Search

The COVID-19 booster vaccination rate has declined despite the wide availability of vaccines. As COVID-19 is becoming endemic and the introduction of charges for regular booster vaccination, measurement of public acceptance and willingness to pay for regular COVID-19 boosters is ever more crucial.This study aims to 1) investigate public acceptance for regular COVID-19 boosters, 2) assess willingness to pay for a COVID-19 booster shot, and 3) identify factors associated with vaccine hesitancy. Our results provide crucial insights and implications for policy response as well as the development of a feasible and effective vaccination campaign, during Vietnam's waning vaccine immunity period.A cross-sectional study was conducted among 871 Vietnamese online participants from April 2022 to August 2022. An online questionnaire based on the Discrete Choice Experiment design was developed, distributed using the snowball sampling method, and subsequently conjointly analyzed on the Qualtrics platform. History of COVID-19 infection and vaccination, health status, willingness to vaccinate, willingness to pay, and other factors were examined.Among participants, 87.4% had received or were waiting for a COVID-19 booster shot. However, the willingness to pay was low at $US 8, and most participants indicated an unwillingness to pay (25.8%) or willingness to pay for only half of the vaccine costs (25.4%). While information insufficiency and wariness towards vaccines were factors most associated with the unwillingness to pay, long-term side effects, immunity duration, and mortality rate were the attributes most concerned with during the vaccine decision-making period. Participants who had children less than 18 years old in their homes infected with COVID-19 had a lower willingness to pay (OR = 0.54; 95% CI = 0.39; 0.74). Respondents who had children under 12 years old in their family who received at least 1 dose had a higher willingness to pay (OR = 2.03; 95% CI = 1.12; 3.66). The burden of medical expenses (OR = 0.33; 95% CI = 0.25; 0.45) and fear of vaccine (OR = 0.93; 95% CI = 0.86; 1.00) were the negative factors of the level of willingness to pay.Significant inconsistency between high acceptance and low willingness to pay underscores the role of vaccine information and public trust. In addition to raising awareness about the most concerning characteristics of the COVID-19 booster, social media, and social listening should be utilized in collaboration with health professionals to establish a two-way information exchange. Work incentives and suitable mandates should continue to encourage workforce participation. Most importantly, all interventions should be conducted with informational transparency to strengthen trust between the public and authorities.

Background Antiretroviral therapy (ART) is considered the most important intervention for HIV-positive patients; thus, encouraging the use of and adherence to ART are vital to HIV treatment outcomes. Advances in web and mobile technologies hold potential in supporting HIV treatment management. Objective The aim of this study was to evaluate the feasibility and efficacy of a theory-based mobile health (mHealth) intervention on health behaviors and HIV treatment adherence among patients with HIV/AIDS in Vietnam. Methods We performed a randomized controlled trial on 425 HIV patients in two of the largest HIV clinics in Hanoi, Vietnam. Both the intervention group (238 patients) and the control group (187 patients) received regular consultations with doctors and then participated in 1-month and 3-month follow-up visits. Patients in the intervention group received a theory-driven smartphone app to facilitate medication adherence and self-efficacy in HIV patients. Measurements were developed based on the Health Belief Model, which included the visual analog scale of ART Adherence, HIV Treatment Adherence Self-Efficacy Scale, and HIV Symptom Management Self-Efficacy Scale. We also included the 9-item Patient Health Questionnaire (PHQ-9) to assess patients’ mental health throughout treatment. Results In the intervention group, the adherence score increased significantly (β=1.07, 95% CI .24-1.90) after 1 month, whereas the HIV adherence self-efficacy was significantly higher after 3 months (β=2.17, 95% CI 2.07-2.27) compared to the control group. There was a positive but low level of change in risk behaviors such as drinking, smoking, and drug use. Factors related to positive change in adherence were being employed and having stable mental well-being (lower PHQ-9 scores). Factors associated with self-efficacy in treatment adherence and symptom management were gender, occupation, younger age, and having no other underlying conditions. A longer duration of ART increased treatment adherence but decreased self-efficacy in symptom management. Conclusions Our study demonstrated that the mHealth app could improve the overall ART adherence self-efficacy of patients. Further studies with larger sample sizes and longer follow-up periods are needed to support our findings. Trial Registration Thai Clinical Trials Registry TCTR20220928003; https://www.thaiclinicaltrials.org/show/TCTR20220928003

Background: Prior research has investigated how the excessive use of social media has an impact on one’s functioning. Youths are among the most vulnerable subjects to the impacts of social media overuse, especially in Vietnam (a developing country). However, very little evidence has been provided on social media addiction. This work aims to determine the prevalence of social media addiction amongst Vietnamese individuals and the factors associated with social media addiction. Method: An online cross-sectional study was conducted from June to July 2020 in Vietnam. Participants completed the structured questionnaire, which comprised four main components: (1) social characteristics; (2) The Bergen Social Media Addiction Scale; (3) stress associated with neglect and negative reactions by online peers and fear of missing out (FOMO); and (4) status of social media platform usage. Results: Some demographic factors, such as gender, the locality of accommodation, and relationship status affected the overall scores. The results also indicated Facebook, Zalo, and Youtube to be the most popular social media platforms among Vietnamese youths. Individuals who used social media for gaming also had higher BSMAS scores. FOMO and stress associated with neglect by online peers had a high correlation with social media addiction. Conclusions: This study is one of the first studies to examine social media addiction and its associated factors in Vietnam. Interventions for social media addiction need to be developed in different fields: clinical research, policy, and education.

BACKGROUND Antiretroviral therapy (ART) is considered the most important intervention for HIV-positive patients; thus, encouraging the use of and adherence to ART are vital to HIV treatment outcomes. Advances in web and mobile technologies hold potential in supporting HIV treatment management. OBJECTIVE The aim of this study was to evaluate the feasibility and efficacy of a theory-based mobile health (mHealth) intervention on health behaviors and HIV treatment adherence among patients with HIV/AIDS in Vietnam. METHODS We performed a randomized controlled trial on 425 HIV patients in two of the largest HIV clinics in Hanoi, Vietnam. Both the intervention group (238 patients) and the control group (187 patients) received regular consultations with doctors and then participated in 1-month and 3-month follow-up visits. Patients in the intervention group received a theory-driven smartphone app to facilitate medication adherence and self-efficacy in HIV patients. Measurements were developed based on the Health Belief Model, which included the visual analog scale of ART Adherence, HIV Treatment Adherence Self-Efficacy Scale, and HIV Symptom Management Self-Efficacy Scale. We also included the 9-item Patient Health Questionnaire (PHQ-9) to assess patients’ mental health throughout treatment. RESULTS In the intervention group, the adherence score increased significantly (β=1.07, 95% CI .24-1.90) after 1 month, whereas the HIV adherence self-efficacy was significantly higher after 3 months (β=2.17, 95% CI 2.07-2.27) compared to the control group. There was a positive but low level of change in risk behaviors such as drinking, smoking, and drug use. Factors related to positive change in adherence were being employed and having stable mental well-being (lower PHQ-9 scores). Factors associated with self-efficacy in treatment adherence and symptom management were gender, occupation, younger age, and having no other underlying conditions. A longer duration of ART increased treatment adherence but decreased self-efficacy in symptom management. CONCLUSIONS Our study demonstrated that the mHealth app could improve the overall ART adherence self-efficacy of patients. Further studies with larger sample sizes and longer follow-up periods are needed to support our findings. CLINICALTRIAL Thai Clinical Trials Registry TCTR20220928003; https://www.thaiclinicaltrials.org/show/TCTR20220928003

