Digital Commons Network^™

Revisiting Delusion Subtypes In Schizophrenia Based On Their Underlying Structures, Andrew D Van Der Vaart, Yizhou Ma, Joshua Chiappelli, Heather Bruce, Mark D Kvarta, Alia Warner, Xiaoming Du, Bhim M Adhikari, Hemalatha Sampath, Peter Kochunov, L Elliot Hong

Faculty, Staff and Student Publications

A clear understanding of the pathophysiology of schizophrenia and related spectrum disorders has been limited by clinical heterogeneity. We investigated whether relative severity and predominance of one or more delusion subtypes might yield clinically differentiable patient profiles. Patients (N = 286) with schizophrenia spectrum disorders (SSD) completed the 21-item Peters et al. Delusions Inventory (PDI-21). We performed factor analysis followed by k-means clustering to identify delusion factors and patient subtypes. Patients were further assessed via the Brief Psychiatric Rating Scale, Brief Negative Symptom Scale, Digit Symbol and Digit Substitution tasks, use of cannabis and tobacco, and stressful life events. The …

Decreasing Polypharmacy In Older Adults With Cancer: A Pilot Cluster-Randomized Trial Protocol, Erika Ramsdale, Mostafa Mohamed, Holly M Holmes, Lisa Zubkoff, Jessica Bauer, Sally A Norton, Supriya Mohile

Faculty, Staff and Student Publications

Introduction: Polypharmacy is prevalent in older adults with cancer and associated with multiple adverse outcomes. A single-site, cluster-randomized clinical trial will enroll older adults with cancer and polypharmacy starting chemotherapy and will assess the effectiveness and feasibility of deprescribing interventions by comparing two arms: a pharmacist-led deprescribing intervention and a patient educational brochure.

Materials and methods: The study will be conducted in two phases. In phase I, focus groups and semi-structured individual interviews will guide adaptation of deprescribing interventions for the oncology clinic (phase Ia), and eight patients will undergo the pharmacist-led deprescribing intervention with iterative adaptations (phase Ib). In …

First Pass Effect As An Independent Predictor Of Functional Outcomes In Medium Vessel Occlusions: An Analysis Of An International Multicenter Study, Răzvan Alexandru Radu, Vincent Costalat, Robert Fahed, Sherief Ghozy, James E Siegler, Hamza Shaikh, Jane Khalife, Mohamad Abdalkader, Piers Klein, Thanh N Nguyen, Jeremy J Heit, Ahmad Sweid, Kareem El Naamani, Robert W Regenhardt, Jose Danilo Bengzon Diestro, Nicole M Cancelliere, Abdelaziz Amllay, Lukas Meyer, Anne Dusart, Flavio Bellante, Géraud Forestier, Aymeric Rouchaud, Suzana Saleme, Charbel Mounayer, Jens Fiehler, Anna Luisa Kühn, Ajit S Puri, Christian Dyzmann, Peter T Kan, Marco Colasurdo, Gaultier Marnat, Jérôme Berge, Xavier Barreau, Igor Sibon, Simona Nedelcu, Nils Henninger, Maéva Kyheng, Thomas R Marotta, Christopher J Stapleton, James D Rabinov, Takahiro Ota, Shogo Dofuku, Leonard Ll Yeo, Benjamin Yq Tan, Juan Carlos Martinez-Gutierrez, Sergio Salazar-Marioni, Sunil Sheth, Leonardo Renieri, Carolina Capirossi, Ashkan Mowla, Stavropoula I Tjoumakaris, Pascal Jabbour, Priyank Khandelwal, Arundhati Biswas, Frédéric Clarençon, Mahmoud Elhorany, Kevin Premat, Iacopo Valente, Alessandro Pedicelli, João Pedro Filipe, Ricardo Varela, Miguel Quintero-Consuegra, Nestor R Gonzalez, Markus A Möhlenbruch, Jessica Jesser, Illario Tancredi, Adrien Ter Schiphorst, Vivek Yedavalli, Pablo Harker, Lina M Chervak, Yasmin Aziz, Benjamin Gory, Christian Paul Stracke, Constantin Hecker, Monika Killer-Oberpfalzer, Christoph J Griessenauer, Ajith J Thomas, Cheng-Yang Hsieh, David S Liebeskind, Andrea M Alexandre, Tobias D Faizy, Charlotte Weyland, Aman B Patel, Vitor Mendes Pereira, Boris Lubicz, Adam A Dmytriw, Adrien Guenego

Faculty, Staff and Student Publications

Introduction: First pass effect (FPE), achievement of complete recanalization (mTICI 2c/3) with a single pass, is a significant predictor of favorable outcomes for endovascular treatment (EVT) in large vessel occlusion stroke (LVO). However, data concerning the impact on functional outcomes and predictors of FPE in medium vessel occlusions (MeVO) are scarce.

