Effective elements of cognitive behaviour therapy for psychosis: results of a novel type of subgroup analysis based on principal stratification

Background. Meta-analyses show that cognitive behaviour therapy for psychosis (CBT-P) improves distressing positive symptoms. However, it is a complex intervention involving a range of techniques. No previous study has assessed the delivery of the different elements of treatment and their effect on outcome. Our aim was to assess the differential effect of type of treatment delivered on the effectiveness of CBT-P, using novel statistical methodology. Method. The Psychological Prevention of Relapse in Psychosis (PRP) trial was a multi-centre randomized controlled trial (RCT) that compared CBT-P with treatment as usual (TAU). Therapy was manualized, and detailed evaluations of therapy delivery and client engagement were made. Follow-up assessments were made at 12 and 24 months. In a planned analysis, we applied principal stratification (involving structural equation modelling with finite mixtures) to estimate intention-to-treat (ITT) effects for subgroups of participants, defined by qualitative and quantitative differences in receipt of therapy, while maintaining the constraints of randomization. Results. Consistent delivery of full therapy, including specific cognitive and behavioural techniques, was associated with clinically and statistically significant increases in months in remission, and decreases in psychotic and affective symptoms. Delivery of partial therapy involving engagement and assessment was not effective. Conclusions. Our analyses suggest that CBT-P is of significant benefit on multiple outcomes to patients able to engage in the full range of therapy procedures. The novel statistical methods illustrated in this report have general application to the evaluation of heterogeneity in the effects of treatment.

Impact of strong deep ocean stratification on the glacial carbon cycle

During the Last Glacial Maximum, the climate was substantially colder and the carbon cycle was clearly different from the late Holocene. According to proxy data deep oceanic δ13C was very low, and the atmospheric CO2 concentration also reduced. Several mechanisms have been proposed to explain these changes, but none can fully explain the data, especially the very low deep ocean δ13C values. Oceanic core data show that the deep ocean was very cold and salty, which would lead to enhanced deep ocean stratification. We show that such an enhanced stratification in the coupled climate model CLIMBER-2 helps get very low deep oceanic δ13C values. Indeed the simulated δ13C reaches values as low as −0.8‰ in line with proxy data evidences. Moreover it increases the oceanic carbon reservoir leading to a small, yet robust, atmospheric CO2 drop of approximately 10 ppm.

Impact of brine-induced stratification on the glacial carbon cycle

During the cold period of the Last Glacial Maximum (LGM, about 21 000 years ago) atmospheric CO2 was around 190 ppm, much lower than the pre-industrial concentration of 280 ppm. The causes of this substantial drop remain partially unresolved, despite intense research. Understanding the origin of reduced atmospheric CO2 during glacial times is crucial to comprehend the evolution of the different carbon reservoirs within the Earth system (atmosphere, terrestrial biosphere and ocean). In this context, the ocean is believed to play a major role as it can store large amounts of carbon, especially in the abyss, which is a carbon reservoir that is thought to have expanded during glacial times. To create this larger reservoir, one possible mechanism is to produce very dense glacial waters, thereby stratifying the deep ocean and reducing the carbon exchange between the deep and upper ocean. The existence of such very dense waters has been inferred in the LGM deep Atlantic from sediment pore water salinity and δ18O inferred temperature. Based on these observations, we study the impact of a brine mechanism on the glacial carbon cycle. This mechanism relies on the formation and rapid sinking of brines, very salty water released during sea ice formation, which brings salty dense water down to the bottom of the ocean. It provides two major features: a direct link from the surface to the deep ocean along with an efficient way of setting a strong stratification. We show with the CLIMBER-2 carbon-climate model that such a brine mechanism can account for a significant decrease in atmospheric CO2 and contribute to the glacial-interglacial change. This mechanism can be amplified by low vertical diffusion resulting from the brine-induced stratification. The modeled glacial distribution of oceanic δ13C as well as the deep ocean salinity are substantially improved and better agree with reconstructions from sediment cores, suggesting that such a mechanism could have played an important role during glacial times.

