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Autism spectrum conditions (ASC) and borderline personality disorder (BPD) have overlapping symptom profiles. Dialectical behaviour therapy (DBT) is an established treatment for self-harm and BPD, but little research has investigated the outcomes of DBT for ASC populations. This exploratory service evaluation aims to investigate the outcomes of a comprehensive DBT programme for adolescents with a diagnosis of emerging BPD and a co-occurring ASC diagnosis as compared to those without an ASC diagnosis.

Differences from the start to end of treatment in the frequency of self-harming behaviours, BPD symptoms, emotion dysregulation, depression, anxiety, the number of A&E attendances and inpatient bed days, education and work status, and treatment non-completion rates were analysed for those with an ASC diagnosis, and compared between those with an ASC diagnosis and those without.

Significant medium to large reductions in self-harming behaviours, BPD symptoms, emotion dysregulation and inpatient bed days were found for those with an ASC diagnosis by the end of treatment. There were no significant differences between those with an ASC and those without in any outcome or in non-completion rates. These findings indicate that DBT may be a useful treatment model for those with an ASC diagnosis, though all results are preliminary and require replication.

To the best of the authors’ knowledge, this is the first study to report the outcomes of a comprehensive DBT programme for adolescents with an ASC diagnosis, and to compare the changes in outcomes between those with a diagnosis and those without.

The outbreak of the COVID-19 pandemic has significantly impacted healthcare systems, presenting unforeseen challenges that necessitated the implementation of change management strategies to adapt to the new contextual conditions. This study aims to analyze organizational changes within the total hip replacement (THR) surgery pathway at multiple levels, including macro, meso and micro. It employs data triangulation from various sources to gauge the complexity of the change process and comprehend how multi-level decision-making influenced an unexpected shift.

A multicentric, single in-depth case study was conducted using a mixed-methods approach. Data sources included patient-reported outcome measures specific to the THR pathway and carefully structured in-depth interviews administered to managers and clinicians in two healthcare organizations serving the same population.

Decisions made at the macro level resulted in an overall reduction in surgical activities. Organizational changes at the meso level led to a complete cessation or partial reorganization of activities. Micro-level actions for change and adaptation revealed diverse and fragmented change management strategies.

Organizations with segmented structures may require a robust and structured department for coordinating change management responses to prevent the entire system from becoming stuck in the absorptive phase of change. However, it is important to recognize that absorptive solutions can serve as a starting point for genuine innovations in change management.

The utilization of data triangulation enables the authors to visualize how specific changes implemented in response to the pandemic have influenced the observed outcomes. From a managerial perspective, it provides insights into how future innovations could be introduced.

This paper aims to explore examine the therapeutic potential of head-mounted display (HMD)-based Virtual Reality Relaxation Therapy (VRRT) sessions for people individuals with dementia in Jordan.

This cross-sectional survey recruited 75 dementia-diagnosed elderly individuals from three Jordanian care homes. A VRRT intervention comprising 10 tailored RT sessions held over the course of five weeks was administered to the participants. Apathy, cognitive performance, anxiety and depression were evaluated before and after the intervention to determine any changes. The Person-Environment Apathy Rating Scale's (PEARS) Arabic translation's validity and reliability were also evaluated.

The VRRT intervention yielded noteworthy results in reducing apathy, as indicated by a substantial decrease in PEARS scores from 17.20 to 11.15. The findings of the study revealed that the participants demonstrated enhanced cognitive abilities, as evidenced by a significant rise in their Saint Louis University Mental Status ratings, which increased from 15.11 to 19.70. The levels of anxiety and depression exhibited a significant decrease subsequent to the implementation of VRRT, with anxiety levels decreasing from 13.66 to 8.23 and depression levels decreasing from 13.62 to 9.33. Furthermore, a notable 70% of participants demonstrated statistically significant decreases in indifference.

This study makes a significant contribution to the advancement of innovative treatment approaches aimed at addressing the needs of the aging population, hence enhancing health outcomes and raising the quality of care in Jordan.

