Significant Reduction In Fear Research Articles

The Effects of Exergaming on Fear of Falling and the Balance Function in Anxious and Non-Anxious Older Adults: A Pilot Study

ABSTRACT Background Anxiety can exacerbate fear of falling and balance issues, potentially affecting intervention efficacy. This study examines exergaming’s impact on fear of falling and balance in anxious and non-anxious older adults. Materials and Methods Twenty older adults (10 anxious, 10 non-anxious) participated in six weeks of balance-oriented gaming. Fear of falling was assessed using the Falls Efficacy Scale and the Activities-specific Balance Confidence Scale. Balance was measured with the Berg Balance Scale and the Timed Up and Go Test before, after, and six weeks post-intervention. Results Both groups showed significant improvements in balance and mobility, sustained during follow-up. However, only the non-anxious group exhibited significant reductions in fear of falling and increased balance confidence. Anxiety was linked to reduced enjoyment, lower efficacy perception, and heightened tension during the intervention. Conclusion Exergaming improves balance and reduces fear of falling in non-anxious older adults. Anxiety may diminish these benefits. Clinical implications Assessing anxiety levels is crucial when prescribing exergaming interventions. Tailoring treatments to address anxiety could enhance outcomes.

Synchronization of a Virtual Reality Scenario to Uterine Contractions for Labor Pain Management: Development Study and Randomized Controlled Trial.

Background: Labor is described as one of the most painful events women can experience through their lives, and labor pain shows unique features and rhythmic fluctuations. Purpose: The present study aims to evaluate virtual reality (VR) analgesic interventions for active labor with biofeedback-based VR technologies synchronized to uterine activity. Materials and Methods: We developed a VR system modeled on uterine contractions by connecting it to cardiotocographic equipment. We conducted a randomized controlled trial on a sample of 74 cases and 80 controls during active labor. Results: Results of the study showed a significant reduction of pain scores compared with both preintervention scores and to control group scores; a significant reduction of anxiety levels both compared with preintervention assessment and to control group and significant reduction in fear of labor experience compared with controls. Conclusion: VR may be considered as an effective nonpharmacological analgesic technique for the treatment of pain and anxiety and fear of childbirth experience during labor. The developed system could improve personalization of care, modulating the multisensory stimulation tailored to labor progression. Further studies are needed to compare the synchronized VR system to uterine activity and unsynchronized VR interventions.

The impact environmental variance in waiting rooms has on the expression of fear in canine patients

Canine patients commonly express fear-related behaviour while in practice. Prior research predominately focuses on the efficacy of interventions, such as dog appeasing pheromone, often without consideration for surroundings. This study aimed to identify and evaluate the influence environmental factors in the waiting room may have on the expression of fear-related behaviours in canine patients visiting a veterinary practice. Convenience sampling was used to test a canine sample population of 54 dogs (aged 1–10 years old) across 5 different practices. Patient behaviour was observed pre- and post-consultation during the period of time patients were in the waiting room. Analysis of these data demonstrated a significant reduction in fear during the post-consultation phase (Z=-3.821, P<0.001). Environmental aspects of each practice were scored and analysed against behavioural data, demonstrating weak negative correlation (rs=-0.27, P=0.050) between environmental scores and pre-consultation behaviour scores. A weak positive correlation (rs=0.28, P=0.035) between slippery flooring and increased fear was also found. Negative aspects of the environment such as flooring, noise and footfall should be considered and manipulated where possible to promote positive patient experiences. Further research should use a stratified sampling method to ensure variance between patients and practice designs. This research has provided proof of concept for this methodology and field of enquiry, providing scope for further research of this kind on a larger sample population of practices and patients.