BACKGROUND: The advances in experimental psychology in the last decade have led to a greater understanding of cognitive bias, and the investigation of cognitive bias modifications as a therapeutic option. Whilst conventionally such interventions are delivered in a laboratory, technological advances are changing the potential modes of delivery of these interventions. Whereas mobile delivery of interventions might seem to increase accessibility and encourage compliance, this might not be the case for cognitive bias modification interventions. To reduce boredom, researchers have investigated whether gamification of the task could help reduce repetitiveness, and the diminished motivation that participants had over time. In a prior review of cognitive bias modification interventions, a collaboration between academics and developers was recommended to ensure that the developed product is evidence-based. With the increased recognition of the importance of participatory action research, participants could better help conventional intervention to meet their needs. OBJECTIVE: The aim of this article was to describe the iterative steps in the conceptualization of the co-designed gamified cognitive bias modification intervention for individuals with opioid use disorders. METHODS AND RESULTS: A multidisciplinary team worked through the differences in the perspectives offered by healthcare professionals and patient participants, and jointly worked with a developer to conceptualize a new co-designed gamified attention bias modification intervention. The methods shared in this article could be considered and applied to future conceptualization of co-designed interventions.

Background: We have found our 5-minute mindful breathing technique to be effective in reducing distress in palliative cancer patients. As palliative cancer patients tend to experience high levels of distress, the integration of this technique into a smartphone-based application could be a viable intervention option for these patients as well as their caregivers. Objective: We aim to further examine the efficacy of our mindful breathing module on distress reduction within the context of a smartphone-based application for palliative cancer patients and caregivers over a seven day period. We hypothesized that the intervention group (access to mindful breathing module) would have significantly greater distress regulation than the control group (access to soothing music) over seven days of using the smartphone-based application.Methods: 35 subjects were recruited from the palliative care ward at University Malaya Medical Centre (UMMC) and randomly assigned to either the control (access to soothing music) or intervention (access to mindful breathing module) group respectively. They then used and followed instructions as per the smartphone-based application for seven days. Results: While both groups reported a reduction in distress in using the application, there was no significant difference in reported distress levels between those who had access to the mindful breathing module and those who had access to only soothing music over the seven days. Our hypothesis was not supported. Conclusion: Although not significantly greater than the control group, the intervention group reported a reduction in distress using the smartphone application, which suggests that the integration of mindfulness and smartphone applications could potentially play a role in future distress reduction for patients and caregivers in view of its accessibility, ease of administration and anonymity.

OBJECTIVES: The aim of this study was to examine the reliability and validity of the Job Content Questionnaire (JCQ) in Vietnamese among hospital nursing staff.METHODS: The 22-items version of the JCQ was used. This includes four scales: (a) psychological demands (5 items); (b) job control (9 items); (c) supervisor support (4 items); and (d) coworker support (4 items). All 1258 nurses in a general hospital in Vietnam, excluding 11 who were due to retire, were invited to complete the cross-sectional survey. The internal consistency reliability was estimated using Cronbach's α. Construct validity was examined using exploratory factor analysis (EFA). Convergent validity was evaluated by calculating correlations between the JCQ scores and DASS 21 and overtime work.RESULTS: In total, 949 (75%) of the 1258 eligible nurses completed the survey. Cronbach's α values demonstrated acceptable internal consistency in two scales (supervisor support α = .87; coworker support α = .86), while Cronbach's α was below the acceptable threshold of 0.70 for job control (α = .45) and job demand (α = .50). EFA assuming a four-factor structure showed a factor structure that was almost identical to the original JCQ, with two items loading on other scales. The subscales of depression, anxiety, and stress response of DASS 21 and the subscales of JCQ were significantly correlated, as expected.CONCLUSION: The results suggest that the JCQ in Vietnamese can be used with some reliability and validity for examining psychosocial work environment among nurses. Further studies should be done to confirm and expand our findings in a variety of occupational groups and in other Asian low- and middle-income countries.

After the concept of “Internet addiction” was first proposed in 2004, “Internet gaming disorder” (IGD) was included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a disorder requiring further research. IGD is prevalent in South Korea, and many studies have been conducted on the disorder. Previous studies have helped in understanding various aspects of IGD, but a comprehensive understanding of the research trends is required to identify research gaps. Therefore, we conducted a bibliometric review of all published IGD studies in South Korea. For the identification of articles, the Web of Science database was used. Data analysis was performed using Biblioshiny. A total of 330 publications were included in the analysis. The average number of citations per document was 17.12. These publications were written by a total of 658 authors, and the number of coauthors per document was 5.07. The years with the most publications were 2018 (n = 57), 2017 (n = 45), and 2019 (n = 40). The top three journals containing publications were the Journal of Behavioral Addictions (n = 46), Frontiers in Psychiatry (n = 19), and Psychiatry Investigation (n = 14). In a keyword analysis (apart from “IGD”, “internet addiction”, and “addiction”), the keywords “adolescent” (n = 31), “self-control” (n = 11), and “impulsivity” (n = 11) were included. T. This bibliometric analysis explores and summarizes the publications on IGD in South Korea. The results are expected to provide researchers with insights for further studies into IGD.