The dark side of CRM: advantaged and disadvantaged customers

Purpose – CRM treats various profiles of customers or individual customers differently, purposively favoring certain customers while deliberately disadvantaging others. This research aims to provide insights into how advantaged (favored) and (non-favored) disadvantaged customers perceive fairness in retailers’ marketing tactics. Design/methodology/approach – A multiple study approach has been adopted, influenced by a three-stage process, which involved exploratory interviews, pilot tests, and the main survey. Findings – The results have provided marketers with a perspective on maintaining and enhancing relationships. Service and marketing communications concern the advantaged customers most, while pricing is the most important aspect for the disadvantaged customers. Practical implications – In terms of handling customers, there are important implications from recognizing how those who are favored and those who are not so advantaged perceive their treatment. Failure to appreciate the pitfalls for visibly treating certain customers more favorably and others demonstrably less so, will have stark consequences for retail management and consumer marketing. Originality/value – Contributions are made to the literatures on CRM and on unfairness, particularly in terms of how to address the inevitable inequities inherent in retailers’ CRM offerings. Identification of the advantaged and disadvantaged customers and their respective views allows marketers to develop more appropriate approaches for handling customers who are sensitive to perceived unfairness.

Visceral behaviours and leadership: a dark side of boardroom life?

Purpose – Characteristics of leaders whose behaviour is visceral include taking action based on instinct rather than intellect and exhibiting coarse, base and often negative emotions. Despite the challenge of precisely defining the nature of visceral behaviour, the purpose of this paper is to provide insight into this less attractive side of boardroom life. Design/methodology/approach – Following a literature review of the research into the negative behaviour leaders exhibit, the paper highlights four forms of visceral behaviour based on focused and intimate qualitative case studies involving the experiences of those on the receiving end of that behaviour within a boardroom context. Findings – Based on interviews with an international sample of five chief executive officers (CEOs), plus three subordinates with substantial profit and loss responsibility, the study reveals a distinctly human experience from which no one is exempt. The idiosyncratic nature of the visceral behaviour experienced resulted in each study participant's unique experience. The authors conclude that leaders need to adopt specific measures in order to control and reduce the darker human tendencies. Research limitations/implications – The experiences of study participants are presented in four case studies, providing insight into their experiences whilst also protecting their identity. The study participants were drawn from a sample of companies operating globally within a single sector of the manufacturing industry. The concepts the authors present require validating in other organisations with different demographic profiles. Originality/value – The paper presents a model based on two dimensions – choice and level of mastery – that provides the reader with insight into the forms of visceral behaviour to which leaders succumb. Insight enables us to offer managers strategic suggestions to guard against visceral behaviour and assist them in mitigating its worst aspects, in both those with whom they work and themselves.

Avoiding the dark side of positive online consumer reviews: enhancing reviews' usefulness for high risk-averse travelers

The influence of positive online consumer reviews on a traveler's decision making remains unclear. To better understand the perceived usefulness of online reviews, this study conducts two experiments using positive and negative online consumer reviews. Study results suggest that high risk-averse travelers find negative online reviews more useful than positive reviews. For positive online reviews, high-risk averse travelers feel expert reviewers' postings, travel product pictures, and well-known brand names enhance usefulness of the positive online reviews. These findings offer interesting implications for both marketing theory and practice.