Patients and methods: We conducted an international retrospective study on MeVO cases. Multivariable logistic modeling was used to establish independent predictors of FPE. Clinical and safety outcomes were compared between the two study groups (FPE vs non-FPE) using logistic regression models. Good outcome was defined as modified Rankin Scale …

Breastfeeding Initiation, Duration, And Associated Factors Among People With Hepatitis C Virus Infection, Jennifer L Grasch, Jessica A De Voest, George R Saade, Brenna L Hughes, Uma M Reddy, Maged M Costantine, Edward K Chien, Alan T N Tita, John M Thorp, Torri D Metz, Ronald J Wapner, Vishakha Sabharwal, Hyagriv N Simhan, Geeta K Swamy, Kent D Heyborne, Baha M Sibai, William A Grobman, Yasser Y El-Sayed, Brian M Casey, Samuel Parry, Eunice Kennedy Shriver National Institute Of Child Health And Human Development (Nichd) Maternal-Fetal Medicine Units (Mfmu) Network

Faculty, Staff and Student Publications

OBJECTIVE: To characterize breastfeeding behaviors and identify factors associated with breastfeeding initiation among people with hepatitis C virus (HCV) infection.

METHODS: We conducted a secondary analysis of a multicenter observational cohort of pregnant people with singleton gestations and HCV seropositivity. This analysis includes individuals with data on breastfeeding initiation and excludes those with human immunodeficiency virus (HIV) co-infection. The primary outcome was self-reported initiation of breastfeeding or provision of expressed breast milk. Secondary outcomes included duration of breastfeeding. Demographic and obstetric characteristics were compared between those who initiated breastfeeding and those who did not to identify associated factors. Univariable and …

Obstetric Racism, Education, And Racial Concordance, Terri L Major-Kincade

Faculty, Staff and Student Publications

The United States holds the distinction of being the developed country with the worst perinatal outcomes despite spending the most per capita on health care. Black women are three to four times more likely than White women to experience adverse birth outcomes. These outcomes persist despite access to prenatal care, insurance, and college education. A long overdue racial reckoning has arrived, beginning with acknowledging the fallacy of race-based medicine and the role of enduring systemic racism as foundational to obstetric racism in the reproductive lives of Black women. Centering voices of Black women and honoring their lived experiences are essential …

Cost Analysis For Robotic And Open Gastrectomy, Yuki Hirata, Heather G Lyu, Ahad M Azimuddin, Pamela Lu, Jeeva Ajith, Jason A Schmeisser, Elizabeth P Ninan, Kyung Hyun Lee, Brian D Badgwell, Paul Mansfield, Naruhiko Ikoma

Faculty, Staff and Student Publications

Objective: To determine the magnitude of the perioperative costs associated with robotic gastrectomy (RG).

Background: A robotic surgery platform has a high implementation cost and requires maintenance costs; however, whether the overall cost of RG, including all perioperative costs, is higher than conventional open gastrectomy (OG) remains unknown.

Methods: Patients who underwent a major gastrectomy during February 2018 through December 2021 were retrospectively identified. We calculated the perioperative costs of RG and OG and compared them overall as well as in different phases, including intraoperative costs and 30-day postsurgery inpatient and outpatient costs. We investigated factors potentially associated with high …

Coronary Branch Steal Due To An Anomalous Single And Diseased Vessel, Alexandru Achim, Danai Kitkungvan, Richard L Kirkeeide, Nils P Johnson

Faculty, Staff and Student Publications

No abstract provided.

