title: Behavioural interventions delivered to people in rural areas via telehealth: A narrative systematic review of studies from the last 12 years

authors: Gustilo, Jovani

subjects: Behaviour

abstract: People who live in rural areas have historically experienced a disparity when receiving behavioural health services. Specialty treatment providers are often located in cities and require people who need help to travel great distances. The recent advent of COVID 19 has highlighted this issue but has also pushed forward the necessity of developing alternative means of service delivery which can be beneficial for people in rural areas. One such alternative is telehealth, which utilises telecommunications technologies in place of traditional media. Clients could receive much needed treatment via synchronous telehealth using videoconferencing technology, asynchronous telehealth, which could be an effective consultation tool, patient monitoring with the help of fitness trackers or diaries and mobile health which makes use of applications on mobile devices. This review seeks to answer the following questions: A.) What behavioural interventions are currently being adapted to be delivered via telehealth to people in rural areas? B.) What types and methods of telehealth delivery is most used? C.) How effectively are these interventions being applied? D.) What elements make them effective? E.) What are the challenges of delivering ABA interventions via telehealth technologies to rural areas? F.) What solutions have the studies presented to overcome these challenges?

Methodology
Five databases were searched using multiple keywords optimised to find studies that are most relevant to the research questions. The studies needed to have been conducted in rural areas, implemented behavioural interventions, delivered via telehealth and should have been conducted in the last ten years.

Results
The behavioural interventions that the researchers trialled in the qualifying studies were Cognitive Behavioural Therapy and Behavioural strategies such as contingency management, shaping, prompting, and fading. The most common type of telehealth used was hybrid telehealth which is a combination of two or more types, followed by asynchronous telehealth and synchronous telehealth. An element that may have contributed to success was the level of therapist involvement in the treatment and the immediacy of feedback. The interventions were also found to be cost effective and highly acceptable by the participants. The researchers reported having encountered technical difficulties, limited availability and knowledge on equipment, internet inconsistencies, constant distractions due to uncontrolled settings and reduced participant adherence in the absence of therapist involvement. Some of the solutions suggested included providing a nearby centralised venue with good internet and equipment access, utilising more easily accessible technologies such as mobile phones, setting up a specific area in the home for treatment, and increasing therapist involvement in care.

Conclusion
Although only few studies met the inclusion criteria, this review was able to determine that behavioural interventions can be delivered effectively to people in rural areas and be highly acceptable by the target population despite existing limitations.

text: Behavioural interventions delivered to people in rural areas via telehealth: A narrative systematic review of studies from the last 12 years People who live in rural areas have historically experienced a disparity when receiving behavioural health services. Specialty treatment providers are often located in cities and require people who need help to travel great distances. The recent advent of COVID 19 has highlighted this issue but has also pushed forward the necessity of developing alternative means of service delivery which can be beneficial for people in rural areas. One such alternative is telehealth, which utilises telecommunications technologies in place of traditional media. Clients could receive much needed treatment via synchronous telehealth using videoconferencing technology, asynchronous telehealth, which could be an effective consultation tool, patient monitoring with the help of fitness trackers or diaries and mobile health which makes use of applications on mobile devices. This review seeks to answer the following questions: A.) What behavioural interventions are currently being adapted to be delivered via telehealth to people in rural areas? B.) What types and methods of telehealth delivery is most used? C.) How effectively are these interventions being applied? D.) What elements make them effective? E.) What are the challenges of delivering ABA interventions via telehealth technologies to rural areas? F.) What solutions have the studies presented to overcome these challenges?

Methodology
Five databases were searched using multiple keywords optimised to find studies that are most relevant to the research questions. The studies needed to have been conducted in rural areas, implemented behavioural interventions, delivered via telehealth and should have been conducted in the last ten years.

Results
The behavioural interventions that the researchers trialled in the qualifying studies were Cognitive Behavioural Therapy and Behavioural strategies such as contingency management, shaping, prompting, and fading. The most common type of telehealth used was hybrid telehealth which is a combination of two or more types, followed by asynchronous telehealth and synchronous telehealth. An element that may have contributed to success was the level of therapist involvement in the treatment and the immediacy of feedback. The interventions were also found to be cost effective and highly acceptable by the participants. The researchers reported having encountered technical difficulties, limited availability and knowledge on equipment, internet inconsistencies, constant distractions due to uncontrolled settings and reduced participant adherence in the absence of therapist involvement. Some of the solutions suggested included providing a nearby centralised venue with good internet and equipment access, utilising more easily accessible technologies such as mobile phones, setting up a specific area in the home for treatment, and increasing therapist involvement in care.

