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When fertilization in vitro was developed by the pioneers, Dr Robert G (Bob) Edwards, Miss Jean Purdy and Dr Patrick Steptoe, their primary focus was to obtain oocytes which could be successfully fertilized in laboratory conditions. Embryo culture and embryo selection were just secondary aims at that time. In the early 70s, the first attempts to obtain a pregnancy after IVF were in cycles in which ovarian stimulation was performed by administration of human menopausal gonadotropins (hMG) (Elder & Johnson, 2015).
Cognitive behavioural therapy (CBT) is an effective treatment for panic disorder with agoraphobia (PDA). However, implementation of some of the procedures involved, particularly in vivo exposure, can be time consuming and taxing for routine health care services. CBT with exposure taking place in virtual reality (VR-CBT) is a more time-efficient option and has shown promising results in the treatment of PDA. However, VR-CBT requires expensive equipment and appropriate virtual environments, which historically has been costly and cumbersome to produce. Thus, access to VR-CBT has been sparse in regular care environments.
Aims:
The aim of this study was to investigate whether VR-CBT using filmed virtual environments produced with a low-cost 360-degree film camera can be a feasible and acceptable treatment for PDA when implemented in a primary care context.
Method:
This was an open feasibility trial with a within-group design, with assessments conducted at pre-test, post-test, and 6-month follow-up. Participants (n = 12) received a 10–12 week treatment programme of VR-CBT and PDA-related symptoms were assessed by the primary outcome measure The Mobility Inventory for Agoraphobia (MIA) and the Panic-Disorder Severity Scale-Self Rated (PDSS-SR).
Results:
The results showed that treatment satisfaction was high and participants were significantly improved on PDA-related measures at post-treatment and at 6-month follow-up with large effect sizes (Cohen’s d range = 1.46–2.82). All 12 participants completed the treatment.
Conclusions:
These findings suggest that VR-CBT with 360-degree video virtual environments delivered to primary care patients with PDA is feasible, acceptable, and potentially efficacious.
Whilst assisted reproduction techniques (ART) have become increasingly successful and largely standardized, there is still only a partial understanding of what constitutes a 'true' embryo environment. Replicating the varying physiological conditions of the in-vivo environment that the embryo travels through in the in-vitro culture is still a major challenge in ART. This practical volume details how to organize and operate an IVF laboratory in order to mimic these conditions for successful embryo culture. Environments and equipment that are essential for running safe and efficient facilities such as maintaining good air quality and hygiene protocols, and utilizing an effective layout are covered in detail. Other chapters discuss the different consumables needed, optimal handling techniques and parameter monitoring systems, as well as recent advances in the area including artificial intelligence and automation. This is an indispensable guide to understanding the background science of culturing embryos, crucial to successful outcomes in ART.
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