The effectiveness of VRRT in reducing apathy among Jordanian senior citizens residing in nursing homes has not yet been fully investigated. Therefore, this paper seeks to assess the effectiveness of HMD-based VRRT by conducting pre- and post-intervention evaluations. This research aims to provide valuable insights into the applicability and significance of VRRT in the Jordanian context, contributing to the development of culturally appropriate and cutting-edge therapeutic interventions for older individuals in Jordan. Through this study, the authors aim to promote improved health and elevated standards of care for this population.

The study aims to drive conceptual clarity around resistance to information technology projects, integrating multiple facets of the phenomenon from earlier studies.

The study conducts a meta-synthesis of qualitative studies on resistance to technology projects; it analyzes those studies at a case-specific level, compares and contrasts emergent concepts against each other, and “translates” those to the rest of the studies. The study uses the seven-step meta-ethnography method by Noblit and Hare to reciprocally translate emergent concepts to construct the conceptual model.

Through meta-synthesis, the study derives a new conceptual model for resistance to information technology projects, exemplifying how the identified antecedents create user resistance and how the phenomenon progresses within organizations.

This study enriches the observations and conclusions of past individual studies while explicating various facets of the mechanisms that generate and progress technology resistance within organizations. It offers fresh insights into the equivocal nature of the phenomenon and the distinctive ways it progresses from individual to group level.

Many ambitious and costly digital transformation efforts do not succeed due to user resistance. Understanding the mechanisms that create user resistance can help organizations manage technology projects better, thereby reducing the technology assimilation gap and protecting returns on related investments.

There have been extensive studies on technology acceptance (enablers) within organizations, while those relating to technology inhibitors are somewhat limited. However, the symmetry of understanding between enablers and inhibitors is vital for organizations to assimilate promising technologies and transform their business models. This model uses a new lens of sensemaking theory to explain how the antecedents trigger perceived threats and resistance behavior; it highlights the nuances around the development of resistance within individuals and its progression to groups. The resultant model offers better generalizability in organizational contexts.

The transtheoretical model (TTM) has been applied to varying areas of physical health, e.g. diabetes. However, research into its applicability to psychotherapy is mixed. The TTM is applied through the University of Rhode Island Change Assessment (URICA). Investigating the utility of the URICA is needed to improve patient care and outcomes. This study aims to assess whether the URICA scores relate to patient outcomes; patient attendance; practitioner ratings of patient readiness, appropriateness, insight, motivation and potential for improvement; and to explore practitioner’s perspectives on the URICA.

Correlational methods were used to assess the relationship between the URICA and therapeutic outcome, attendance and practitioner-rated areas. Content analysis was used to analyse practitioner qualitative data.

The URICA did not correlate with either therapeutic outcome or attendance. A significant negative correlation was found between the URICA and practitioner-rated appropriateness of the referral. This means practitioners perceived individuals with lower URICA scores to be a more appropriate referral, despite the score indicating a reduced readiness to change. Qualitative categories included positive views, negative views, ambivalence and changes to measure and process. To conclude, the URICA does not explain a patient’s outcome or attendance. The URICA may not be appropriate to use in its current format in mental health services; therefore, assessing the TTM verbally may be more helpful.

This study provides research into suitability of using the URICA to assess the TTM and its applicability to attendance and outcome in psychological therapies.

This paper aims to explore the potential utility of Identity Structure Analysis (ISA) in single-case and group-level outcome and process evaluations.

A study was conducted to evaluate mentalization-based therapy by using ISA and its linked framework software, Ipseus. Ten patients with borderline personality disorder and substance use disorder were involved in the study. ISA/Ipseus was administered prior to and at the completion of the treatment. Five-year follow-up data, comprising behavioural indicators, were also collected and compared to ISA/Ipseus results.

Improvements occurred in the evaluation of stressful, demanding and emotionally burdening situations. Evaluations on concerned others also improved, together with progress in self-reflection. Changes in the evaluation of recovery-related themes were less salient. On a case level, changes in the self-states and role models were consistent with the results of the five-year-follow up data. An initial crisis state seems suggestive of progress, while initial defensive positions with high positive self-regard, of stagnation.

ISA/Ipseus, integrating the benefits of qualitative and quantitative approaches in evaluation, is a potential method to explore the complexity of identity changes during therapy.

