida Mohd-Said
Keyword(s):  
Adverse Effects ◽  
Scoping Review ◽  
Oral Hygiene ◽  
English Language ◽  
Final Analysis ◽  
Clinical Effectiveness ◽  
Periodontal Health ◽  
Clinical Attachment Loss ◽  
Tooth Cleaning ◽  
Wide Range

Abstract Background Siwak is a chewing stick used as an oral hygiene aid associated with Muslim communities across the globe since more than 1500 years ago. Used either exclusively or in conjunction with a regular toothbrush, there is evidence supporting its clinical effectiveness in plaque control, but adverse effects on periodontal health remains inconclusive. Objective This study aims to systematically review the wide range of data and literatures related to siwak practice and its effect on periodontal health. Method The review was conducted based on scoping review techniques, searching literature in EBSCOHOST, PubMed, SCOPUS and Google scholar databases using the following search terms: “siwak’ or ‘miswak’ or ‘chewing stick” for intervention, and “periodontium or ‘periodontal’ or ‘periodontal health’ or ‘periodontal disease” for outcome. Articles published between January 1990 to March 2021 and written in English language were included. Results A total of 721 articles collected from the search and 21 of them were eligible for the final analysis. Results of this study was described based on clinical and antibacterial reporting of siwak, method of siwak practice and its adverse effect on oral health. Siwak was found effective at removing dental plaque and improving periodontal health over time although its effect on subgingival microbiota was inconclusive. Presence of gingival recession and clinical attachment loss were much more commonly reported in siwak users, attributable to variations in the methods employed for tooth cleaning using the siwak. Conclusion There is substantial evidence that the lack of standardised reporting for effective siwak use may have resulted in contradictory findings about its oral hygiene benefits and adverse effects. As such, future work on safe and effective siwak practice is to be advocated among its users.

Meaningful Ways of Understanding and Measuring Change for People with Borderline Personality Disorder: A Thematic Analysis

2018 ◽  
Vol 46 (5) ◽  
pp. 528-540 ◽  
Author(s):  
Louise McCusker ◽  
Marie-Louise Turner ◽  
Georgina Pike ◽  
Helen Startup
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Focus Groups ◽  
Thematic Analysis ◽  
Borderline Personality ◽  
Complex Nature ◽  
Service Users ◽  
Starting Point ◽  
Wide Range ◽  
Measuring Change

Background:The effective treatment of Borderline Personality Disorder (BPD) presents healthcare providers with a significant challenge. The evidence base remains limited partially due to a lack of professional consensus and service user involvement regarding ways of measuring change. As a result, the limited evidence that is available draws on such a wide range of outcome measures, that comparison across treatment types is hindered, maintaining a lack of clarity regarding the clinical needs of this group.Aims:This investigation aimed to follow the National Institute of Clinical Excellence (NICE, 2009) research recommendations by asking service users about meaningful change within their recovery. This forms a starting point for the future development of a tailored outcome measure.Method:Fifteen service users with a diagnosis of BPD participated in three focus groups across two specialist Personality Disorder services. The focus groups were analysed using Thematic Analysis.Results:Two superordinate themes were synthesized from the data: (1) recovery to what?: ‘How do you rewrite who you are?’; and (2) conditions for change. Each superordinate theme further consisted of three subordinate themes which elucidated the over-arching themes.Conclusion:This investigation highlights the complex nature of measuring change in people who have received a BPD diagnosis. Further research is needed to develop meaningful ways of measuring change according to the needs and priorities of people with BPD.

The personal social network of psychiatric service users

2020 ◽  
Vol 66 (7) ◽  
pp. 682-692
Author(s):  
François Wyngaerden ◽  
Marie Tempels ◽  
Jean-Louis Feys ◽  
Vincent Dubois ◽  
Vincent Lorant
Keyword(s):  
Social Networks ◽  
Social Network ◽  
Psychosocial Functioning ◽  
Care Delivery ◽  
Psychiatric Service ◽  
Size Composition ◽  
Mapping Technique ◽  
Service Users ◽  
Personal Network ◽  
Personal Social Networks

Background: For psychiatric service users, the personal social network offers resources such as behavioural guidance, social support, and coherence of care delivery. So far, most research on the subject has assessed the availability of these resources using size and composition measures. However, the availability of network resources also depends on the cohesion of the relationships between network members, a topic that is rarely addressed in the literature. Aims: In this article, we aim to describe the cohesion of psychiatric service users’ networks. Method: We carried out a personal network survey and collected data on the social networks of 380 service users recruited in outpatient and inpatient services in Belgium. We used an ego-network mapping technique. The data were analysed using several structural metrics describing size, composition, and cohesion. We carried out analysis of variance (ANOVA) in relation to residential status, level of education, psychiatric history, and psychosocial functioning and analysed three cohesion indicators (density, fragmentation, and centralisation) with regression analyses. Results: Personal social networks were small and not very cohesive. Most were composed of a dense subgroup as well as several isolated network members. The analyses revealed that highly educated psychiatric service users had more fragmented networks, while users living in independent accommodation had less dense networks. Density and fragmentation were not associated with the severity of psychosocial functioning, whereas centralisation was. Conclusions: The low level of cohesion may indicate that service users aim to access multiple and diverse social resources and that better-off service users are more successful at doing so. On the whole, however, these personal social networks were fragile, because they contained a high number of isolated network members. Finally, it could be beneficial for professionals to pay special attention to the central persons within the networks of psychiatric service users.

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