An online contextual schema therapy workshop for social anxiety symptoms – A randomized controlled trial

Given the high prevalence of social anxiety, developing accessible psychological interventions for this condition becomes a priority. Self-criticism and experiential avoidance have been established as two transdiagnostic mechanisms involved in social anxiety. Contextual Schema Therapy (Cst; roediger, stevens, & brockman, 2018) is a novel psychological treatment addressing these two mechanisms by conceptualizing them as two distinct patterns of schema activation (modes). We therefore aimed to test the efficacy of a brief (single session) CST intervention, delivered in an online group format, for individuals with social anxiety symptoms. We also examined experiential avoidance as a potential mechanism of change. 112 participants with social anxiety symptoms above cut-off were randomized to either the CST group intervention or a waitlist control group. The Brief Fear of Negative Evaluation Scale – Second Version (BFNE-II) and the Acceptance and Action Questionnaire – Second Version (AAQ-2) were filled in by participants at baseline, immediately after the intervention and at a two-week follow-up. The CST intervention comprised psychoeducation, a conceptualization of social anxiety in schema and mode terms, reflection exercises, chairwork and imagery techniques. At follow-up, significant reductions in fear of negative evaluation and experiential avoidance were found in the CST group. Experiential avoidance was a marginally significant mediator of the changes in fear of negative evaluation from pre-test to follow-up. The results support the potential large-scale usefulness of brief online CST interventions with socially anxious individuals.

Follow Friends One Hour a Day: Limiting Time on Social Media and Muting Strangers Improves Well-Being

Introduction: Social media use is ubiquitous among young adults, and empirical research is increasingly suggesting that how it is used and how much time is spent using it have significant implications for psychological well-being and mental health. Most recent studies find that limiting but not eliminating social media has beneficial effects. Correlational findings suggest that following actual friends is beneficial, while following strangers can be harmful. Method: This study sought to test the impact of limiting time spent on social media as well as “muting” strangers on Instagram and eliminating TikTok use in an experimental paradigm. Results: Replicating prior studies, we found that limiting social media use to 60 minutes per day (versus unlimited use) led to reductions in depression, F(1,96) = 5.84, p = .018, for the most depressed participants. Moreover, limiting stranger content (by muting strangers on Instagram and eliminating TikTok use), in addition to limiting time, led to significant reductions in fear of missing out, F(2,138) = 4.806, p = .01, for the most depressed participants and to significant reductions in social comparison, F(2,138) = 4.367, p = .015. Discussion: In conclusion, it is not just how much time one spends on social media that matters to well-being, but how one uses that time and who one is interacting with.

The Impact of Virtual Reality Exposure on Stress Level and Sense of Competence in Ambulance Workers.

Virtual reality (VR) exposure is used in clinical psychology to treat anxiety disorders. It is also used to enhance resilience in soldiers by allowing them to confront virtual combat environments to help fortify them against the negative consequences of trauma exposure. Most VR studies have focused on military and emergency medical staff; however, thus far, none have investigated VR in ambulance workers (AWs), who are confronted with traumatic situations daily. The current study aimed to assess the impact of a single VR exposure session on self-perceived competence and stress level in a sample of AWs. Participants (N = 40) were randomly assigned to either a VR immersion (i.e., experimental group, n = 20) or an audio immersion (i.e., control group, n = 20) of a shooting attack situation. We hypothesized that compared to controls, VR participants would report decreased anxiety, as measured using visual analog scales, as well as an increased sense of competence. The results showed a significant reduction in fear in both groups, d = 0.33, and an increased sense of competence in VR participants, d = 0.35. Although our hypotheses were only partially confirmed, the observed beneficial effects of VR and the audio immersion on stress levels in AWs suggest that VR exposure could be a useful way to increase resilience in AWs.