Background The COVID-19 booster vaccination rate has declined despite the wide availability of vaccines. As COVID-19 is becoming endemic and charges for regular booster vaccination are being introduced, measuring public acceptance and the willingness to pay for regular COVID-19 boosters is ever more crucial. Objective This study aims to (1) investigate public acceptance for regular COVID-19 boosters, (2) assess the willingness to pay for a COVID-19 booster shot, and (3) identify factors associated with vaccine hesitancy. Our results will provide crucial insights into and implications for policy response as well as the development of a feasible and effective vaccination campaign during Vietnam’s waning vaccine immunity period. Methods A cross-sectional study was conducted among 871 Vietnamese online participants from April to August 2022. An online questionnaire based on the discrete choice experiment (DCE) design was developed, distributed using the snowball sampling method, and subsequently conjointly analyzed on the Qualtrics platform. A history of COVID-19 infection and vaccination, health status, willingness to vaccinate, willingness to pay, and other factors were examined. Results Among the participants, 761 (87.4%) had received or were waiting for a COVID-19 booster shot. However, the willingness to pay was low at US $8.02, and most participants indicated an unwillingness to pay (n=225, 25.8%) or a willingness to pay for only half of the vaccine costs (n=222, 25.4%). Although information insufficiency and a wariness toward vaccines were factors most associated with the unwillingness to pay, long-term side effects, immunity duration, and mortality rate were the attributes the participants were most concerned with during the vaccine decision-making period. Participants who had children less than 18 years old in their homes infected with COVID-19 had a lower willingness to pay (odds ratio [OR] 0.54, 95% CI 0.39-0.74). Respondents who had children under 12 years old in their family who received at least 1 vaccine dose had a higher willingness to pay (OR 2.03, 95% CI 1.12-3.66). The burden of medical expenses (OR 0.33, 95% CI 0.25-0.45) and fear of the vaccine (OR 0.93, 95% CI 0.86-1.00) were negative factors associated with the level of willingness to pay. Conclusions A significant inconsistency between high acceptance and a low willingness to pay underscores the role of vaccine information and public trust. In addition to raising awareness about the most concerning characteristics of the COVID-19 booster, social media and social listening should be used in collaboration with health professionals to establish a 2-way information exchange. Work incentives and suitable mandates should continue to encourage workforce participation. Most importantly, all interventions should be conducted with informational transparency to strengthen trust between the public and authorities.

An explosion of Internet and social network sites (SNSs) among Vietnamese youths and adolescents increases the likelihood of being exposed or influenced by risky perceptions and beliefs from online peers, leading to the development of risk behaviors, especially new habits such as shisha smoking. However, evidence about the online peer influence on the occurrence of shisha smoking is limited. The objective of this study is to determine the associations between online peer influence and the shisha use among young Internet active users in Vietnam. An online cross-sectional study was conducted with 1041 young people, who were recruited by respondent-driven sampling method. The study found that 4.1% have had smoked shisha in the last 12 months. Among participants, 52.9% and 49.5% reported frequently visited places and engaged in activities recommended by online friends, respectively. People who were male (OR = 4.04; 95%CI = 1.94–8.41), of older age (OR = 1.27; 95%CI = 1.06–1.54) and having higher levels of “visiting places recommended by online friends” (OR = 3.05; 95%CI = 1.84–5.06) were more likely to smoke shisha. This study highlighted the influence of online peers on the occurrence of shisha smoking among youths and adolescents. Future interventions should educate young people to understand the harmful effects of shisha smoking as well as risky online presentations and online interactions.

To report a pilot trial protocol for testing the effectiveness of the Support for New Mums smartphone application in a cohort of first-time mothers.A pilot/feasibility randomized controlled trial using a two-group pre-test and repeated post-test design.This protocol follows the Standard Protocol Items: Recommendations for Intervention Trials (SPIRIT) guidelines. The Intervention group will receive access to the smartphone application for 6 weeks post birth. Both Intervention and control groups will receive standardized institutional postnatal care services. Trial funding was gained from respective grant sponsors in May and November 2016.The Support for New Mums smartphone application could be a novel method for addressing the gap in provision of postpartum care services providing psychoeducation and improving maternal parental self-efficacy for Australian childbearing women.Australian New Zealand Clinical Trials Registry ACTRN12618001580268.目的: 报告一项试验方案,以测试新手妈妈中”新手妈妈支持”智能手机应用的有效性。 设计: 试点/可行性随机对照试验,采用两组(预测和重复后测)设计。 方法: 该方案遵循《规范临床研究方案内容--干预试验建议》指南。干预组将在生产后6周内接触智能手机应用。干预组和对照组都将获得标准化的机构产后护理服务。2016年5月和11月,从各自的赞助方获得了试验资金。 讨论: ”新手妈妈支持”智能手机应用可能是解决产后护理服务缺口的新方法,为澳大利亚育龄妇女提供心理教育,提高做母亲的自我效能感。 试验注册: 澳大利亚新西兰临床试验注册中心ACTRN12618 001580268.

There are growing concerns on stress among nurses in low- and middle-income countries (LMICs) in South-East Asia. It is important to improve mental health among nurses in these countries. The objective of this study was to examine the efficacy of two types of newly developed smartphone-based stress management programs in improving depressive and anxiety symptoms among hospital nurses in Vietnam. This study was a three-arm (including two intervention groups and one control group) randomized trial. Participants were recruited from nurses in a large general hospital in Hanoi, Vietnam. Two types (free-choice and fixed sequential order) of smartphone-based stress management programs were developed. Participants were randomly allocated to Program A (a free-choice, multimodule stress management), Program B (a fixed-order, internet cognitive behavioral therapy, iCBT), or a control group (treatment as usual). The depressive and anxiety symptoms were measured by using the Depression Anxiety and Stress Scales at baseline, 3-, and 7-month follow-up surveys. 951 participants were randomly allocated to each of the three groups. Program B showed a statistically significant effect on improving depressive symptoms at 3-month (p = 0.048), but not at 7-month (p = 0.92); Cohen’s d was − 0.18 (95% CI − 0.34 to − 0.02) and 0.03 (95% CI − 1.00 to 1.05), respectively. Program A failed to show a significant intervention effect on any of the outcomes at 3- or 7-month follow-up (p > 0.05). Despite the small effect size, the present fixed-order iCBT program seems effective in improving depression of hospital nurses in Vietnam. A public health impact of the intervention can be scalable, when considering its accessibility and minimal cost.Trial registration number: The study protocol is registered at the UMIN Clinical Trials Registry (UMINCTR; ID = UMIN000033139). Registered date of the protocol is 1st Jul. 2018. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000037796