Attitudes On Artificial Intelligence Use In Pediatric Care From Parents Of Hospitalized Children, Lauren C Haley, Alexandra K Boyd, Nutan B Hebballi, Eric W Reynolds, Keely G Smith, Peter T Scully, Thao L Nguyen, Elmer V Bernstam, Linda T Li

Faculty, Staff and Student Publications

Introduction: Artificial intelligence (AI) may benefit pediatric healthcare, but it also raises ethical and pragmatic questions. Parental support is important for the advancement of AI in pediatric medicine. However, there is little literature describing parental attitudes toward AI in pediatric healthcare, and existing studies do not represent parents of hospitalized children well.

Methods: We administered the Attitudes toward Artificial Intelligence in Pediatric Healthcare, a validated survey, to parents of hospitalized children in a single tertiary children's hospital. Surveys were administered by trained study personnel (11/2/2021-5/1/2022). Demographic data were collected. An Attitudes toward Artificial Intelligence in Pediatric Healthcare score, assessing openness …

Secular Trends In Patent Ductus Arteriosus Management In Infants Born Preterm In The National Institute Of Child Health And Human Development Neonatal Research Network, Dinushan C Kaluarachchi, Matthew A Rysavy, Benjamin A Carper, Valerie Y Chock, Matthew M Laughon, Carl H Backes, Tarah T Colaizy, Edward F Bell, Patrick J Mcnamara

Faculty, Staff and Student Publications

We evaluated changes in patent ductus arteriosus (PDA) diagnosis and treatment from 2012 through 2021 in a network of US academic hospitals. PDA treatment decreased among infants born at 26-28 weeks but not among infants born at 22-25 weeks. Rates of indomethacin use and PDA ligation decreased while acetaminophen use and transcatheter PDA closure increased.

Advances And Challenges In Conventional And Modern Techniques For Halal Food Authentication: A Review, Ifrah Usman, Saima Sana, Muhammad Afzaal, Ali Imran, Farhan Saeed, Aftab Ahmed, Yasir Abbas Shah, Muniba Munir, Huda Ateeq, Atka Afzal, Iqra Azam, Afaf Ejaz, Gulzar Ahmad Nayik, Mahbubar Rahman Khan

Faculty, Staff and Student Publications

Food is one of the most necessary needs since human civilization. For Muslims, it is mandatory to consume halal food. From a halal authentication perspective, adulteration of food products is an emerging challenge worldwide. The demand for halal food consumption has resulted in an ever-increasing need for halal product validity. In the market, there are several food products in which actual ingredients and their source are not mentioned on the label and cannot be observed by the naked eye. Commonly nonhalal items include pig derivatives like lard, pork, and gelatin derivatives, dead meats, alcohol, blood, and prohibited animals. Purposely, various …

Channel Gating In Kalium Channelrhodopsin Slow Mutants, Oleg A Sineshchekov, Elena G Govorunova, Hai Li, Yumei Wang, John L Spudich

Faculty, Staff and Student Publications

Kalium channelrhodopsin 1 from Hyphochytrium catenoides (HcKCR1) is the first discovered natural light-gated ion channel that shows higher selectivity to K+ than to Na+ and therefore is used to silence neurons with light (optogenetics). Replacement of the conserved cysteine residue in the transmembrane helix 3 (Cys110) with alanine or threonine results in a >1,000-fold decrease in the channel closing rate. The phenotype of the corresponding mutants in channelrhodopsin 2 is attributed to breaking of a specific interhelical hydrogen bond (the “DC gate”). Unlike CrChR2 and other ChRs with long distance “DC gates”, the HcKCR1 structure does …

A Case Of Epstein-Barr Virus Encephalitis And Orbital-Face Inflammation, Rui T Tang, Jose Gavito-Higuera, Claudia M Prospero Ponce

Faculty, Staff and Student Publications

Epstein-Barr virus (EBV) can cause follicular conjunctivitis, keratitis, oculoglandular syndrome, meningitis, and encephalitis. We report a 54-year-old Hispanic male who presented with right pupil-involved complete ophthalmoplegia, orbital and masticatory muscle inflammation, trigeminal enhancement, and new corneal infiltrate highly suggestive of EBV. Labwork was negative except for positive EBV polymerase chain reaction (PCR) in serum. Magnetic resonance imaging (MRI) of his brain and orbits with contrast showed enhancement of the right ganglion of the trigeminal nerve, oculomotor nerve, all extraocular muscles in the right orbit, and right masticatory and temporalis muscles and a right subacute lacunar infarct. The patient was diagnosed …

Implementation Of A Home Blood Pressure Monitoring Program For The Management Of Hypertensive Disorders Of Pregnancy, An Observational Study In British Columbia, Canada, Karen C Tran, Sabina Freiman, Tessa Chaworth-Musters, Susan Purkiss, Colleen Foster, Nadia A Khan, Wee Shian Chan

Faculty, Staff and Student Publications

BACKGROUND: COVID-19 pandemic has influenced health care delivery. We conducted an observational study to understand how obstetric medicine (ObM) physicians utilized home blood pressure monitoring (HBPM) to manage hypertension in pregnancy.