Conclusion
Although only few studies met the inclusion criteria, this review was able to determine that behavioural interventions can be delivered effectively to people in rural areas and be highly acceptable by the target population despite existing limitations.

year: 2023

title: Timing in Possums: Accounting for Resurgence in the Peak Procedure

authors: Stanley, Christopher D.

abstract: This study attempted to account for resurgence on the Peak Procedure using 6 possums (Trichosurus vulpecula) as subjects. The Peak Procedure is made up of randomly mixed fixed intervals (FI) and peak intervals (PI), with the ratio of FI trials to PI trials being 4:1 respectively. Conditions 1-4 were used to replicate Church et al.’s (1991) procedure from their second experiment. The authors found that when the PI trial length was variable, data from PI trials showed that responding did not resurge, as it did when the PI duration was fixed.  Condition 1 used a FI 20 s and a variable PI with a mean of 80 s. Responding did not resurge, but rather decreased to a low level throughout the PI trial. Condition 2 used a FI 20 and a fixed PI of 100 s. Responding resurged for this condition. Condition 3 and 4 repeated Condition 1 and 2 respectively to give an ABAB design. Responding again decreased and increased as the PI changed to being variable and fixed respectively. These results are similar to that found by Church et al. (1991), and show support for what Sanabria and Killeen (2007) call the anticipation theory (where escape from a non-reinforced PI trial is negatively reinforcing). The PI duration was shortened to twice the FI length in Condition 5 and lengthened to 300 s, or 15 times the FI in Condition 6. This was in order to investigate whether responding would resurge at very short and very long PI durations. Responding did not resurge at the shorter PI length, and this may be due to there not being enough time to do so. At the extreme length of 300 s, responding was seen to resurge; a result that is not consistent with other studies that used a similar procedure (Sanabria & Killeen, 2007). When the procedure returned to using a FI 20 s and a variable PI with a mean of 80 s in Condition 7, resurgence decreased to a minimum and remained stable till the end of the trial. 
Results from the present study support Church et al.’s (1991) anticipation theory, and that as long as the animals can track the end of the PI trial, responding will resurge; if it is variable, animals cannot predict the end of the trial and so response resurgence does not occur.

text: Timing in Possums: Accounting for Resurgence in the Peak Procedure This study attempted to account for resurgence on the Peak Procedure using 6 possums (Trichosurus vulpecula) as subjects. The Peak Procedure is made up of randomly mixed fixed intervals (FI) and peak intervals (PI), with the ratio of FI trials to PI trials being 4:1 respectively. Conditions 1-4 were used to replicate Church et al.’s (1991) procedure from their second experiment. The authors found that when the PI trial length was variable, data from PI trials showed that responding did not resurge, as it did when the PI duration was fixed.  Condition 1 used a FI 20 s and a variable PI with a mean of 80 s. Responding did not resurge, but rather decreased to a low level throughout the PI trial. Condition 2 used a FI 20 and a fixed PI of 100 s. Responding resurged for this condition. Condition 3 and 4 repeated Condition 1 and 2 respectively to give an ABAB design. Responding again decreased and increased as the PI changed to being variable and fixed respectively. These results are similar to that found by Church et al. (1991), and show support for what Sanabria and Killeen (2007) call the anticipation theory (where escape from a non-reinforced PI trial is negatively reinforcing). The PI duration was shortened to twice the FI length in Condition 5 and lengthened to 300 s, or 15 times the FI in Condition 6. This was in order to investigate whether responding would resurge at very short and very long PI durations. Responding did not resurge at the shorter PI length, and this may be due to there not being enough time to do so. At the extreme length of 300 s, responding was seen to resurge; a result that is not consistent with other studies that used a similar procedure (Sanabria & Killeen, 2007). When the procedure returned to using a FI 20 s and a variable PI with a mean of 80 s in Condition 7, resurgence decreased to a minimum and remained stable till the end of the trial. 
Results from the present study support Church et al.’s (1991) anticipation theory, and that as long as the animals can track the end of the PI trial, responding will resurge; if it is variable, animals cannot predict the end of the trial and so response resurgence does not occur.