There is significant interest in understanding the pathophysiology of Obsessive-Compulsive Disorder (OCD) using resting-state fMRI (rsfMRI). Previous studies acknowledge abnormalities within and beyond the fronto-striato-limbic circuit in OCD that require further clarifications. However, limited information could be inferred from the conventional way of investigating the functional connectivity differences between OCD and healthy controls. Here, we identified altered brain organization in patients with OCD by applying individual-based approaches to maximize the identification of underlying network-based features specific to the OCD group. rsfMRI of 20 patients with OCD and 22 controls were preprocessed, and individual-fMRI-subspace was derived for each subject within each group. We evaluated group differences in functional connectivity using individual-fMRI-subspace and established its advantage over conventional-fMRI methodology. We applied prediction-based approaches to highlight the group differences by evaluating the differences in functional connections that predicted the clinical scores (namely, the Obsessive-Compulsive Inventory-Revised (OCI-R) and Hamilton Anxiety Rating Scale). Then, we explored the brain network organization of both groups by estimating the subject-specific communities within each group. Lastly, we evaluated associations between the inter-individual variation of nodes in the communities to clinical measures using linear regression. Functional connectivity analysis using individual-fMRI-subspace detected 83 connections that were different between OCD and control groups, compared to none found using conventional-fMRI methodology. Connectome-based prediction analysis did not show significant overlap between the two groups in the functional connections that predicted the clinical scores. This suggests that the functional architecture in patients with OCD may be different compared to controls. Seven communities were found in both groups. Interestingly, within the OCD group but not controls, we observed functional connectivity between cerebellar and visual regions, and lack of connectivity between striato-limbic and frontal areas. Inter-individual variations in the community-size of these two communities were also associated with the OCI-R score (p

Introduction: Advances in experimental psychology have led to a better understanding of automatic, unconscious processes, referred to as attentional biases. Despite the growing evidence from meta-analytical studies, we still do not understand why some individuals have a greater magnitude of these biases, and why others have none. There has been little focus on elucidating individual differences and task parameters that affect the overall magnitude of the biases. In this opinion piece, we will attempt to identify these. We will then discuss both the research and clinical implications. Methods and Analysis: To identify the factors that modulated the magnitude of attentional biases across all the substance disorders (i.e., opioid use, cannabis use, and stimulant-use disorders), we performed a search using the bibliographic databases PubMed and MEDLINE. The search terminologies &ldquo, attention bias&rdquo, or &ldquo, cognitive bias&rdquo, approach bias&rdquo, avoidance bias&rdquo, were used when we looked for relevant articles. Results: It was evident from the published literature that several individual differences and factors modulated the magnitude of baseline biases. Across opioid, cannabis, and stimulant-use disorders, the most common individual differences identified were the severity of the dependence and the quantity of substance used. For both opioid and cannabis disorders the timing of stimulus presentation influenced the detection of attentional bias, it appeared that short stimulus timing was better able to detect attentional bias. Other identified individual differences included subjective craving and impulsiveness. The results highlight several research and clinical implications. Conclusions: The discovery of these individual differences and factors of the task paradigm that affect the magnitude of attentional biases will help in the future conceptualization of attention-bias-modification intervention.

Background Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder with a worldwide prevalence rate of 5%. Individuals with ADHD often tend to have difficulties with emotional regulation. The advances in experimental psychology have led to the discovery of emotional biases. Targeting emotional biases could potentially help improve the core symptoms of irritability and short-temperedness among these individuals. Emotional biases refer to the preferential allocation of attention toward emotional stimuli. A recent study reported the presence of emotional biases among individuals with ADHD when they compared individuals with ADHD with those without. Gamification technologies have been explored to help diminish the repetitiveness of the task and increase the intrinsic motivation to train. These inconsistent findings of the impact of gaming on the effectiveness of mobile interventions call for further work to better understand the needs of patients (users) and health care professionals. Objective The aim of this research study is to collate health care professionals’ perspectives on the limitations of the existing task, and to determine if gamification elements could be incorporated, to refine the conventional intervention. Methods A qualitative research approach, that of a focus group, will be used. Health care professionals from the Department of Development Psychiatry, Institute of Mental Health, Singapore will be invited to participate in this qualitative research. During the focus group, participants are to comment on the limitations of the existing emotional bias intervention; recommend strategies to improve the intervention; and provide their perspectives pertaining to the use of gamification to improve the intervention. Results We expect that the study will be completed in 12 months from the publication of this protocol. Conclusions To our best knowledge, this is perhaps one of the only few studies that have attempted to explore emotional biases among adolescents with ADHD. International Registered Report Identifier (IRRID) PRR1-10.2196/24078

The advances in experimental psychology have led to the discovery of unconscious, automatic biases (attentional and approach biases) that account for the lapse and relapses amongst individuals with addictive disorders. To date, there has been extensive investigation into the assessment and modification of attention biases amongst individuals with the highly prevalent substance use disorders. Alternative modalities, such as technology, has also been evaluated for the delivery of these interventions. Given this, the specific objectives of this perspective article are in highlighting the emerging knowledge that has accrued over the last three years, and in addressing several of the research gaps in the previous article. Firstly, this perspective article will examine the evidence for biases and bias modification amongst the highly prevalent substance use disorders. This article will also examine how such bias modification has been utilized clinically. Secondly, this perspective article will also examine how technology has been applied to these bias modification interventions. Thirdly, this article will also examine the literature to highlight the biological underpinnings following bias modification. Fourthly, this article also examines the limitations of existing bias modification paradigms and methods taken to better these conventional interventions. The article concludes with highlighting the outstanding gaps in the current knowledge. To date, there remains mixed evidence for the modification of attention biases, and there are a paucity of studies examining the effectiveness of mobile delivery of bias intervention. Only one study has considered patients&rsquo, perspective in the development of an intervention. There remained several gaps in the knowledge, which future research could address.

In recent years, advances in experimental psychology have led to a better understanding in automatic, unconscious processes, referred to as attentional and approach biases amongst individuals with substance use disorders. Attentional biases refer to the relatively automatic tendencies for attention to be preferentially allocated towards substance-related cues. Whereas, approach bias refers to the relatively automatic behavioral tendencies of individuals to reach out to substance-related cues in their natural environment. While, several reviews confirm the existence of these biases, and the effectiveness of bias modification, the conduct of cognitive bias modification amongst substance-using individuals is not without its challenges. One of these is that cognitive biases, both attentional and approach biases, are not universally present; and several individual differences factors modulate the magnitude of the biases. Another challenge that investigators faced in their conduct of cognitive bias modification relates to the selection of the appropriate task for bias assessment and modification. Other challenges intrinsic to cognitive bias modification intervention relates to that of participant attrition, much like conventional psychotherapies. Negative findings, of the absence of biases at baseline, or the lack of effectiveness of bias modification have been reported in studies of cognitive bias modification. All these challenges could have an impact on bias assessment and modification. In this perspective paper, we will explore the literature surrounding each of these challenges and discuss potential measures that could be undertaken to mitigate these clinical and research challenges. Ministry of Health (MOH) National Medical Research Council (NMRC) Published version MWZ is supported by a grant under the Singapore Ministry of Health’s National Medical Research Council (grant number NMRC/Fellowship/0048/2017) for PhD training. The funding source was not involved in any part of this project.