Rescripting Social Trauma: A Pilot Study Investigating Imagery Rescripting as an Adjunct to Cognitive Behaviour Therapy for Social Anxiety Disorder

The current pilot study aimed to investigate the benefit of imagery rescripting (IR) as an adjunct to Group Cognitive Behavioural Therapy (GCBT) for SAD, given recent research suggesting that IR is beneficial in the treatment of social anxiety disorder (SAD). Fifteen participants with SAD completed eight sessions of GCBT and two additional individual sessions of IR to address negative meanings embedded in memories of traumatic social experiences. As expected, participants reported significant reductions in fear of negative evaluation and identification of negative core beliefs as valid/accurate over the course of the two session IR intervention. Moreover, IR yielded significant improvements in negative affect and maladaptive appraisals associated with self-imagery and aversive memories, as well as depressive symptoms. However, unexpectedly, IR did not yield significant additive reductions in social anxiety symptoms over and above GCBT. Results indicate that IR appears to be a beneficial adjunct to GCBT, and lack of improvement in social anxiety symptoms across IR sessions may be due to methodological limitations. Outcomes suggest that IR may also benefit patients with comorbid depression, given high rates of comorbid unipolar depression for people with SAD, presenting an exciting area for further investigation. Taken together, findings suggest that IR may be a valuable adjunct to GCBT for SAD, especially among patients with comorbid unipolar depression. However, further research including a follow up period is indicated.

Effects of a Poetry Intervention on Emotional Wellbeing in Hospitalized Pediatric Patients.

The hospital is often a challenging and unfamiliar environment for families. Hospitalization can increase stress and anxiety among children and caregivers. In this study, we are the first to explore the possible therapeutic effects of poetry on hospitalized pediatric patients' emotional wellbeing. Patients aged 8 to 17 years old admitted to the inpatient pediatric ward and their parents or guardians were eligible for inclusion. With the validated Pediatric Quality of Life Present Functioning Visual Analogue Scales, 6 items were measured before and after the poetry intervention for each participant: fear, sadness, anger, worry, fatigue, and pain in the present moment. The intervention itself consisted of poetry-based reading and writing exercises. Participants and parents also completed an open-ended qualitative survey on their experience. Data from 44 participants were analyzed. Using the Wilcoxon signed rank test, we showed that the poetry intervention had a statistically significant reduction in 5 of the 6 Pediatric Quality of Life Present Functioning Visual Analogue Scales symptom measures: fear (P = .021), sadness (P = .004), anger (P = .039), worry (P = .041), and fatigue (P < .001). Reduction in pain was not statistically significant (P = .092). Six coded themes emerged from qualitative analysis: the poetry intervention facilitated (1) happiness and (2) family involvement, was viewed as a (3) good distraction and (4) screenless activity, and cultivated (5) creativity and (6) self-reflection. The poetry intervention led to statistically significant reductions in fear, sadness, anger, worry, and fatigue but not in pain. The study reveals promising results and serves as a starting point for future investigations on the therapeutic impact of poetry on hospitalized pediatric patients.

Effectiveness of a Snoezelen Room on Fear, Anxiety, and Satisfaction of Nulliparous Women: A Randomized Controlled Trial

Background: Pregnancy and childbirth are natural phenomena in a women’s life, associated with stress and anxiety, leading to adverse effects in the mother and fetus. Using complementary medicine, such as aromatherapy, music, light radiation, and aquariums in an environment that engage a person’s multiple senses can make mothers relax through mental deviations. Objectives: The aim of this study was to evaluate the effects of a Snoezelen room on fear, anxiety, and satisfaction of childbirth’s nulliparous women. Methods: This randomized clinical trial was carried out on 130 eligible women in a selected hospital affiliated to the Iran University of Medical Sciences in Tehran. One hundred thirty women were randomly assigned to the intervention (n = 65) and control (n = 65) groups using six modes blocks using the convenient sampling method. The delivery room was designed to distract women’s minds in the intervention group. Data were collected using a demographic characteristics form, Harman’s Childbirth Attitude questionnaire (CAQ), Visual Analogue scale (VAS) to measure childbirth anxiety, and the Mackey Childbirth Satisfaction Rating scale. Data were analyzed by SPSS version 16 using independent t-test, repeated measures analysis of variance, and Bonferroni and chi-square tests. Results: The results showed a significant reduction in fear in the active phase and postpartum in the intervention group compared with the control group (P &lt; 0.001 and P &lt; 0.001, respectively). Anxiety showed a significant difference and was lower at dilatation of 6 to 7 and 7 to 8 cm, and after childbirth in the interventional group. The satisfaction of childbirth significantly increased in the interventional group (P &lt; 0.001). Conclusions: These results confirmed the importance of a Snoezelen room in the childbirth of nulliparous women, which can promote vaginal childbirth.