This study aims to explore the evolutionary pattern of discussion topics over time in an online depression self-help community.

Using the Latent Dirichlet Allocation (LDA) method, the authors analyzed 17,534 posts and 138,567 comments posted over 8 years on an online depression self-help group in China and identified the major discussion topics. Based on significant changes in the frequency of posts over time, the authors identified five stages of development. Through a comparative analysis of discussion topics in the five stages, the authors identified the changes in the extent and range of topics over time. The authors discuss the influence of socio-cultural factors on depressed individuals' health information behavior.

The results illustrate an evolutionary pattern of topics in users' discussion in the online depression self-help group, including five distinct stages with a sequence of topic changes. The discussion topics of the group included self-reflection, daily record, peer diagnosis, companionship support and instrumental support. While some prominent topics were discussed frequently in each stage, some topics were short-lived.

While most prior research has ignored topic changes over time, the study takes an evolutionary perspective of online discussion topics among depressed individuals. The authors provide a nuanced account of the progression of topics through five distinct stages, showing that the community experienced a sequence of changes as it developed. Identifying this evolutionary pattern extends the scope of research on depression therapy in China and offers a deeper understanding of the support that individuals with depression seek, receive and provide online.

This study aims to evaluate and summarize the effectiveness of cognitive behavioral therapy (CBT) and internet-based CBT (ICBT) interventions on relapse prevention and severity of symptoms among individuals with major depressive disorder (MDD). CBT is one of the most used and suggested interventions to manage MDD, whereas ICBT is a novel effective proposed approach.

The review was conducted following the preferred reporting items for systematic review and meta-analysis protocol. A comprehensive and extensive search was performed to identify and evaluate the relevant studies about the effectiveness of CBT and ICBT on relapse prevention and severity of symptoms among patients with MDD.

A total of eight research studies met the inclusion criteria and were included in this systematic review. RCT studies were conducted to assess and evaluate the effectiveness of CBT and ICBT on relapse prevention and severity of symptoms among patients with MDD. It has been found that CBT is a well-supported and evidently based effective psychotherapy for managing depressive symptoms and reducing the relapse and readmission rate among patients diagnosed with MDD. The ICBT demonstrated greater improvements in depressive symptoms during major depressive episodes among patients with MDDS. The ICBT program had good acceptability and satisfaction among participants in different countries.

Despite the significant findings from this systematic review, certain limitations should be acknowledged. First, it is important to note that all the studies included in this review were exclusively conducted in the English language, potentially limiting the generalizability of the findings to non-English speaking populations. Second, the number of research studies incorporated in this systematic review was relatively limited, which may have resulted in a narrower scope of analysis. Finally, a few studies within the selected research had small sample sizes, which could potentially impact the precision and reliability of the overall conclusions drawn from this review. The authors recommend that nurses working in psychiatric units should use CBT interventions with patients with MDD.

This paper, a review of the literature gives an overview of CBT and ICBT interventions to reduce the severity of depressive symptoms and prevent patients’ relapse and rehospitalization and shows that CBT interventions are effective on relapse prevention among patients with MDD. In addition, there is still no standardized protocol to apply the CBT intervention in the scope of reducing the severity of depressive symptoms and preventing depression relapse among patients with major depressive disorder. Further research is needed to confirm the findings of this review. Future research is also needed to find out the most effective form and contents of CBT and ICBT interventions for MDD.

CBT is a psychological intervention that has been recommended by the literature for the treatment of major depressive disorder (MDD). It is a widely recognized and accepted approach that combines cognitive and behavioral techniques to assist individuals overcome their depressive symptoms and improve their overall mental well-being. This would speculate that effectiveness associated with several aspects and combinations of different approaches in CBT interventions and the impact of different delivery models are essential for clinical practice and appropriate selection of the interventional combinations.

This systematic review focuses on the various studies that explore the effectiveness of face-to-face CBT and ICBT in reducing depressive symptoms among patients with major depressive disorder. These studies were conducted in different countries such as Iran, Australia, Pennsylvania and the USA.