year: 2013

title: An investigation into the commercial feasibility of Jasus edwardsii aquaculture in New Zealand

authors: Ruru, Ian Hector

subjects: New Zealand

abstract: In 1996 New Zealand introduced legislation to allow Jasus edwardsii pueruli to be collected as "seedstock" and ongrown in a commercial aquaculture trial. The aim of this thesis was to investigate the commercial feasibility of J. edwardsii aquaculture in New Zealand by working with an organisation involved in the trial.
The methodology involved a combination of experiments in the field, in laboratories, and within an ongrowing facility. This thesis examined five key areas and found the following:
1. Data obtained in the research indicates that New Zealand will continue to rely on harvesting pueruli from the wild since significant technical obstacles remain in the development of commercial scale pueruli hatcheries. Forecast data, obtained using the delphi technique and information about current research on larval rearing, indicates that commercial scale supply of pueruli from hatcheries may occur between 2017 and 2021.
2. Harvesting trials collected a low number of pueruli with the lowest unit cost for collection being $1.80. A greater collection rate could be achieved with a better understanding of seasonal and local settlement patterns.
3. Survival rates in pueruli transporting experiments were significantly affected by stocking density, time and temperature. The safest transit conditions were achieved with 15 pueruli per litre for less than 6 hours at 14°C.
4. A range of stocking densities, from 3 lobsters per tank to 12 per tank, were tested for their effect on growth of six-month old lobsters. The lobsters were reared in a total recirculation seawater system at a constant 16°C, and fed fresh mussels (Perna canaliculus). For the 121 day trial, no statistically significant effect was detected. However, there was a trend for growth rates to be highest at 3 and 6 lobsters per tank and for growth rates at stocking densities of 9 and 12 lobsters per tank to decrease after Day 50. Lobsters showed increased mortality at the highest stocking rate.
5. A bioeconomic model of a hypothetical farm was developed to assess economic benefits and risks and to determine overall profitability. The model showed an annual net cash position of $287,100 and cumulative cash position of $859,200 by the 10th year of operation based on annual sales of 10,837 kg at $65 per kg. The model indicates that the highest cost components in the first 10 years are processing and transport, and labour. Based on the model and the scenarios examined, profitability is very sensitive to factors such as the farm size, processing and transport costs, and sale price. Biological factors such as growth rates, survival, and feed requirements also influence overall profitability. Good returns will depend upon consistent exports of high quality lobsters.
The study concludes that commercial feasibility will be affected by these key areas. The potential of J. edwardsii aquaculture in New Zealand will continue to benefit from further research.

text: An investigation into the commercial feasibility of Jasus edwardsii aquaculture in New Zealand In 1996 New Zealand introduced legislation to allow Jasus edwardsii pueruli to be collected as "seedstock" and ongrown in a commercial aquaculture trial. The aim of this thesis was to investigate the commercial feasibility of J. edwardsii aquaculture in New Zealand by working with an organisation involved in the trial.
The methodology involved a combination of experiments in the field, in laboratories, and within an ongrowing facility. This thesis examined five key areas and found the following:
1. Data obtained in the research indicates that New Zealand will continue to rely on harvesting pueruli from the wild since significant technical obstacles remain in the development of commercial scale pueruli hatcheries. Forecast data, obtained using the delphi technique and information about current research on larval rearing, indicates that commercial scale supply of pueruli from hatcheries may occur between 2017 and 2021.
2. Harvesting trials collected a low number of pueruli with the lowest unit cost for collection being $1.80. A greater collection rate could be achieved with a better understanding of seasonal and local settlement patterns.
3. Survival rates in pueruli transporting experiments were significantly affected by stocking density, time and temperature. The safest transit conditions were achieved with 15 pueruli per litre for less than 6 hours at 14°C.
4. A range of stocking densities, from 3 lobsters per tank to 12 per tank, were tested for their effect on growth of six-month old lobsters. The lobsters were reared in a total recirculation seawater system at a constant 16°C, and fed fresh mussels (Perna canaliculus). For the 121 day trial, no statistically significant effect was detected. However, there was a trend for growth rates to be highest at 3 and 6 lobsters per tank and for growth rates at stocking densities of 9 and 12 lobsters per tank to decrease after Day 50. Lobsters showed increased mortality at the highest stocking rate.
5. A bioeconomic model of a hypothetical farm was developed to assess economic benefits and risks and to determine overall profitability. The model showed an annual net cash position of $287,100 and cumulative cash position of $859,200 by the 10th year of operation based on annual sales of 10,837 kg at $65 per kg. The model indicates that the highest cost components in the first 10 years are processing and transport, and labour. Based on the model and the scenarios examined, profitability is very sensitive to factors such as the farm size, processing and transport costs, and sale price. Biological factors such as growth rates, survival, and feed requirements also influence overall profitability. Good returns will depend upon consistent exports of high quality lobsters.
The study concludes that commercial feasibility will be affected by these key areas. The potential of J. edwardsii aquaculture in New Zealand will continue to benefit from further research.

year: 2000