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Exposure therapy is a widely used treatment for patients with post-traumatic stress dis -order. It involves reduction of fear through progressive exposure to frightening stimuli in a therapeutic environment. Here we propose a new method designed to improve the effectiveness of exposure therapy. We hypothesized that device-guided breathing during exposure therapy can increase the capability of the patient to undergo effective exposure. The successful application of the method is described for a single patient. Using a device to slow and regularize breathing, the patient was calmed and experienced a greater sense of control and a profound effect of the exposure. The use of the breathing-guiding device is believed to reduce arousal level and excitability of sympathetic “fight-flight” behaviors. The present study suggests that device-guided breathing integrated with exposure therapy may provide a practically feasible and potentially promising non-pharmacological treatment after trauma.

This study was performed to confirm that autonomic nervous activity is affected by breathing speed. I hypothesized that prolonged expiratory breathing would promote parasympathetic dominance, whereas rapid breathing would promote sympathetic dominance. Ten healthy men, ages 21-28 years old, were instructed to perform prolonged expiratory breathing (6 seconds expiration, 4 seconds inspiration) after spontaneous breathing and rapid breathing (1 second expiration, 1 second inspiration) after spontaneous breathing; changes in high frequency (HF) and low frequency (LF)/HF of heart rate variability (HRV) were measured during each type of breathing. During prolonged expiratory breathing, parasympathetic nervous function was significantly activated. Conversely, during rapid breathing, parasympathetic nervous function was significantly suppressed. The HRV method assessing sympathetic and parasympathetic modulation in this study is an indirect, noninvasive method with clear limitations. The use of additional techniques should be considered to clarify the relationships between the breathing speed and the mind.

This paper covers the development of a multidimensional contract administration performance model (CAPM) for construction projects. The proposed CAPM is intended to be used by the industry stakeholders to measure the construction contract administration (CCA) performance and identify the strengths and weaknesses of the CCA system for running or completed projects.

The research design follows a sequential mixed methodology of qualitative and quantitative data collection and analysis. In the first phase, contract administration indicators were collected from relevant literature. In the second phase, an online questionnaire was prepared, and data were collected and analyzed using the crisp value of fuzzy membership function, and structural equation modeling (SEM). The fuzzy set was chosen for this study due to the presence of uncertainty and fuzziness associated with the importance of several key indicators affecting the CCA performance. Finally, SEM was used to test and analyze interrelationships among constructs of CCA performance.

The data collected from 336 construction professionals worldwide through an online survey was utilized to develop the fuzzy structural equation model. The goodness-of-fit and reliability tests validated the model. The study concluded a significant correlation between CCA performance, CCA operational indicators, and the process groups.

The contribution of this paper to the existing knowledge is the development of a fuzzy structural equation model that serves as a measurement tool for the contract administration performance. This is the first quantitative structural equation model to capture contract administration performance. The model consists of 93 Construction Contract Administration(CCA) performance indicators categorized into 11 project management process groups namely: project governance and start-up; team management; communication and relationship management; quality and acceptance management; performance monitoring and reporting management; document and record management; financial management; changes and control management; claims and dispute resolution management; contract risk management and contract closeout management.