Effectiveness and User Experience of Virtual Reality for Social Anxiety Disorder: Systematic Review

BACKGROUND

Social anxiety disorder (SAD) is a debilitating psychiatric disorder that affects occupational and social functioning. Virtual reality (VR) therapies can provide effective treatment for people with SAD. However, with rapid innovations in immersive VR technology, more contemporary research is required to examine the effectiveness and concomitant user experience outcomes (ie, safety, usability, acceptability, and attrition) of emerging VR interventions for SAD.

OBJECTIVE

The aim of this systematic review was to examine the effectiveness and user experience of contemporary VR interventions among people with SAD.

METHODS

The Cochrane Library, Emcare, PsycINFO, PubMed, ScienceDirect, Scopus, and Web of Science databases were searched between January 1, 2012, and April 26, 2022. Deduplicated search results were screened based on title and abstract information. Full-text examination was conducted on 71 articles. Studies of all designs and comparator groups were included if they appraised the effectiveness and user experience outcomes of any immersive VR intervention among people with SAD. A standardized coding sheet was used to extract data on key participant, intervention, comparator, outcome, and study design items.

RESULTS

The findings were tabulated and discussed using a narrative synthesis. A total of 18 studies met the inclusion criteria.

CONCLUSIONS

The findings showed that VR exposure therapy-based interventions can generally provide effective, safe, usable, and acceptable treatments for adults with SAD. The average attrition rate from VR treatment was low (11.36%) despite some reported user experience difficulties, including potential simulator sickness, exposure-based emotional distress, and problems with managing treatment delivered in a synchronous group setting. This review also revealed several research gaps, including a lack of VR treatment studies on children and adolescents with SAD as well as a paucity of standardized assessments of VR user experience interactions. More studies are required to address these issues.

TRIAL REGISTRATION

PROSPERO CRD42022353891; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=353891.

Implicit bias toward people with disability: A systematic review and meta-analysis

PURPOSE

People with disabilities (PWD) experience barriers to accessibility and employment, harming their quality of life. Strategies aimed at reducing disparity for PWD have not changed key statistics such as unemployment rates. Previous research has focused on explicit attitudes, generally found to be positive, prompting investigation into factors such as implicit bias. This systematic review and meta-analysis investigated implicit bias toward PWD and associated factors.

METHOD

Forty-six peer-reviewed studies published between January 2000 and April 2020 utilizing the Implicit Association Test were included. Of these, 12 studies met the inclusion criteria for meta-analysis.

RESULTS

A significant moderate pooled effect (mean difference = 0.503, 95% CI [0.497-0.509], p < .001) was found, suggesting moderate negative implicit attitudes toward general disability. Negative implicit attitudes were also found toward physical, and intellectual disability. PWD were implicitly stereotyped as incompetent, cold, and "child-like." Findings were inconsistent for factors associated with bias including age, race, sex, and individual differences. Contact with PWD may be associated with implicit bias; however, measures were inconsistent.

CONCLUSION

This review has found moderate negative implicit biases toward PWD, however, factors associated with this bias remain unclear. Further research should investigate implicit bias toward specific disability groups and strategies to shift such biases. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Evaluating the Acceptance of Hemp Food in Australian Adults Using the Theory of Planned Behavior and Structural Equation Modelling

This research presents a mixed methods (qual-QUANT) approach to the evaluation of the intention to consume hemp foods in an Australian sample soon after its legalization, using the Theory of Planned Behavior (TPB). Structural equation modeling was used to evaluate items developed from semi-structured interviews, with a focus on the TPB factors; attitudes toward hemp food consumption, subjective beliefs, and perceptions of control. Findings support the notion that consumers may be confused about associations between Cannabidiol (CBD) oil, tetrahydrocannabinol (THC), and hemp food produced from Cannabis sativa. Highly salient negative associations are mediated by the perception of positive aspects of CBD for some consumers, but the value placed on others' acceptance of hemp food is the greatest indicator of intention to consume hemp food products. It is suggested that greater education of consumers might allay fears borne of association of hemp food to either CBD or THC, and any move toward disassociation of hemp food to either entity would have positive repercussions for the hemp food industry. Findings have implications for other novel foods that carry highly salient negative associations for consumers.