Fear of Movement Is Related to Low Back Disability During a Two-Year Period in Patients Who Have Undergone Elective Lumbar Spine Surgery

To evaluate change in fear of movement and the relationship of fear of movement and pain intensity to low back disability and general health-related quality of life over a 2-year period. Consecutive patients scheduled for lumbar spine surgery were included. In addition to clinical background variables, back pain intensity, fear of movement, low back disability, and general health-related quality of life were assessed at baseline, 1 year, and 2 years after surgery. Linear mixed-effects models were used to analyze data. In total, 348 patients were included in the final analyses. There was a significant reduction in fear of movement and a significant interaction between fear of movement and low back disability across assessments, showing that greater levels of fear of movement were related to greater levels of disability over the 2-year period. Similarly, greater levels of back pain intensity were related to lower levels of general health-related quality of life during this period. We found that greater levels of fear of movement were related to greater levels of low back disability, following lumbar spine surgery, in a longitudinal study. This shows the need to address fear of movement in prehabilitation/rehabilitation pre- or postsurgically to improve health outcomes for patients who undergo lumbar spine surgery.

A Randomized Controlled Trial on the Use of Virtual Reality for Needle-Related Procedures in Children and Adolescents in the Emergency Department.

Objective: A large number of children report fear and distress when undergoing blood work and intravenous placement. In pediatric departments, Child Life interventions are considered to be the gold standard in nonmedical pain management techniques. Virtual reality (VR) has also been identified as an effective tool for pain distraction in children undergoing painful medical procedures. The aim of this study was to document the efficacy of VR as a mode of distraction during a medical procedure compared with two comparison conditions: watching television (TV, minimal control condition) and distraction provided by the Child Life (CL, gold standard control condition) program. Materials and Methods: A total of 59 children aged 8-17 years (35% female) were recruited through the emergency department (ED) of the Children's Hospital of Eastern Ontario and randomly assigned to one of the three conditions. The key outcome measures were visual analog scale ratings of pain intensity and fear of pain, administrated before and right after the procedure. Patient satisfaction was also measured after the intervention. Results: A significant reduction in fear of pain and pain intensity was reported in all three conditions. A larger and statistically significant reduction in fear of pain was observed among children who used VR distraction compared with the CL and TV conditions, but this effect was not observed for pain intensity. The children's satisfaction with the VR procedure was significantly higher than for TV and comparable to CL. Discussion: The advantages of using VR in the ED to manage pain in children are discussed.

A preliminary test of the therapeutic potential of written exposure with rescripting for generalized anxiety disorder

This experiment tested a novel written exposure intervention for generalized anxiety disorder (GAD) that consisted of guided rescripting of participants’ worst fear. After describing their worst fear, adults with GAD ( N = 79) were randomly assigned to one of three writing interventions, each consisting of three sessions on consecutive days: (1) standard written exposure (WE), (2) written exposure with rescripting (RWE), and (3) neutral control writing (NC). Measures of symptoms and worry-associated processes were administered at pre- and post-intervention, and at 1-week and 1-month follow-ups. Worry declined significantly in all three conditions. Participants in WE reported significant reductions in fear of anxiety, whereas those in RWE reported significant reductions in fear of anger. Participants in RWE and NC reported a significant decrease in fear of positive emotion. Following RWE, participants perceived their feared scenario as less costly and perceived themselves as better able to cope with it, whereas participants in the WE and NC did not show these changes. Cognitive avoidance, intolerance of uncertainty, and negative problem orientation did not change. Findings suggest overall, RWE was not superior to WE, and that more research is needed to assess their therapeutic potential. Strengths and limitations are discussed for the benefit of future research on exposure for GAD.