METHODS: Pregnant participants with risk factors or diagnosis of hypertensive disorders of pregnancy (HDP) were enrolled, May 2020-December 2021, and provided with validated home blood pressure (BP) monitor. ObM physicians completed questionnaires to elicit how home BP readings were interpreted to manage HDP.

RESULTS: We enrolled 103 people: 44 antepartum patients (33.5 ± 5 years, gestational age of 24 ± 5 weeks); 59 postpartum patients (35 ± 6 years, …

Finding The Humanity In Policy Work: A Teacher Educators’ Response To The 2023 Amle Policy Agenda, Kristina N. Falbe

Faculty Publications - College of Education

[In the absence of an abstract, the conclusion is presented.] When I first opened the document containing the policy priorities, I was struck by the way that AMLE centered the voices of young adolescent students. By including direct quotes from 6th, 7th, and 8th graders, AMLE positioned the priorities as being about middle school students and not just problem solving to answer calls about teacher retention, class sizes, or other structural issues that need to be addressed. I believe that policy must be in pursuit of improving and meeting the needs of these young peoples’ lives. I am hopeful that …

Acute Kidney Injury After Percutaneous Coronary Intervention Guided By Intravascular Ultrasound, Minh Tran Duc, Thai Nguyen Quoc, Bach Yen T Nguyen, Ngoc Vu Quang, Nhuong Nguyen Duc, Hung Nguyen Duc, Lam Truong Hoai, Vu Nguyen Hoai, Hung Phan Kieu, Hieu Nguyen Trung

Faculty, Staff and Student Publications

Purpose We investigated the impact of intravascular ultrasound guidance on reducing the incidence of contrast-induced acute kidney injury (CI-AKI) in patients undergoing percutaneous coronary intervention (PCI). Methods Ninety-nine patients were enrolled in this prospective cohort who were not randomly assigned to angiography-guided percutaneous coronary intervention or intravascular ultrasound-guided percutaneous coronary intervention. The patients were hospitalized at the Vietnam National Heart Institute - Bach Mai Hospital between 2019 and 2020. Acute kidney injury incidence during hospitalization was the primary endpoint. Results A total of 99 patients were divided into two groups: the intravascular ultrasound-guided group (33 participants) and the angiography-guided group …

Overcoming Fear Of Developing Country: A Case Report Of Retroperitoneal Laparoscopic Partial Nephrectomy For T3a Renal Cell Carcinoma, Vo Anh Vinh Trang, Thien Tan Tri Tai Truyen, Nam Hoang Nguyen, Giang Trieu Quach, Phu Phat Pham, Phuc Cam Hoang Nguyen

Faculty, Staff and Student Publications

INTRODUCTION: Renal cell carcinoma poses significant challenges in kidney diseases, particularly in the context of the T3 stage, where treatment strategies remain controversial. The utilization of laparoscopic partial nephrectomy, particularly in developing countries, has been restricted for such patients, primarily due to limited infrastructure and concerns about recurrence risk and long-term pathologic outcomes.

PRESENTATION OF CASE: In this report, we present a case of a 64-year-old male diagnosed with T3aN0M0 renal cell carcinoma (RCC). Abdominal computed tomography revealed a 5.2 × 5.2 × 5.1 cm mass on the right upper part of the kidney with a possible thrombus in the …

Ecotheology In Context: A Critical Phenomenological Study Of Graduates Of Environmentally Focused Seminary Programs In The United States Of America, Cherice Bock

Antioch University Dissertations & Theses

In recent decades, the field of ecotheology has emerged in dialogue with the context of the interconnected environmental and climate crises, particularly relating to the critique of Christianity being used to justify human and resource exploitation. A range of disciplines within the religious academy have taken up these intersecting concerns, together termed “ecologically informed theological education.” Graduate institutions training faith leaders and theological educators have created degree programs and certifications, and/or incorporated awareness of ecology, sustainability, and care for creation into their curricula. A research approach for ecotheology is described through the conceptual framework of critical ecotheology, which acknowledges ecotheology …

America's Duty To Protect Post-Trump V. Hawaii: A Call For Updated Federal Legislation To Save Animus Doctrine And Prevent Executive Discrimination In Immigration Decisions, Nicholas Fiorino

Journal of International Business and Law

No abstract provided.

