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1.  Analysing a family-centred preoperative intervention programme: a dismantling approach 
BJA: British Journal of Anaesthesia  2011;106(5):713-718.
The goal of this project was to identify key effective components of ADVANCE, a family-centred preoperative intervention programme, through the use of a dismantling approach. ADVANCE was previously demonstrated to be more effective than parental presence and just as effective as midazolam in reducing children's preoperative anxiety. The total programme, however, may be difficult to implement in hospitals across the country.
Subjects in this follow-up dismantling report were 96 children aged 2–10 who were part of the original study and who underwent anaesthesia and surgery. Baseline characteristics, parental adherence to the components of ADVANCE, and child and parent anxiety were assessed.
We found that greater parental adherence to the ADVANCE intervention was associated with lower child anxiety before surgery. The two components of ADVANCE that emerged as having a significant impact on children's anxiety were practising with the anaesthesia mask at home and parental planning and use of distraction in the preoperative holding area. In fact, not only did children experience significantly less preoperative anxiety when their parents were adherent to mask practise and use of distraction, their anxiety tended to remain stable and relatively low throughout the preoperative period.
Shaping and exposure (i.e. practise with the anaesthesia mask) and parental use of distraction in the surgical setting are two beneficial components that could be included in preoperative preparation programmes that will be designed in the future.
PMCID: PMC3077749  PMID: 21324929
children; surgery, paediatric; surgery, preoperative period
2.  Using intermittent reinforcement to program maintenance of verbal/nonverbal correspondence. 
We investigated the effects of an intermittent reinforcement procedure on maintenance of verbal/nonverbal correspondence with nutritious snack choices in a day-care setting. Nutritious snack choices were first established using correspondence training procedures in a multiple baseline across three children. Withdrawal of the procedures with one subject led to loss of appropriate responding, suggesting the need for a maintenance strategy. The intermittent reinforcement procedure was implemented in a multiple baseline across subjects. Nutritious snack choices were observed consistently during the intermittent reinforcement condition and the subsequent extinction condition.
PMCID: PMC1285969  PMID: 3610897
3.  Reducing severe diurnal bruxism in two profoundly retarded females. 
Several diurnal audible teeth grinding (bruxism) was found to affect 21.5% of a profoundly retarded population. However, no previous research has treated bruxism in retarded individuals. In the current study a multiple baseline across subjects design was used to assess the effectiveness of contingent "icing," brief contingent tactile applications of ice, as a treatment for bruxism. Three 15-minute treatment periods and two 5-minute generalization periods were conducted 5 days per week. One resident displayed a 95% reduction in the percentage of intervals during which bruxism occurred during treatment periods and a 67% reduction during generalization periods. The other resident displayed a 94% reduction in the percentage of intervals during which bruxism occurred during treatment periods and a 53% reduction during generalization periods.
PMCID: PMC1308302  PMID: 6891381

Results 1-3 (3)