Tai Chi Chuan can improve balance and reduce fear of falling in community dwelling older adults: a randomized control trial.

Fear of falling and balance impairment are prevalent in older adults and cause major morbidities for this population. The aim of this study was to evaluate the effect of Tai Chi Chuan on balance and fear of falling in community-dwelling older adults. This study was a single-blind randomized control trial. Sixty older adults were randomly allocated into two groups using a 4-cell random block design. The participants of intervention group were trained in Tai Chi Chuan for eight weeks, twice a week, and 55 min in each session. Balance and fear of falling were assessed by Timed Up and Go (TUG) test, Tinetti test and Falls Efficacy Scale International in baseline and after 8 weeks. After eight weeks of intervention, the mean scores of the TUG and Tinetti scales in the intervention group were improved significantly compared to the baseline and the control group (P<0.001). Moreover, the intervention group showed a significant reduction in fear of falling scores (P<0.001), while those in the control group remained unchanged. Tai Chi Chuan effectively improves the balance and fear of falling and could be considered as a practical and useful method for fall prevention in community-dwelling older adults.

Soap bubbles as a distraction technique in the management of pain, anxiety, and fear in children at the paediatric emergency room: A pilot study.

Hospitals can cause anxiety, pain, and fear in children perceiving medical procedures as intrusive and painful. Among the nonpharmacological strategies, distraction techniques have proved to be effective in the management of pain and distress. The aim of the present study is to assess the effectiveness of soap bubbles as a distraction technique for the management of anxiety, fear, and pain in children waiting for a medical examination at the paediatric emergency room. We employed a parallel trial design with a sample consisting of 74 children (M=9.30; SD=1.10; 50% female) randomly assigned to either a control or experimental group. The children in the experimental group underwent the soap bubble protocol while waiting for a medical examination at the paediatric emergency room. Anxiety, fear, and pain were assessed by self-report administered to the children before the triage and the application of the soap bubbles (baseline), after the application of the soap bubbles (T1), and after the medical examination (T2). The children in the experimental group showed a significant reduction of perceived pain while waiting for the medical examination (T1), whereas no difference was found after the medical examination (T2). Furthermore, the children in the experimental group showed a significant reduction in fear (T1 and T2), whereas no difference was found in the anxiety scores measured by the Child Anxiety. The use of soap bubbles is a good distraction technique in the reduction of fear and the perception of pain in children awaiting a medical examination at the paediatric emergency room.

Cognitive Behavioral Therapy for Insomnia Reduces Fear of Sleep in Individuals With Posttraumatic Stress Disorder.

Our study aims were to examine (1) the association between fear of sleep and posttraumatic stress disorder (PTSD) symptoms, (2) the association between fear of sleep and subjective and objective insomnia symptoms and disruptive behaviors during sleep, and (3) whether fear of sleep decreases following cognitive behavioral therapy for insomnia (CBT-I). Forty-five adults with PTSD and insomnia participated in the study. Fear of sleep was assessed using the Fear of Sleep Inventory; PTSD symptoms were assessed using the Clinician Administered PTSD Scale; and sleep disturbance symptoms were assessed using the Insomnia Severity Index, polysomnography, sleep diaries, and the Pittsburgh Sleep Quality Index Addendum for PTSD. Participants were randomly assigned to 8 weeks of CBT-I (n = 29) or a waitlist control condition (n = 16). Greater fear of sleep was associated with greater PTSD symptom severity, greater nightmare frequency, and greater hypervigilance intensity. Greater fear of sleep was associated with decreased wake after sleep onset (WASO), reduced total sleep time, and greater disruptive nocturnal behaviors. Following CBT-I, there was a significant reduction in fear of sleep compared to the waitlist condition. These improvements persisted 6 months later. Fear of sleep was related to sleep disturbances specific to trauma rather than "classic" insomnia symptoms. Unexpectedly, greater fear of sleep was associated with reduced WASO. These results may be related to having a truncated sleep period and thus more consolidated sleep. Fear of sleep deceased following CBT-I despite not being a permissible target for this research protocol and not being related to insomnia symptoms. Registry: CinicalTrials.gov; Name: Treating People with Post-traumatic Stress Disorder with Cognitive Behavioral Therapy for Insomnia; Identifier: NCT00881647; URL: https://clinicaltrials.gov/ct2/show/NCT00881647.