Unraveling The Falkland Dispute: Is The Sea Lion Oil Field The Key To A Compromise That Would Establish The Falkland Islands' Uncontested Sovereignty, Eden Kataev

Journal of International Business and Law

No abstract provided.

Transformasi Dan Marginalisasi Masyarakat Adat: Suku Ata Modo Di Tengah Hegemoni Pengembangan Pariwisata Taman Nasional Komodo (Transformation And Marginalization Of Indigenous Communities: The Ata Modo Tribe's Experience Amidst The Hegemony Of Komodo National Park Tourism Development), Arif Putra Pratama, Avicenna Elang Chandra, Noor Risa Isnanto, An Nuur Khairune Nisa

The Indonesian Journal of Socio-Legal Studies

The massive development of tourism in Komodo National Park (KNP) has had a signi;icant impact on the local community there, in this case the Ata Modo Tribe. This tribe is a local tribe that has remained silent for a long time and was formed on Komodo Island long before the Komodo National Park was established. They have also lived side by side with the endangered Komodo dragon for decades and tried to maintain their culture and customs amidst the existence of KNP tourism development. This research tries to answer what cultural potential is still maintained by the Ata Modo Tribe, …

Perbandingan Pengaturan Kuota Pemilihan Perempuan Dan Kondisi Keterwakilan Perempuan Di Parlemen: Studi Kasus Indonesia, Timor-Leste, Dan Finlandia (A Comparison Study Of The Quotas And Conditions For Women's Representation In Parliament In Indonesia, Timor-Leste, And Finland), Ramadhanya Elwinne Huzaima Sibarani

The Indonesian Journal of Socio-Legal Studies

Women’s representation in parliament is an important aspect of improving gender equality in a country. As of the 2019 parliamentary elections, women’s representation in the Parliament of the Republic of Indonesia (DPR RI) has only reached 21.4%. This figure is far below Timor-Leste and Finland, which respectively have 40% and 47% women’s representation. To increase the number of women’s representation in parliament, there is a concept called women's electoral quota. This study attempts to compare how women’s electoral quotas are regulated in Indonesia, Timor-Leste, and Finland. In addition, this study also reviews the condition of women’s representation in the parliaments …

Tunisian Democracy At A Crossroads: A Comparative Analysis Of Beji Caid Essebsi And Kais Saied Regimes, Nizar Lukman

Jurnal Politik

As a new democracy, Tunisia is quite vulnerable to democratic erosion. The implementation of democracy in the country was quite effective during the leadership of Beji Caid Essebsi, resulting in a high democracy index driven by various policies that supported the implementation of this system. However, Tunisia’s quality of democracy significantly declined since President Kais Saied took power in 2019. The dissolution of Parliament, the prime minister's dismissal, the introduction of freedom of expression for council members, and unilateral electoral reforms aimed at consolidating his power are some cases of proof. This pattern raises questions about the recurring nature of …

Pakistan's Dependence On China For The Second Phase Of Cpec Cooperation In 2020-2021, Agnes Deandra Bangkur

Jurnal Politik

The China-Pakistan Economic Corridor (CPEC), an important component of China's Belt and Road Initiative (BRI), has been a landmark project since its inception in 2015. The project aims to develop a modern Silk Road that increases China's economic reach by capitalizing on Pakistan's strategic geographic position. However, this cooperation has raised concerns about Pakistan's growing dependence on China, posing a risk to the country's long-term stability. Artiel examines the implications of Pakistan's dependence on China within the framework of Dependency Theory, particularly in the continuation of the second phase of CPEC cooperation. By analyzing a wide range of literature and …

Feminist Policy Analysis On Gender Mainstreaming Policy In Indonesian International Peacekeeping Forces, Zahra Ayu Kusuma Ricarvy, Sri Lestari Wahyuningroem