The purpose of this study is to investigate and demonstrate the advancements achieved in the field of chest X-ray image captioning through the utilization of dynamic convolutional encoder–decoder networks (DyCNN). Typical convolutional neural networks (CNNs) are unable to capture both local and global contextual information effectively and apply a uniform operation to all pixels in an image. To address this, we propose an innovative approach that integrates a dynamic convolution operation at the encoder stage, improving image encoding quality and disease detection. In addition, a decoder based on the gated recurrent unit (GRU) is used for language modeling, and an attention network is incorporated to enhance consistency. This novel combination allows for improved feature extraction, mimicking the expertise of radiologists by selectively focusing on important areas and producing coherent captions with valuable clinical information.

In this study, we have presented a new report generation approach that utilizes dynamic convolution applied Resnet-101 (DyCNN) as an encoder (Verelst and Tuytelaars, 2019) and GRU as a decoder (Dey and Salemt, 2017; Pan et al., 2020), along with an attention network (see Figure 1). This integration innovatively extends the capabilities of image encoding and sequential caption generation, representing a shift from conventional CNN architectures. With its ability to dynamically adapt receptive fields, the DyCNN excels at capturing features of varying scales within the CXR images. This dynamic adaptability significantly enhances the granularity of feature extraction, enabling precise representation of localized abnormalities and structural intricacies. By incorporating this flexibility into the encoding process, our model can distil meaningful and contextually rich features from the radiographic data. While the attention mechanism enables the model to selectively focus on different regions of the image during caption generation. The attention mechanism enhances the report generation process by allowing the model to assign different importance weights to different regions of the image, mimicking human perception. In parallel, the GRU-based decoder adds a critical dimension to the process by ensuring a smooth, sequential generation of captions.

The findings of this study highlight the significant advancements achieved in chest X-ray image captioning through the utilization of dynamic convolutional encoder–decoder networks (DyCNN). Experiments conducted using the IU-Chest X-ray datasets showed that the proposed model outperformed other state-of-the-art approaches. The model achieved notable scores, including a BLEU_1 score of 0.591, a BLEU_2 score of 0.347, a BLEU_3 score of 0.277 and a BLEU_4 score of 0.155. These results highlight the efficiency and efficacy of the model in producing precise radiology reports, enhancing image interpretation and clinical decision-making.

This work is the first of its kind, which employs DyCNN as an encoder to extract features from CXR images. In addition, GRU as the decoder for language modeling was utilized and the attention mechanisms into the model architecture were incorporated.

Due to the rapid development of artificial intelligence (AI) technology, increasing the use of AI in healthcare is critical, but few studies have explored the extent to which physicians cooperate with AI in their work to achieve productive and innovative performance, which is a key issue in operations management (OM). We conducted empirical research to answer this question.

We developed a conceptual model based on the ambidextrous perspective. To test our model, we collected data from 200 Chinese hospitals. One senior and one junior physician from each hospital participated in this research so that we could get a more comprehensive view. Based on the sample of 400 participants and the conceptual model, we examined whether different types of AI use have distinct impacts on physicians’ productivity and innovation by conducting hierarchical regression and post hoc tests. We also introduced team psychological safety climate (TPSC) and AI technology uncertainty (AITU) as moderators to investigate this topic in further detail.

We found that augmentation AI use is positively related to overall productivity and innovative job performance, while automation AI use is negatively related to these two outcomes. Furthermore, we focused on the impacts of the ambidextrous use of AI on these two outcomes. The results highlight the positive impacts of complementary use on both outcomes and the negative impact of balance on innovative job performance. TPSC enhances the positive impacts of complementary use on productivity, whereas AITU inhibits the negative impacts of automation and balanced use on innovative job performance.

In the age of AI, organizations face greater trade-offs between performance and technology management. This study contributes to the OM literature from the perspectives of operational performance and technology management in three ways. First, it distinguishes among different AI implementations and their diverse impacts on productivity and innovative performance. Second, it identifies the different conditions under which automation AI use and augmentation are superior. Third, it extends the ambidextrous perspective by becoming an early adopter of this approach to explore the implications of different types of AI use in light of contingency factors.