Effect of decipher test on adjuvant treatment decision-making among men with high-risk pathology at radical prostatectomy: Results from a multicenter prospective PRO-IMPACT study.

24 Background: The decision to provide adjuvant therapy to men with high risk pathology after radical prostatectomy (RP) is confounded by tremendous uncertainty. We prospectively evaluated the impact of the Decipher test, which predicts metastases after RP, on men and providers decision quality. Methods: 150 adjuvant pts were enrolled by 43 urologists from 19 practices. Pts with pathologic T3 stage or positive surgical margins (SM+) after RP were included. Participating physicians provided a treatment (Tx) recommendation before and after exposure to Decipher test results. Pts completed validated surveys on health-related quality of life, decisional conflict, and PCa-related anxiety. Results: Median patient age at RP was 64 years; 67% and 50% had pT3 and SM+ pathology, respectively. Decipher classified 46%, 22% and 32% of men as low-, intermediate- and high-risk, respectively. Pre-Decipher, observation was recommended for 89%. Post-Decipher, 18% (95% CI 12-25%) of Tx recommendations changed. Men’s Decisional Conflict Scale (DCS) scores decreased (indicating higher decision quality) after exposure to Decipher results (median DCS pre-Decipher 25 [IQR 8-44], median DCS post-Decipher 19 [IQR 2-30], p&lt;0.001), with greatest decreases in the subdomains of decision uncertainty and decision support. Low-risk Decipher results experienced a trend toward decreased PCa-specific anxiety (p=0.13) and a significant reduction in fear of PCa recurrence (p=0.02). Physicians’ median DCS scores decreased from 32 [IQR 28-36] to 28 [IQR 12-42] (p&lt;0.001). Decipher results were associated with the decision to pursue ART in an MVA analysis (OR 1.48; 95% CI 1.19-1.85, p&lt;0.001). Conclusions: Observation is the predominantly prescribed management strategy for men with high risk features at RP. Knowledge of Decipher results was associated with Tx decision-making: men at low risk for metastasis had higher rates of observation recommendations and men at high risk had higher rates of ART recommendations. Decision quality was improved and PCa-specific anxiety was decreased for men exposed to Decipher results. Clinical trial information: NCT02080689.

Comparison between Tai Chi and Balance-Strength Training Exercise to Decrease Fear of Fall and Improving Balance and Functional Mobility in Elderly

Background of the study: Falls in older people are a common and important problem that can have devastating consequences for individuals and their support networks. The purpose of this trial is to compare the effect of two types of exercise, Tai Chi versus Balance and strength training (BS Training) to reduce fear of fall and to improve balance and functional mobility in elderly. Method: It was a two-group, single-blind, randomized clinical trial in subjects, and aged 60-80 years old. They were divided in 2 equal groups; Group A was Tai Chi group and Group B was B.S. training group. Exercises were given for both the groups 5 days in a week for 8 weeks, Study outcome include fear of fall (Fall Efficacy Scale- FES), Balance (Berg Balance Scale -BBS) and Function Mobility (Timed up and go test -TUG). Result: There were significant reduction in fear of fall and improvement in balance & functional Mobility in both the groups after 8 weeks of intervention. Tai Chi group had better effect as compare to the Balance-Strength training group in reducing fear of fall & improving Functional Mobility. Conclusion: This study demonstrate that Tai Chi have better beneficial effects in reducing fear of fall and improving balance & functional mobility as compared to Balance-Strength training in elderly after 8 weeks of intervention.