Jurnal Politik

This study analyzes the implementation of gender mainstreaming policies within the Garuda troops using the Feminist Policy Analysis (FPA) approach in the context of Indonesia's commitment to gender equality in peacekeeping operations. Gender mainstreaming policies are expected to ensure equal access, participation, control, and benefits for both women and men within the defense system, as well as minimize gender discrimination. The method used in this research involves policy analysis as regulated in Presidential Instruction No. 9/2000, with a focus on its application in Peacekeeping Missions (IPM). Data were collected through interviews with relevant officials from the Ministry of Defense and …

“Old Soldiers Need Only Apply”: Exploring Pathways To The Quasi-Civilianisation Of The Maritime Sector In Indonesia, I Gusti Bagus Dharma Agastia

Jurnal Politik

This article explores the phenomenon of quasi-civilianisation, or the inclusion of former or active-duty military officers in civilian administrative positions, in maritime security governance in Indonesia. To what extent is the maritime sector quasi-civilianised? Second, what are the pathways to quasi-civilianisation in the maritime sector? This paper finds that quasi-civilians tend to be concentrated in paramilitary agencies and to a lesser extent, in limited functional roles within the civilian administration. Quasi-civilians are desirable for these positions due to their expertise and ability to mediate between military and civilian counterparts. Moreover, the appointment of quasi-civilians has generally complied with prevailing regulations …

One Hundred Years Of The Communist Party Influencing The Islamic World, Muhammad Ridha

Jurnal Politik

The ideology of Communism has had a significant impact on Muslim-majority countries in the Middle East, North Africa, Central Asia and Southeast Asia. The emergence of Communist parties has triggered prolonged social and political tensions and changed the power dynamics in Muslim countries.

Against The Mainstreaming Of The Term Sex Work: Advocacy With India's Supreme Court, Pravin Patkar

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

Long-Term Follow-Up Of Acceptance-Enhanced Behavior Therapy For Trichotillomania, Kathryn E. Barber, Douglas W. Woods, Laura J. Ely, Stephen M. Saunders, Scott N. Compton, Angela Neal-Barnett, Martin E. Franklin, Matthew R. Capriotti, Christine A. Conelea, Michael P. Twohig

Psychology Faculty Publications

Acceptance-enhanced behavior therapy for trichotillomania (AEBT-TTM) is effective in reducing trichotillomania (TTM) symptoms, but the durability of treatment effects remains in question. This study analyzed 6-month follow-up data from a large randomized clinical trial comparing AEBT-TTM to an active psychoeducation and supportive therapy control (PST). Adults with TTM (N=85; 92% women) received 10 sessions of AEBT-TTM or PST across 12 weeks. Independent evaluators assessed participants at baseline, post-treatment, and 6 months follow-up. For both AEBT-TTM and PST, self-reported and evaluator-rated TTM symptom severity decreased from baseline to follow-up. TTM symptoms did not worsen from posttreatment to follow-up. At …

Everything Matters: Gordon Spykman - A Neo-Calvinist Theologian, Steve Bishop

Pro Rege

No abstract provided.

Investigating An Acceptance And Commitment Therapy-Based Exposure Therapy Intervention In Treatment-Refractory Ocd And Related Disorders: Changes In Psychological Flexibility, Treatment Engagement, And Treatment Perceptions, Nate G. Gruner, Jenifer M. Cullen, Jesse M. Crosby, Stephanie N. Decross, Brittany Mathes, Lauryn Garner, Christina Gironda, Yuanjun Hu, Jason W. Krompinger, Jason A. Elias, Michael P. Twohig

Psychology Faculty Publications

While exposure therapy is the most effective psychological treatment for obsessive-compulsive, anxiety, and traumatic stress-related disorders, it is not universally effective, indicating a need for further treatment optimization. This study investigated a shift in approach to exposure therapy with 29 treatment-refractory adults in an OCD clinic not responding to standard treatment, comprising habituation-based exposure therapy. Participants completed a standard exposure as continuation of standard clinic treatment, followed by an Acceptance and Commitment Therapy (ACT) consultation session to assess psychological inflexibility processes interfering with treatment progress, and then an ACT-based exposure targeting behavior change through increasing psychological flexibility. After each exposure, …