BACKGROUND Smoking is a global health threat. Attentional bias influences smoking behaviors. Although attentional bias retraining has shown benefits and recent advances in technology suggest that attentional bias retraining can be delivered via smartphone apps, there is a paucity of research on this topic. OBJECTIVE This study aims to address this gap by exploring the use of attentional bias retraining via a novel smartphone app using a mixed methods pilot study. In the quantitative phase, it is hypothesized that participants in the training group who undertake attentional bias retraining via the app should have decreased levels of attentional bias, subjective craving, and smoking frequency, compared with those in the control group who do not undertake attentional bias retraining. The qualitative phase explores how the participants perceive and experience the novel app. METHODS In all, 10 adult smokers (3 females and 7 males) between the ages of 26 and 56 years (mean 34.4 years, SD 9.97 years) were recruited. The participants were randomly allocated to the training and control groups. In weeks 1 and 3, participants from both groups attempted the standard visual probe task and rated their smoking frequency and subjective craving. In week 2, the participants in the training group attempted the modified visual probe task. After week 3, participants from both groups were interviewed about their views and experiences of the novel app. RESULTS The results of the quantitative analysis did not support this study’s hypothesis. The qualitative data were analyzed using thematic analysis. The results yielded 5 themes: ease, helpfulness, unhelpful aspects, barriers, and refinement. CONCLUSIONS Findings from the qualitative study were consistent with those from previous studies on health-related smartphone apps. The qualitative results were helpful in understanding the user perspectives and experiences of the novel app, indicating that future research in this innovative area is necessary. CLINICALTRIAL

OBJECTIVE This meta-analysis evaluates the pooled prevalence of depression, anxiety, adjustment disorder, and posttraumatic stress disorder (PTSD) among heart transplant recipients globally and determines underlying moderators. METHODS The authors searched PubMed, Embase, PsychINFO, BIOSIS, Science Direct, and Cochrane CENTRAL databases from inception to March 1, 2019, and 1321 records and 42 full-text articles were selected and reviewed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We calculated the pooled prevalence proportion of depression, anxiety, adjustment disorder, and PTSD using random-effects models. Meta-regression was performed to identify important moderators that contribute to heterogeneity. RESULTS Twenty studies met the inclusion criteria and comprised 2169 patients. The pooled prevalence of depression was 21.6% (95% confidence interval [CI] = 16.8%-27.3%), anxiety 11.1% (95% CI = 3.8%-28.5%), adjustment disorder 11.0% (95% CI = 3.1%-32.1%), and PTSD 13.5% (95% CI = 8%-21.8%). There was significant heterogeneity. Meta-regression was conducted to account for the heterogeneity of the prevalence proportion. Predisposing factors, for example, New York Heart Association classes II and III/IV, steroid treatment, and acute rejection of transplant (

This meta-analytic review aimed to examine the pooled prevalence rates of Internet addiction and gaming disorders in Southeast Asia. Several databases including PubMed, MEDLINE, PsycINFO, Web of Science, Embase, and Cochrane Central were searched and a total of 24 studies were included in this study. The selection of studies was conducted in accordance to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Two meta-analyses were conducted to examine data on Internet addiction and gaming disorders separately. A random-effects model was employed to derive the pooled prevalence rate. Mixed-effects meta-regression and subgroup analyses were performed to examine the moderators of the between-study heterogeneity. Publication bias was tested using the Egger’s regression test and funnel plot. Only seven out of the 11 Southeast Asian countries were represented in the literature. All except for two of the included studies were cross-sectional in nature. The findings revealed a pooled prevalence rate of 20.0% (95% confidence interval: 14.5%–27.0%) and 10.1% (95% confidence interval: 7.3%–13.8%) for Internet addiction and gaming disorders respectively. Mean age and study population were significant moderators of the between-study heterogeneity in the prevalence rates of gaming disorders such that samples involving older participants showed higher prevalence rate than those involving younger individuals. Country of study was found to be significant moderator of the between-heterogeneity for both Internet addiction and gaming disorders, however the findings should be interpreted with caution due to the small and unbalanced sample sizes. There was no significant publication bias. Such epidemiology research should be extended to the Southeast Asian countries that have not been studied or are under-studied. Given that the prevalence rates appear to be higher in Southeast Asia than in other world regions, future research should also explore the factors behind these inter-regional differences. Further longitudinal studies should also be conducted to examine the trajectories of such disorders. Published version

BackgroundIn the four months after the discovery of the index case of coronavirus disease (COVID-19), several studies highlighted the psychological impact of COVID-19 on frontline health care workers and on members of the general public. It is evident from these studies that individuals experienced elevated levels of anxiety and depression in the acute phase, when they first became aware of the pandemic, and that the psychological distress persisted into subsequent weeks. It is becoming apparent that technological tools such as SMS text messages, web-based interventions, mobile interventions, and conversational agents can help ameliorate psychological distress in the workplace and in society. To our knowledge, there are few publications describing how digital tools have been used to ameliorate psychological symptoms among individuals.ObjectiveThe aim of this review was to identify existing SMS text message, web-based, mobile, and conversational agents that the general public can access to ameliorate the psychological symptoms they are experiencing during the COVID-19 pandemic.MethodsTo identify digital tools that were published specifically for COVID-19, a search was performed in the PubMed and MEDLINE databases from the inception of the databases through June 17, 2020. The following search strings were used: “NCOV OR 2019-nCoV OR SARS-CoV-2 OR Coronavirus OR COVID19 OR COVID” and “mHealth OR eHealth OR text”. Another search was conducted in PubMed and MEDLINE to identify existing digital tools for depression and anxiety disorders. A web-based search engine (Google) was used to identify if the cited web-based interventions could be accessed. A mobile app search engine, App Annie, was used to determine if the identified mobile apps were commercially available. Results: A total of 6 studies were identified. Of the 6 identified web-based interventions, 5 websites (83%) could be accessed. Of the 32 identified mobile interventions, 7 apps (22%) could be accessed. Of the 7 identified conversational agents, only 2 (29%) could be accessed.ResultsA total of 6 studies were identified. Of the 6 identified web-based interventions, 5 websites (83%) could be accessed. Of the 32 identified mobile interventions, 7 apps (22%) could be accessed. Of the 7 identified conversational agents, only 2 (29%) could be accessed.ConclusionsThe COVID-19 pandemic has caused significant psychological distress. Digital tools that are commercially available may be useful for at-risk individuals or individuals with pre-existing psychiatric symptoms.