Soil quality assessment based on carbon stratification index in different olive grove management practices in Mediterranean areas

In Mediterranean areas, conventional tillage increases soil organic matter losses, reduces soil quality, and contributes to climate change due to increased CO2 emissions. CO2 sequestration rates in soil may be enhanced by appropriate agricultural soil management and increasing soil organic matter content. This study analyzes the stratification ratio (SR) index of soil organic carbon (SOC), nitrogen (N) and C:N ratio under different management practices in an olive grove (OG) in Mediterranean areas (Andalusia, southern Spain). Management practices considered in this study are conventional tillage (CT) and no tillage (NT). In the first case, CT treatments included addition of alperujo (A) and olive leaves (L). A control plot with no addition of olive mill waste was considered (CP). In the second case, NT treatments included addition of chipped pruned branches (NT1) and chipped pruned branches and weeds (NT2). The SRs of SOC increased with depth for all treatments. The SR of SOC was always higher in NT compared to CT treatments, with the highest SR of SOC observed under NT2. The SR of N increased with depth in all cases, ranging between 0.89 (L-SR1) and 39.11 (L-SR3 and L-SR4).The SR of C:N ratio was characterized by low values, ranging from 0.08 (L-SR3) to 1.58 (NT1-SR2) and generally showing higher values in SR1 and SR2 compared to those obtained in SR3 and SR4. This study has evaluated several limitations to the SR index such as the fact that it is descriptive but does not analyze the behavior of the variable over time. In addition, basing the assessment of soil quality on a single variable could lead to an oversimplification of the assessment. Some of these limitations were experienced in the assessment of L, where SR1 of SOC was the lowest of the studied soils. In this case, the higher content in the second depth interval compared to the first was caused by the intrinsic characteristics of this soil's formation process rather than by degradation. Despite the limitations obtained SRs demonstrate that NT with the addition of organic material improves soil quality.

The dark side of brand attachment: a conceptual framework of brand attachment's detrimental outcomes

Brand attachment recently has received great attention among practitioners and academics alike. Scholars consider brand attachment a key requisite in consumer-brand relationships that create favourable consumer behaviours such as positive brand attitudes and brand loyalty. Few studies, however, examine the detrimental outcomes of brand attachment. In this paper, we develop a conceptual framework that explores how brand attachment may explain detrimental consumer behaviours, such as oppositional brand loyalty and antibrand actions. We investigate consumers' trash-talking and schadenfreude in brand communities and their subsequent outcomes. Our framework reveals that the link between brand attachment and oppositional brand loyalty is driven by consumers' social identity and sense of rivalry. Furthermore, we put forward that brand attachment leads to anti-brand actions when relationships deteriorate. We identify two factors behind the deterioration: (1) companies' opportunism activities, and (2) incongruity between consumers' values and the brand's values. Theoretical and managerial implications are discussed arising from our emerging 'dark side' brand attachment framework.

Direct observation by time-resolved infrared spectroscopy of the bright and the dark excited states of the [Ru(phen)2(dppz)]2+ light-switch compound in solution and when bound to DNA

The [Ru(phen)2(dppz)]2+ complex (1) is non-emissive in water but is highly luminescent in organic solvents or when bound to DNA, making it a useful probe for DNA binding. To date, a complete mechanistic explanation for this “light-switch” effect is still lacking. With this in mind we have undertaken an ultrafast time resolved infrared (TRIR) study of 1 and directly observe marker bands between 1280–1450 cm-1, which characterise both the emissive “bright” and the non-emissive “dark” excited states of the complex, in CD3CN and D2O respectively. These characteristic spectral features are present in the [Ru(dppz)3]2+ solvent light-switch complex but absent in [Ru(phen)3]2+, which is luminescent in both solvents. DFT calculations show that the vibrational modes responsible for these characteristic bands are predominantly localised on the dppz ligand. Moreover, they reveal that certain vibrational modes of the “dark” excited state couple with vibrational modes of two coordinating water molecules, and through these to the bulk solvent, thus providing a new insight into the mechanism of the light-switch effect. We also demonstrate that the marker bands for the “bright” state are observed for both L- and D enantiomers of 1 when bound to DNA and that photo-excitation of the complex induces perturbation of the guanine and cytosine carbonyl bands. This perturbation is shown to be stronger for the L enantiomer, demonstrating the different binding site properties of the two enantiomers and the ability of this technique to determine the identity and nature of the binding site of such intercalators.