Psychological Contract in HIV Prevention Clinical Trials in Resource Poor Communities in Africa

The paper explored the application of psychological contract in HIV prevention clinical trials in resource poor communities in Africa. The psychological contract was discussed in relation to practices in New HIV Prevention Technologies in Africa. From this discussion, it would seem risk for exposure to HIV infection is less well articulated in the psychological contract between the promoters of HIV prevention clinical trials and participants in resource poor communities in Africa. The trialing of New HIV Prevention Technologies in Africa should have in-built psychological contract transparency to reduce the risk of participant exposure to HIV infection in clinical trials.     

Slouching Toward Policy: Lazy Bioethics and the Perils of Science Fiction

Too much contemporary bioethical discourse is weak on science, lazily citing and adopting science fiction scenarios rather than science facts in the framing of analyses and policies. We challenge bioethicists to take more seriously the role of providing informed insight into and oversight over contemporary science and its implications and applications. Bioethicists must work harder to understand the fast-changing truths and limits of basic science, and they must incorporate only appropriate and authentic science into their discourse, just as they did in the past when addressing the quandaries of clinical medicine. The field of bioethics is not so old and entrenched that its future is assured. Bioethicists must make themselves useful to society in order to deserve and retain the public's trust. They can best do this by ensuring that decision making and public policy are grounded in facts, not fictions and fantasies.     

症状性颈动脉狭窄CEA治疗时机的Meta分析

评估症状性颈动脉狭窄（SCAS）患者颈动脉内膜剥脱术（CEA）手术时机选择及伴发症状对预后的影响.通过相关检索策略查找探讨CEA手术时机选择对于患者预后影响的随机对照试验.所有数据均采用Revman5.0分析软件进行Meta分析.纳入22篇文献,总计9 037名患者.Meta分析结果显示：SCAS患者4w、2w、1w 前后行CEA术后卒中再发率或死亡率组间无统计学差异.合并脑卒中的患者4w、2w 前后及合并短暂性脑缺血发作（TIA）或心肌梗死（MI）的患者4w前后行CEA术后卒中再发率或死亡率无统计学差异.症状稳定的SCAS患者应尽早行CEA术,伴发症状脑卒中、TIA 和MI不影响手术预后.     

A randomized wait-list controlled pilot study of dialectical behaviour therapy guided self-help for binge eating disorder

This study examined the efficacy of guided self-help based on dialectical behaviour therapy (DBTgsh) for binge eating disorder (BED). Individuals (88.3% female; mean 42.8 years) were randomized to DBTgsh (n = 30) or wait-list (WL; n = 30). DBTgsh participants received an orientation, DBT manual, and six 20-min support calls over 13 weeks. All participants were assessed pre- and post-treatment using interview and self-report; also, DBTgsh participants were re-assessed six months post-treatment. At treatment end, DBTgsh participants reported significantly fewer past-month binge eating episodes than WL participants (6.0 versus 14.4) and significantly greater rates of abstinence from binge eating (40.0% versus 3.3%). At six-month follow-up, DBTgsh participants reported significantly improved quality of life and reduced ED psychopathology compared to baseline scores. In addition, most improvements in the DBTgsh group were maintained, although binge eating abstinence rates decreased to 30%. These preliminary positive findings indicate that DBTgsh may offer an effective, low-intensity treatment option for BED.     

Integrated Behavior Therapy for Selective Mutism: A randomized controlled pilot study

Objective

To evaluate the feasibility, acceptability, and preliminary efficacy of a novel behavioral intervention for reducing symptoms of selective mutism and increasing functional speech.

Method

A total of 21 children ages 4 to 8 with primary selective mutism were randomized to 24 weeks of Integrated Behavior Therapy for Selective Mutism (IBTSM) or a 12-week Waitlist control. Clinical outcomes were assessed using blind independent evaluators, parent-, and teacher-report, and an objective behavioral measure. Treatment recipients completed a three-month follow-up to assess durability of treatment gains.

Results

Data indicated increased functional speaking behavior post-treatment as rated by parents and teachers, with a high rate of treatment responders as rated by blind independent evaluators (75%). Conversely, children in the Waitlist comparison group did not experience significant improvements in speaking behaviors. Children who received IBTSM also demonstrated significant improvements in number of words spoken at school compared to baseline, however, significant group differences did not emerge. Treatment recipients also experienced significant reductions in social anxiety per parent, but not teacher, report. Clinical gains were maintained over 3 month follow-up.

Conclusion

IBTSM appears to be a promising new intervention that is efficacious in increasing functional speaking behaviors, feasible, and acceptable to parents and teachers.     

Health messages to promote fruit and vegetable consumption at different stages: A match-mismatch design

Objective: To examine the effectiveness of matching health messages promoting fruit and vegetable intake to the Health Action Process Approach stages of change.

Design: In a randomised controlled trial, 205 undergraduate students (non-intenders n = 123; intenders n = 82) were exposed to one of three health messages, targeted at non-intenders, intenders and controls.

Main outcome measures: Three longitudinal assessments of stage, fruit and vegetable intake, and social-cognitive determinants were obtained.

Results: Stage-specific effects of the interventions were confirmed. For self-efficacy, a stage by health message crossover interaction emerged, with both non-intenders and intenders in the matched conditions scoring higher in self-efficacy. Furthermore, in line with predictions, non-intenders in the matched condition showed higher risk perception, outcome expectancies, intention, and stage progression immediately after message exposure, and lower levels of action planning and coping planning a week later in the mismatched condition, but for these outcomes no differences across conditions were obtained among intenders. Multiple mediation analyses confirmed the facilitating role of self-efficacy and behavioural intention among non-intenders.

Conclusions: Stages should be considered when designing health messages, although more interactive interventions for intenders and extended measurement time frames may be required.     

信息加工阶段与情绪刺激加工

情绪刺激的特定加工路径使其能够有效捕获注意并获得加工资源,在一定程度上反映了其加工优势。然而,由于信息加工资源的有限性,由情绪信息引发的、不受自上而下认知因素影响的加工优势并非一直存在。本文根据情绪刺激在信息加工过程不同阶段的加工特点,阐述了情绪注意效应与自上而下注意效应在知觉阶段的注意选择过程中的交互影响,以及在执行控制阶段,情绪刺激加工与执行控制功能间的相互作用。