Immediate Extinction Attenuates Spontaneous Recovery and Reinstatement in a Passive Avoidance Paradigm.

Recent research suggests that extinction occurring shortly after fear conditioning attenuates spontaneous recovery and reinstatement of fear. Two experiments investigated whether immediate extinction would prevent spontaneous recovery and reinstatement of fear using a passive avoidance paradigm. In Experiment 1, naive female adult rats (N = 40) received extinction training either immediately or 24 hours (delayed) after fear conditioning. Both extinction groups showed a significant reduction in fear at a 1-day test. At a 15-day test, spontaneous recovery was observed in the delayed extinction group while the immediate extinction group continued to show significant extinction. In Experiment 2, using a naive group of adult female rats (N = 16), the extinction result was replicated in both the immediate and delayed extinction groups at the 1-day interval. Reinstatement of fear, elicited by foot-shock in a neutral environment, was observed for the delayed group but not for the immediate group. By utilizing the passive-avoidance paradigm, these experiments replicate and extend previous findings that immediate extinction attenuates spontaneous recovery and reinstatement of fear.

Reducing the pain of intramuscular benzathine penicillin injections in the rheumatic fever population of Counties Manukau District Health Board

To evaluate the effectiveness of lignocaine and a vibrating device with cold pack (Buzzy) for pain management of intramuscular (IM) benzathine penicillin injections in the rheumatic fever (RF) population of Counties Manukau District Health Board (CMDHB). Four hundred and five RF patients receiving four weekly injections in the CMDHB region were offered 0.25 mL of lignocaine 2% and Buzzy for pain management of their injections. The lignocaine was mixed in with the benzathine penicillin prior to administration. A pre and post survey assessed pain scores during, 2-min and 1-h post administration and the following day. Questions assessing fear were also included. In total 49% of patients responded to the survey. There were 118 surveys paired pre and post intervention. Pain at injection delivery and fear scores were higher for participants ≤13 years of age. Overall pain scores were significantly reduced over all four time points. There was also a significant reduction in fear of the injections. Lignocaine and Buzzy resulted in a greater reduction in pain than lignocaine alone, only when the injection was being administered to those ≤13 years. After five months, a file audit showed that 66% of all RF patients of CMDHB were choosing to use lignocaine and 43% were choosing to use Buzzy. In total, 71% of all RF patients were choosing one or both of these analgesic interventions. This study demonstrates a clinically important reduction in the subjective experience of pain when two analgesic interventions were offered with IM delivery of benzathine penicillin. These pain reduction strategies have been popular in the RF population of CMDHB with a 71% uptake and a corresponding reduction in pain and fear.

Child′s dental fear: Cause related factors and the influence of audiovisual modeling

Delivery of effective dental treatment to a child patient requires thorough knowledge to recognize dental fear and its management by the application of behavioral management techniques. Children's Fear Survey Schedule - Dental Subscale (CFSS-DS) helps in identification of specific stimuli which provoke fear in children with regard to dental situation. Audiovisual modeling can be successfully used in pediatric dental practice. To assess the degree of fear provoked by various stimuli in the dental office and to evaluate the effect of audiovisual modeling on dental fear of children using CFSS-DS. Ninety children were divided equally into experimental (group I) and control (group II) groups and were assessed in two visits for their degree of fear and the effect of audiovisual modeling, with the help of CFSS-DS. The most fear-provoking stimulus for children was injection and the least was to open the mouth and having somebody look at them. There was no statistically significant difference in the overall mean CFSS-DS scores between the two groups during the initial session (P > 0.05). However, in the final session, a statistically significant difference was observed in the overall mean fear scores between the groups (P < 0.01). Significant improvement was seen in group I, while no significant change was noted in case of group II. Audiovisual modeling resulted in a significant reduction of overall fear as well as specific fear in relation to most of the items. A significant reduction of fear toward dentists, doctors in general, injections, being looked at, the sight, sounds, and act of the dentist drilling, and having the nurse clean their teeth was observed.