Background Ecological momentary assessment (EMA) tools appear to be useful interventions for collecting real-time data on patients’ behavior and functioning. However, concerns have been voiced regarding the acceptability of EMA among patients with schizophrenia and the factors influencing EMA acceptability. Objective The aim of this study was to investigate the acceptability of a passive smartphone-based EMA app, evidence-based behavior (eB2), among patients with schizophrenia spectrum disorders and the putative variables underlying their acceptance. Methods The participants in this study were from an ongoing randomized controlled trial (RCT) of metacognitive training, consisting of outpatients with schizophrenia spectrum disorders (F20-29 of 10th revision of the International Statistical Classification of Diseases and Related Health Problems), aged 18-64 years, none of whom received any financial compensation. Those who consented to installation of the eB2 app (users) were compared with those who did not (nonusers) in sociodemographic, clinical, premorbid adjustment, neurocognitive, psychopathological, insight, and metacognitive variables. A multivariable binary logistic regression tested the influence of the above (independent) variables on “being user versus nonuser” (acceptability), which was the main outcome measure. Results Out of the 77 RCT participants, 24 (31%) consented to installing eB2, which remained installed till the end of the study (median follow-up 14.50 weeks) in 14 participants (70%). Users were younger and had a higher education level, better premorbid adjustment, better executive function (according to the Trail Making Test), and higher cognitive insight levels (measured with the Beck Cognitive Insight Scale) than nonusers (univariate analyses) although only age (OR 0.93, 95% CI 0.86-0.99; P=.048) and early adolescence premorbid adjustment (OR 0.75, 95% CI 0.61-0.93; P=.01) survived the multivariable regression model, thus predicting eB2 acceptability. Conclusions Acceptability of a passive smartphone-based EMA app among participants with schizophrenia spectrum disorders in this RCT where no participant received financial compensation was, as expected, relatively low, and linked with being young and good premorbid adjustment. Further research should examine how to increase EMA acceptability in patients with schizophrenia spectrum disorders, in particular, older participants and those with poor premorbid adjustment. Trial Registration ClinicalTrials.gov NCT04104347; https://clinicaltrials.gov/ct2/show/NCT04104347
Reactions capable of transposing the oxidation levels of adjacent carbon atoms in organic molecules enable rapid and fundamental alteration of a molecule’s reactivity. Herein, we report the 1,2-transposition of carbon atom oxidation level in cyclic and acyclic tertiary amides, resulting in the one-pot synthesis of 1,2- and 1,3-oxygenated tertiary amines. This oxidation level transfer was facilitated by the careful orchestration of an iridium-catalyzed reduction with the functionalization of transiently-formed enamine intermediates. Remarkably, a novel 1,2-carbonyl transposition was observed when the commercial oxidant mCPBA was selected as the coupling partner. The scope of this transformation and the breadth of this redox transposition strategy has been explored and the diverse β-functionalized amine products were shown to be multi-faceted and valuable synthetic intermediates, accessing challenging biologically-relevant motifs.
BACKGROUND Ecological momentary assessment (EMA) tools collect real-time data on patients’ behaviour and functioning and may be useful interventions. However, concerns have been voiced regarding acceptability of EMA among patients with schizophrenia and what may underlie this remains poorly understood. OBJECTIVE To investigate acceptability of a passive smartphone-based EMA app, the Evidence-Based Behavior (eB2), among patients with schizophrenia spectrum disorders and putative variables underlying this. METHODS Participants came from an ongoing randomised controlled trial (RCT) of metacognitive training - outpatients with schizophrenia spectrum disorders (SSD) (F20-29-ICD10 codes), age 18-64 - none of whom received any financial compensation. Those who consented to installation of the eB2 app (users) were compared with those who did not (non-users) in sociodemographic, clinical, premorbid adjustment (Premorbid Adjustment Scale -PAS-), neurocognitive, psychopathological, insight and metacognitive variables. A multivariable binary logistic regression tested the influence of the above (independent) variables on ‘being user vs. non-user’ (acceptability), which was the main outcome measure. RESULTS Out of N=77 RCT participants, n=24 subjects (31%) consented to eB2, which remained installed at the end of the study (median follow-up=14.50 weeks) in n=14 subjects (70%). Users were younger and had a high education level, better premorbid adjustment, better executive function (according to the Trail Making Test) and higher cognitive insight levels (measured with the Beck Cognitive Insight Scale) than non-users (univariate analyses), although only age (OR 0.93, 95% CI 0.86-0.99; P=.048) and early adolescence PAS (OR 0.75, 95% CI 0.61-0.93; P=.010) survived the multivariable regression model, thus predicting eB2 acceptability. CONCLUSIONS Acceptability of a passive smartphone-based EMA app among SSD participants in this RCT where no participant received financial compensation was, as expected, relatively low, and linked with being young and good premorbid adjustment. Further research should examine how to increase EMA acceptability to SSD patients, particularly older participants and those with poor premorbid adjustment. CLINICALTRIAL This stusy is part of a randmised controlled trial which has been registered at ClinicalTrials.gov (NCT04104347) since the 26/09/2019. URL of registry https://clinicaltrials.gov/ct2/show/NCT04104347
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