Relationships between consumption patterns, health beliefs, and subjective wellbeing in Chinese Baijiu consumers

Background

Alcohol consumption in China has increased rapidly, and there have been calls for policies and programs to address the issue. Alcohol plays a complex and important role in Chinese culture, where it is considered a symbol of happiness and is associated with wellbeing. Alcohol reduction policies may fail unless they take these cultural and social meanings of alcohol, and its relationship to wellbeing into consideration. Baijiu is a clear fermented spirit that is widely consumed in China and has strong cultural associations with health, wellbeing and prosperity. There is a lack of research on how consumption patterns relate to cultural beliefs and subjective wellbeing.

Methods

An online survey of n = 1992 Chinese adults was conducted to determine frequency and volume of baijiu consumed; beliefs about health benefits and traditional importance; and associations with subjective wellbeing.

Results

Higher frequency and volume consumed were associated with higher subjective wellbeing, controlling for age and income. We also found small to medium significant associations between consumption frequency and volume and: belief that baijiu is healthy; and that tradition dictated they should drink baijiu.

Conclusions

The traditional and health values placed on baijiu, and its association with wellbeing, may help inform policy developments and alcohol reduction campaigns.

Thermal Taster Subgroups and Orosensory Responsiveness Dataset

Thermal taste is a phenomenon whereby some individuals, known as thermal tasters (TT) experience taste sensations when their tongue is warmed or cooled. It was first reported in 2000 by Cruz and Green [1] and since then, most research has focused on comparing TT to thermal non-tasters (TnT; individuals who do not experience thermally-elicited sensations). As TT rate the intensity of taste stimuli higher than TnT, understanding the nature of this difference may help inform how individual differences in taste perception impact consumer liking and consumption of food and beverages. However, as the mechanism(s) underlying thermal tasting are yet to be fully elucidated, it is unclear if TT should be considered a homogeneous group or if subgroups exist. We created a dataset to help determine if the orosensory advantage is universal across all TT, or if it is mainly attributable to one or more subgroups of TT. To this end, the thermal taste screening data of 297 TT from 12 previous recruitment drives (‘cohorts’) was combined. This created the largest dataset of TT reported to date in a single study, allowing for an in-depth analysis of the differences between TT. After training on appropriate scale use, participants were familiarized with common taste and chemesthetic stimuli (sweet, sour, salty, bitter, umami, astringent and metallic). Using a sip-and-spit protocol, participants rinsed with the stimuli and rated the maximum intensity each stimulus elicited on a generalized Visual Analogue Scale (gVAS) or a generalized Labeled Magnitude Scale (gLMS). To account for minor methodological differences between the cohorts, ratings from each cohort were first converted to z-scores before being combined into the overall dataset. Next, participants underwent a series of 12 trials that assessed response to a thermal elicitation device during which each combination of two temperature regimes (warming and cooling) and three lingual sites (tongue tip, 1 cm to left, 1 cm to the right) were examined in duplicate. Participants were asked to rate the maximum intensity of any sensations experienced during each trial. TT were classified into subgroups based on the type of thermally-elicited taste reported (typically sweet, sour, salty, bitter, metallic), the temperature regime during which the sensation was elicited (warming or cooling) and the location on the tongue tested at which the sensation was experienced. Figures are provided that show the mean intensity ratings of aqueous solutions of chemical stimuli and corresponding standard errors for each of the TT subgroups. In addition, the TT Subgroup Naming Conventions provided should allow for a consistent and clear use of terminology across future thermal taste research. Readers are referred to Homogeneity of thermal tasters and implications for mechanisms and classification[2] for a full discussion of how these findings inform our understanding of the mechanism(s) underlying thermal taste and the practical implications of methodological differences in determining thermal taste status.