Apps that enable contact-tracing are instrumental in mitigating the transmission of COVID-19, but there have been concerns among users about the data collected by these apps and their management. Contact tracing is of paramount importance when dealing with a pandemic, as it allows for rapid identification of cases based on the information collected from infected individuals about other individuals they may have had recent contact with. Advances in digital technology have enabled devices such as mobile phones to be used in the contract-tracing process. However, there is a potential risk of users’ personal information and sensitive data being stolen should hackers be in the near vicinity of these devices. Thus, there is a need to develop privacy-preserving apps. Meanwhile, privacy policies that outline the risk associated with the use of contact-tracing apps are needed, in formats that are easily readable and comprehensible by the public. To our knowledge, no previous study has examined the readability of privacy policies of contact-tracings apps. Therefore, we performed a readability analysis to evaluate the comprehensibility of privacy policies of 7 contact-tracing apps currently in use. The contents of the privacy policies of these apps were assessed for readability using Readability Test Tool, a free web-based reliability calculator, which computes scores based on a number of statistics (ie, word count and the number of complex words) and indices (ie, Flesch Reading Ease, Flesch-Kincaid Reading Grade Level, Gunning Fog Index, and Simplified Measure of Gobbledygook index). Our analysis revealed that explanations used in the privacy policies of these apps require a reading grade between 7 and 14, which is considerably higher than the reading ability of the average individual. We believe that improving the readability of privacy policies of apps could be potentially reassuring for users and may help facilitate the increased use of such apps. Ministry of Health (MOH) National Medical Research Council (NMRC) Published version MWZ is supported by a grant under the Singapore Ministry of Health’s National Medical Research Council (grant number NMRC/Fellowship/0048/2017) for PhD training. The funding source was not involved in any part of this project.

Background Methadone maintenance treatment (MMT) has been proven to be effective in treating opioid dependence. In Vietnam, MMT services are provided primarily by public clinics, with only one private MMT clinic established in recent years. Assessing the preferences of patients for different MMT models is important in evaluating the feasibility of these models. This study measured the preferences of drug users enrolling in public and private MMT clinics in Vietnam and examines the related factors of these preferences. Methods A cross-sectional study was performed on 395 participants at 3 methadone clinics in Nam Dinh. Data about the preferences for MMT models and sociodemographic characteristics of participants were collected. Exploratory factor analysis was employed to explore the construct validity of the questionnaire. The chi-square test and Mann-Whitney test were used for analyzing demographic characteristics and preferences of participants. Multivariate logistic regression identified factors associated with participants’ preferences. Results Half the participants received MMT treatment in a private facility (49.4%). Two preference dimensions were defined as “Availability and convenience of service” and “Competencies of clinic and health professionals”. Self-employed patients were more likely to consider these two dimensions when choosing MMT models. Only 9.9% of participants chose “Privacy” as one of the evaluation criteria for an MMT facility. Compared to public clinics, a statistically higher percentage of patients in the private clinic chose the attitudes of health workers as the reason for using MMT service (34.7% and 7.6% respectively). Mean score of satisfaction towards MMT services was 8.6 (SD = 1.0), and this score was statistically higher in a public facility, compared to the private facility (8.7 and 8.4 respectively). Conclusions The study highlighted patterns of patient preferences towards MMT clinics. Compared to the public MMT model, the private MMT model may need to enhance their services to improve patient satisfaction.

Background Smoking is a global health threat. Attentional bias influences smoking behaviors. Although attentional bias retraining has shown benefits and recent advances in technology suggest that attentional bias retraining can be delivered via smartphone apps, there is a paucity of research on this topic. Objective This study aims to address this gap by exploring the use of attentional bias retraining via a novel smartphone app using a mixed methods pilot study. In the quantitative phase, it is hypothesized that participants in the training group who undertake attentional bias retraining via the app should have decreased levels of attentional bias, subjective craving, and smoking frequency, compared with those in the control group who do not undertake attentional bias retraining. The qualitative phase explores how the participants perceive and experience the novel app. Methods In all, 10 adult smokers (3 females and 7 males) between the ages of 26 and 56 years (mean 34.4 years, SD 9.97 years) were recruited. The participants were randomly allocated to the training and control groups. In weeks 1 and 3, participants from both groups attempted the standard visual probe task and rated their smoking frequency and subjective craving. In week 2, the participants in the training group attempted the modified visual probe task. After week 3, participants from both groups were interviewed about their views and experiences of the novel app. Results The results of the quantitative analysis did not support this study’s hypothesis. The qualitative data were analyzed using thematic analysis. The results yielded 5 themes: ease, helpfulness, unhelpful aspects, barriers, and refinement. Conclusions Findings from the qualitative study were consistent with those from previous studies on health-related smartphone apps. The qualitative results were helpful in understanding the user perspectives and experiences of the novel app, indicating that future research in this innovative area is necessary.

Background Cognitive biases are mostly automatic processes that result in individuals giving increased attention to threatening stimuli, with the difficulties in disengaging from these stimuli. Recent reviews have reported the presence for attention bias in several psychiatric conditions and provided evidence that such biases could be subjected to modification. Web-based and mobile based bias modification have mixed efficacy and gamification techniques proposed as a solution. There remains a gap in knowledge pertaining to the gamified applications for bias modification that are commercially available. Objective An analysis of their gamification approach will help in identification of common gaming elements adopted for use. Methods To identify commercial applications, a manual cross-sectional search was conducted between 1 and 11 November 2017 on the Google Play store. The following search terminologies were used: "Attention bias" and "Cognitive bias". The classification of the gamification technique for both the published applications and commercial applications were based on the six approaches described by Wouter et al. [17] and the 17 gamification techniques described by Hoffman et al. [18]. Results A total of nine applications were included in the current review. Five out of the nine applications involved the addition of gaming elements to an evidence-based task, and three involved the usage of intrinsic integration while leaving the evidence-based task intact. Other common gamification strategies used are that of the inclusion of digital rewards (n= 8) and the provision of feedback (n= 7). The average number of gamification techniques across all the nine applications is 3.2. Conclusions Even though most commercial applications appear to have their basis on a validated gamification approach for the delivery of attention bias modification, there remains a need for further research in evaluating these applications clinically.