Homogeneity of thermal tasters and implications for mechanisms and classification

Thermal tasting, an important type of individual variation in orosensation, is a phenomenon by which some individuals perceive thermally-induced taste sensations simply by having the tip of their tongue warmed or cooled. These individuals, known as thermal tasters, report a variety of thermally-elicited tastes (typically sweet, sour, salty, bitter, metallic) and the tastes reported can vary with the temperature regime used (warming or cooling) and location on the tongue tested. Importantly, when compared to thermal non-tasters, thermal tasters are more responsive to aqueous solutions of basic tastants and to beverages. The mechanism(s) underlying thermal tasting are not well understood and it is unknown if the increased orosensory responsiveness of thermal tasters is universal or if it is driven by a subgroup of thermal tasters. Thermal taste data from 12 previous studies was combined to obtain a large sample of thermal tasters (n = 254) who were divided into subgroups based on the type of thermally-elicited taste reported and the temperature regime/location at which it was experienced. Sweet thermal tasters (n = 77) were 9 times more likely than non-sweet thermal tasters (n = 177) to experience thermally-elicited sensations during lingual warming (p < 0.0001). Similarly, sour thermal tasters (n = 89) were 8 times more likely than non-sour thermal tasters (n = 165) to report thermally induced tastes during cooling (p<0.0001). However, no differences in orosensory responsiveness based on these or other subgroups were identified, suggesting that the heightened orosensory responsiveness of thermal tasters may be centrally-mediated. We discuss how these findings inform our understanding of the mechanism(s) underlying thermal taste and the identification of thermal taste subgroups, along with practical implications of methodological differences in determining thermal taste status.

Subjective wellbeing in the Indian general population: a validation study of the Personal Wellbeing Index

PURPOSE

The Personal Wellbeing Index (PWI) is a commonly used measure of life satisfaction that reflects a person's level of subjective wellbeing (SWB). The present study aimed to establish the validity and reliability of the PWI in a large sample of Indian adults and describe their SWB.

METHODS

2004 Indian adults completed a cross-sectional online survey, which was presented in English and included the PWI and demographic questions. The sample was split to assess the psychometric properties of the 7-item (n = 981) and 8-item (n = 937) versions of the PWI.

RESULTS

Both the 7- and 8-item versions of the PWI demonstrated adequate internal consistency (α = .89 and .88, respectively). The global means for both versions of the PWI (7-item = 74.43, 8-item = 73.82) were within the normative range for Western countries. Achieving in life had the lowest domain scores for both the 7-item (M = 70.51) and 8-item (M = 68.37) versions; the spirituality or religion domain had the highest domain score in the 8-item version (M = 78.84).

CONCLUSION

The findings suggest that both the 7- and 8-item versions of the PWI are valid and reliable measures of life satisfaction for use in India. The global mean scores for both versions of the PWI were within the normative range for Western countries. In this study, Indians reported high levels of satisfaction with their spirituality or religion, suggesting this domain may be an important contributor of SWB; however, more research is needed to determine this.

The pregnancy-related anxiety scale: A validity examination using Rasch analysis

BACKGROUND

Pregnancy-related anxiety is increasingly recognised as a common condition that is associated with many deleterious outcomes for both the mother and infant (e.g., preterm birth, postnatal depression). Limitations in the psychometric properties and/or breadth of existing scales for pregnancy-related anxiety highlight the need for a psychometrically sound measure to facilitate effective screening and possible early interventions. The recently developed Pregnancy-related Anxiety Scale (PrAS) was evaluated using Rasch analysis to explore how the scale's psychometric properties could be fine-tuned.

METHOD

A sample of 497 pregnant women completed the PrAS. Data were subjected to Rasch analysis, and the resulting scale structure examined using Confirmatory Factor Analysis.

RESULTS

After minor modifications, the Rasch model with 33-items and 8-factors demonstrated good fit, unidimensionality and excellent targeting and internal consistency. Confirmatory Factor Analysis confirmed the final structure, and Cronbach's alpha demonstrated excellent reliability.

LIMITATIONS

The use of the same sample for all analyses was a potential limitation due to the possibility of sample-specific influences.

CONCLUSIONS

The Rasch analysis further supports the internal construct validity of the PrAS. Ordinal to interval score conversions provide added precision to the analysis of the PrAS scores. The Rasch results, together with previous validation evidence, point to the PrAS as a comprehensive and psychometrically sound screening scale for pregnancy-related anxiety. The PrAS offers clinicians the ability to screen for pregnancy-related anxiety. The subscales provide additional insights into a woman's pregnancy-related anxiety and her specific areas of concern, enabling more targeted interventions.

SPME Method Optimized by Box-Behnken Design for Impact Odorants in Reduced Alcohol Wines

The important sampling parameters of a headspace solid-phase microextraction-gas chromatography-mass spectrometry (HS-SPME-GC-MS) procedure such as the extraction temperature, extraction time, and sample volume were optimized to quantify 23 important impact odorants in reduced alcohol red and white wines. A three-factor design of Box-Behnken experiments was used to determine the optimized sampling conditions for each analyte, and a global optimized condition at every ethanol concentration of interest determined using a desirability function that accounts for a low signal response for compounds. Shiraz and Chardonnay wines were dealcoholized from 13.7 and 12.2% v/v ethanol respectively, to 8 and 5% v/v, using a commercially available membrane-based technology. A sample set of the reduced alcohol wines were also reconstituted to their natural ethanol level to evaluate the effect of the ethanol content reduction on volatile composition. The three-factor Box-Behnken experiment ensured an accurate determination of the headspace concentration of each compound at each ethanol concentration, allowing comparisons between wines at varying ethanol levels to be made. Overall, the results showed that the main effect of extraction temperature was considered the most critical factor when studying the equilibrium of reduced alcohol wine impact odorants. The impact of ethanol reduction upon the concentration of volatile compounds clearly resulted in losses of impact odorants from the wines. The concentration of most analytes decreased with dealcoholization compared to that of the natural samples. Significant differences were also found between the reconstituted volatile composition and 5% v/v reduced alcohol wines, revealing that the dealcoholization effect is the result of a combination between the type of dealcoholization treatment and reduction in wine ethanol content.

A Population Service Evaluation of the ADHD Pathway of Children and Young People's Services, Malta

Introduction

ADHD is the commonest neurodevelopmental disorder in young people (YP) aged 5–18 years. YP with untreated ADHD are 5 times more likely to develop co-morbid psychiatric disorders.

Objectives

To carry out a population service evaluation of the assessment process and management of YP with ADHD at Child and Young People's Service (CYPS), Malta age 0–16 years for 2014.

Aims

To describe the service input, assessment and treatment of YP attending CYPS and compare to ADHD NICE guidelines 2008.

Methods

All patients diagnosed with ADHD at CYPS throughout 2014 were included. The incidence of YP with ADHD on treatment age 3–16 years in Malta was calculated. Information was collected from; (i) retrospective case file review and (ii) methylphenidate and atomoxetine registry and compared with NICE guidelines.

Results

One hundred and thirty-six YP were diagnosed with ADHD. The minimum 12-month incidence of ADHD on treatment (3–16 years) in Malta was 553 per 100,000. Pre-diagnosis assessments were more frequently performed by other YP services (n = 97, 71.3%, P ≤ 0.01). A psychiatrist or paediatrician confirmed the diagnosis in 113 (83.1%). Sixty-two (45.3%) of YP were prescribed medication, 50 (36.8%) were referred for parental skills course and 55 (40.4%) psychotherapy. Mean waiting time for first appointment was 187.6 days (CI ± 26.9, 0–720), and first specialist review was 301.0 days (CI ± 34.4, 0–800) (1–3).

Conclusions

The incidence for YP (3–16 years) with ADHD on treatment was lower than the US. Since most pre-diagnostic assessments were carried out by other services, this raised the question about the reliability and validity. We recommend a diagnostic MDT meeting following the multimodal assessment to diagnose ADHD. Medication prescribing followed NICE overall, standardising non-pharmacological management is required.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Pregnancy anxiety: A systematic review of current scales

BACKGROUND

Depression in pregnancy is a serious health issue; however, anxiety in pregnancy, with a reported higher prevalence, may also be a serious issue. Anxiety symptoms in pregnancy can relate to several anxiety types, such as general anxiety, anxiety disorders, and pregnancy-related anxiety (PrA), anxiety characterised by pregnancy specific fears and worries. Awareness of these distinctions however, is not always widespread. Both general anxiety and PrA are associated with maternal negative outcomes (e.g. increased nausea) however; PrA is more often associated with negative outcomes for the child (e.g. preterm birth). Furthermore, PrA is potentially a risk factor for postnatal depression with assessment of PrA potentially affording important intervention opportunities. Currently several different instruments are used for PrA however their psychometric properties are unclear. To our knowledge a review of current instruments and their psychometric properties is lacking, this paper aims to fill that gap.