The increasing popularity of Internet raises challenges in preventing the negative influences of the Internet, particularly internet addiction (IA) on lifestyles, including physical activity. However, there has been a scarcity of evidence about the relationship between IA and physical activity among Vietnamese youths. The aim of this study was to see if there is an association between IA and physical activity in Vietnamese adolescents and youths. An online cross-sectional study with 589 Vietnamese adolescents and youths was conducted between August 2015 and October 2015 by using the respondent-driven sampling technique (RDS). Short-form Internet addiction test (s-IAT) and the International Physical Activity Questionnaire – Short form (Iphysical activityQ-SF) were employed to measure IA and level of physical activity. The results revealed that 23.1% of the participants were found to be inactive in physical activity. Our study did not reveal any association between IA and physical activity in Vietnamese youths and adolescents. We found that the level of physical activity was low to moderate for the majority of the participants, showing that necessary steps are required to provide early intervention in order to emphasize the importance and the benefits of physical activity.

We carried out systematic review and meta-analysis to evaluate whether peripheral levels of pro-inflammatory markers including Interleukin-1 beta (IL-1β), Interleukin-6 (IL-6), Tumor Necrosis Factor-α (TNF- α) and C-Reactive Protein (CRP) are significantly higher in elderly with depression and Alzheimer’s disease. We searched Pubmed, PsycINFO and Embase, and thirty-four relevant studies (2609 with Depression, 1645 with Alzheimer’s disease and 14363 Controls) were included. Compared with controls, IL-1β (pooled standardized mean difference [SMD]: 0.642; 95% confidence interval [CI]: 0.078–1.206; significant heterogeneity: I2 = 86.28%) and IL-6 (pooled SMD: 0.377; 95% CI: 0.156–0.598; significant heterogeneity: I2 = 88.75%) were significantly elevated in depression. There was no difference in TNF-α (p = 0.351) and CRP (p = 0.05) between those with depression and controls. Compared with controls, IL-1β (pooled SMD: 1.37, 95% CI: 0.06–2.68, significant heterogeneity: I2 = 96.01%) was significantly elevated in Alzheimer’s disease. There were no differences in IL-6 (p = 0.138), TNF-α (p = 0.451) and CRP (p = 0.07) between elderly with Alzheimer’s disease and controls. After Bonferroni adjustment, only IL-6 remained significantly higher in depression. Elderly with depression have higher IL-6 than controls, while those with Alzheimer’s disease did not have higher peripheral inflammatory markers.

Huong Thi Thu Nguyen,1,2 Mackenzie PI Moir,3 Thanh Xuan Nguyen,2,4 Anh Phuong Vu,5 Long Hoang Luong,2,4 Tam Ngoc Nguyen,1,2 Long Hoang Nguyen,6 Bach Xuan Tran,7,8 Tung Thanh Tran,9 Carl A Latkin,8 Melvyn WB Zhang,10 Roger CM Ho,11 Huyen Thanh Thi Vu1,2 1Department of Gerontology, Hanoi Medical University, Hanoi, Vietnam; 2National Geriatric Hospital, Hanoi, Vietnam; 3School of Public Health, University of Alberta, Edmonton, AB, Canada; 4Dinh Tien Hoang Institute of Medicine, Hanoi, Vietnam; 5Hanoi Medical University, Hanoi, Vietnam; 6School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam; 7Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam; 8Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; 9Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam; 10Biomedical Global Institute of Healthcare Research & Technology (BIGHEART), National University of Singapore, Singapore; 11Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Background: Health-related quality of life (HRQoL) is an important indicator for designing care and treatment services for patients with diabetes. This is especially true given its rapid increase among the elderly population in Vietnam. HRQoL data in elderly diabetic Vietnamese are currently limited. This study aimed to 1) measure the HRQoL of elderly patients with type 2 diabetes (T2DM) in Vietnam and 2) identify related factors and their relationship with HRQoL. Patients and methods: A cross-sectional study was conducted. We recruited 171 patients aged ≥60 years with T2DM at the Outpatient Department, National Geriatric Hospital from June to November 2015. Patients were asked to evaluate their health status using the EuroQol Five Dimensions Three Levels (EQ-5D-3L) and the Visual Analog Scale (VAS). Sociodemographic, diabetic treatment, and management characteristics were collected. Multivariate Tobit regression was used to determine which factors were associated with HRQoL, and the strength of this relationship. Results: Patients reported some problems in all areas of the EQ-5D: pain/discomfort (50.9%), mobility (33.3%), anxiety/depression (24.0%), usual activities (21.1%), and self-care (10.5%). The mean EQ-5D index score was 0.80 (SD=0.20), and the mean EQ-VAS was 57.5 (SD=14.4). Patients who were male, lived in an urban area, could afford treatment, were taking fewer medications, and monitored blood pressure often (1–4 times a week) had a higher EQ-5D index when compared to other groups. Meanwhile, a longer duration of diabetes and older age were negatively associated with the EQ-5D index. Patients with any comorbidity had lower VAS scores than their counterparts. Conclusion: The presence of diabetes and comorbidity were responsible for a significant decrease in HRQoL. Screening and identifying health problems, providing prompt treatment, and facilitating self-management among patients have the potential to increase diabetic patients’ HRQoL. Keywords: elder, quality of life, diabetes, Vietnam

Background and aims The main goal of the present study was to examine the psychometric properties of a Vietnamese version of the short-version of Internet Addiction Test (s-IAT) and to assess the relationship between s-IAT scores and demographics, health related qualify of life and perceived stress scores in young Vietnamese. Methods The Vietnamese version of s-IAT was administered to a sample of 589 participants. Exploratory factor and reliability analyses were performed. Regression analysis was used to identify the associated factors. Results The two-factor model of Vietnamese version of s-IAT demonstrated good psychometric properties. The internal consistency of Factor 1 (loss of control/time management) was high (Cronbach's alpha = 0.82) and Factor 2 (craving/social problems) was satisfactory (Cronbach's alpha = 0.75). Findings indicated that 20.9% youths were addicted to the Internet. Regression analysis revealed significant associations between Internet addiction and having problems in self-care, lower quality of life and high perceived stress scores. Discussion and conclusions The Vietnamese version of s-IAT is a valid and reliable instrument to assess IA in Vietnamese population. Due to the high prevalence of IA among Vietnamese youths, IA should be paid attention in future intervention programs. s-IAT can be a useful screening tool for IA to promptly inform and treat the IA among Vietnamese youths., Highlight • Short-version of Internet Addiction Test (s-IAT) was validated with high reliability and good psychometric properties among Vietnamese youths. • Two factors were identified from s-IAT including: loss of control/time management and craving/social problems. • There are significant associations between Internet addiction and male gender, having problems in self-care and high perceived stress scores.