METHODS

Studies, which assessed PrA, published between 1983 and 2013 in peer-reviewed journals, were identified.

RESULTS

Sixty studies were identified after applying inclusion/exclusion criteria, and classified as: pregnancy-related anxiety specific, scales for other constructs, sub scales of another instrument and general anxiety scales. Each scale's strengths and limitations were discussed.

LIMITATIONS

Our findings may be limited by restricting our review to peer-reviewed journals. This was done however as we sought to identify scales with good psychometric properties.

CONCLUSIONS

Currently no scales are available for pregnancy-related anxiety with sound theoretical and psychometric properties. Clinically the need for such a scale is highlighted by the potential intervention opportunities this may afford. Future research should be directed towards the development of such a scale.

Microfluidic device for circulating tumor cell sorting, characterization, and culture

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Background: Circulating tumor cell (CTC) analysis is a promising approach to further characterize the tumor biology and the metastatic process, but has immediate clinical applications such as early predictive markers of response to chemotherapy. However, the devices that are used currently for CTC detection have a poor sensitivity. Microfluidic techniques offer new exciting perspectives in the field of cell sorting for CTC analysis. Methods: We propose here a new microfluidic system and strategy allowing the sorting of cells, their study by confoncal fluorescent microscopy and/or their subsequent culture. The core of our system is a self-organized array of superparamagnetic particles in a microchannel, allowing for the formation of a perfectly periodic and robust array. The superparamagnetic particles are coated with specific antibodies against surface antigens, in order to capture cells according to specific biomarkers. This original cell-separation microchip was integrated into a fully automated platform combining state-of-the-art microfluidic technologies, microvalves and nanofluidic pneumatic pumps. Results: Using B and T lymphocytes mixtures as a model biological system, the capture yield was better than 90%, and the specificity better than 97%. Captured cells were fully viable and were cultured in situ in the magnetic array. In clinics, immunophenotyping of circulating malignant B cells was performed using fluorescent confocal microscopy, and was successfully compared to flow cytometry data for each sample. Results on breast cancer cells will be presented at the meeting. Conclusions: This new system is a promising approach for efficient CTC sorting, analysis and culture in a completely integrated manner.

No significant financial relationships to disclose.

Biomass selection for optimal anaerobic treatment of olive mill wastewater

This research was conducted to identify the most efficient biomass out of five different types of biomass sources for anaerobic treatment of Olive Mill Wastewater (OMW). This study was first focused on examining the selected biomass in anaerobic batch systems with sodium acetate solutions (control study). Then, the different types of biomass were tested with raw OMW (water-diluted) and with pretreated OMW by coagulation-flocculation using Poly Aluminum Chloride (PACl) combined with hydrated lime (Ca(OH)2). Two types of biomass from wastewater treatment systems of a citrus juice producing company "PriGat" and from a citric acid manufacturing factory "Gadot", were found to be the most efficient sources of microorganisms to anaerobically treat both sodium acetate solution and OMW. Both types of biomass were examined under different concentration ranges (1-40 g l(-1)) of OMW in order to detect the maximal COD tolerance for the microorganisms. The results show that 70-85% of COD removal was reached using Gadot biomass after 8-10 days when the initial concentration of OMW was up to 5 g l(-1), while a similar removal efficiency was achieved using OMW of initial COD concentration of 10 g l(-1) in 2-4 days of contact time with the PriGat biomass. The physico-chemical pretreatment of OMW was found to enhance the anaerobic activity for the treatment of OMW with initial concentration of 20 g l(-1) using PriGat biomass. This finding is attributed to reducing the concentrations of polyphenols and other toxicants originally present in OMW upon the applied pretreatment process.