With the development of online learning, communication, and entertainment, the Internet has become an indispensable tool for university students. Internet addiction (IA) has emerged as a health problem and the prevalence of IA varies from country to country. To date, the global prevalence of IA in medical students remains unknown. The objective of this meta-analysis was to establish precise estimates of the prevalence of IA among medical students in different countries. The pooled prevalence of IA among medical students was determined by the random-effects model. Meta-regression and subgroup analysis were performed to identify potential factors that could contribute to heterogeneity. The pooled prevalence of IA among 3651 medical students is 30.1% (95% confidence interval (CI) 28.5–31.8%, Z = −20.66, df = 9, τ 2 = 0.90) with significant heterogeneity (I 2 = 98.12). Subgroup analysis shows the pooled prevalence of IA diagnosed by the Chen’s Internet Addiction Scale (CIAS) (5.2, 95% CI 3.4–8.0%) is significantly lower than Young’s Internet Addiction Test (YIAT) (32.2, 95% CI 20.9–45.9%) (p

Background Whistle-blowing provides an avenue for healthcare workers to express their concerns when there is a breach of patients' safety. Most healthcare organizations have policies in place to prevent reprisals on whistle-blowers. Despite these protective measures, whistle-blowing often leads to negative consequences. Methods A search of articles on whistle-blowing was conducted on MEDLINE (PubMed). Articles were included if they described the consequences of whistle-blowing in the following 3 areas: medical, nursing, and research/pharmaceutical research (Fig. 1). Results The initial search criteria retrieved 1168 articles, 670 of which were identified for full-text review. A total of 82 studies were included in the final set of literature. Negative consequences to whistle-blowers include occupational, legal, financial, socioemotional, and other (e.g., physical health, character assassination) effects. Positive consequences to clinical services include improvements to patient safety and in successes of employment tribunal claims, settlements, and court injunctions. Positive consequences in research include retraction of articles (with fraudulent data) and changes to medical journal publication rules. Consequences of no whistle-blowing include investigations of individuals for not reporting and negative emotions such as guilt. Conclusions Whistle-blowing is an avenue to improving patient safety in healthcare. The findings from this integrated review will help shape new whistle-blowing policies. Future whistle-blowing policies must minimize negative consequences to whistle-blowers while enhancing levels of patient safety and quality of care rendered.

SummaryMicrodeletion syndrome is an important topic in intellectual disability, associated with various psychiatric symptoms, such as autism, attention deficit, hyperactivity, obsession and compulsion, and psychosis. In this article, we provide a clinical update on the following syndromes and their associated psychiatric disorders: Prader–Willi syndrome, Angelman syndrome, Williams syndrome, Wolf–Hirschhorn syndrome,cri du chatsyndrome, DiGeorge syndrome and Rubinstein–Taybi syndrome.Learning Objectives• Gain an up-to-date understanding of the microdeletion syndromes commonly seen in daily practice• Appreciate the association between underlying chromosomal abnormalities and the resultant intellectual disabilities in microdeletion syndromes• Gain up-to-date knowledge about the treatment options for the various microdeletion syndromes commonly seen in daily practice

Summary This meta-analysis aimed to evaluate the association between childhood and adolescent obesity and depression. We systematically searched PubMed, PsycInfo, EMBASE and Science Direct for studies that compared prevalence of depression and depressive symptoms in normal weight and obese children and adolescents. Observational studies were included if they reported body mass index and assessed depression by validated instruments or diagnostic interviews. Quality assessment was performed using the Newcastle–Ottawa scale. We used the random-effect model to calculate the pooled odds ratios, standard mean differences (SMDs) and subgroup analysis. Findings for a total of 51,272 participants were pooled across 18 studies and examined. Our analyses demonstrated a positive association between childhood and adolescent obesity and depression (pooled odds ratio = 1.34, 95% confidence interval [CI]: 1.1–1.64, p = 0.005) and more severe depressive symptoms (SMD = 0.23, 95% CI: 0.025–0.44, p = 0.028) in the obese groups. Overweight subjects were not more likely to have either depression (pooled odds ratio = 1.16, 95% CI: 0.93–1.44, p = 0.19) or depressive symptoms (SMD = 0, 95% CI: −0.101 to 0.102, p = 0.997). Non-Western and female obese subjects were significantly more likely to have depression and severe depressive symptoms (p

There have been rapid advances in technologies over the past decade and virtual reality technology is an area which is increasingly utilized as a healthcare intervention in many disciplines including that of Medicine, Surgery and Psychiatry. In Psychiatry, most of the current interventions involving the usage of virtual reality technology is limited to its application for anxiety disorders. With the advances in technology, Internet addiction and Internet gaming disorders are increasingly prevalent. To date, these disorders are still being treated using conventional psychotherapy methods such as cognitive behavioural therapy. However, there is an increasing number of research combining various other therapies alongside with cognitive behavioural therapy, as an attempt possibly to reduce the drop-out rates and to make such interventions more relevant to the targeted group of addicts, who are mostly adolescents. To date, there has been a prior study done in Korea that has demonstrated the comparable efficacy of virtual reality therapy with that of cognitive behavioural therapy. However, the intervention requires the usage of specialized screens and devices. It is thus the objective of the current article to highlight how smartphone applications could be designed and be utilized for immersive virtual reality treatment, alongside low cost wearables.

Dementia is known to be an illness which brings forth marked disability amongst the elderly individuals. At times, patients living with dementia do also experience non-cognitive symptoms, and these symptoms include that of hallucinations, delusional beliefs as well as emotional liability, sexualized behaviours and aggression. According to the National Institute of Clinical Excellence (NICE) guidelines, non-pharmacological techniques are typically the first-line option prior to the consideration of adjuvant pharmacological options. Reminiscence and music therapy are thus viable options. Lazar et al. [3] previously performed a systematic review with regards to the utilization of technology to delivery reminiscence based therapy to individuals who are living with dementia and has highlighted that technology does have benefits in the delivery of reminiscence therapy. However, to date, there has been a paucity of M-health innovations in this area. In addition, most of the current innovations are not personalized for each of the person living with Dementia. Prior research has highlighted the utility for open source repository in bioinformatics study. The authors hoped to explain how they managed to tap upon and make use of open source repository in the development of a personalized M-health reminiscence therapy innovation for patients living with dementia. The availability of open source code repository has changed the way healthcare professionals and developers develop smartphone applications today. Conventionally, a long iterative process is needed in the development of native application, mainly because of the need for native programming and coding, especially so if the application needs to have interactive features or features that could be personalized. Such repository enables the rapid and cost effective development of application. Moreover, developers are also able to further innovate, as less time is spend in the iterative process.