Integrated treatment of first episode psychosis with online training (e-learning): study protocol for a randomised controlled trial

Background: The integrated treatment of first episode psychosis has been shown to improve functionality and negative symptoms in previous studies. In this paper, we describe a study of integrated treatment (individual psychoeducation complementary to pharmacotherapy) versus treatment as usual, comparing results at baseline with those at 6-month re-assessment (at the end of the study) for these patients, and online training of professionals to provide this complementary treatment, with the following objectives: 1) to compare the efficacy of individual psychoeducation as add-on treatment versus treatment as usual in improving psychotic and mood symptoms; 2) to compare adherence to medication, functioning, insight, social response, quality of life, and brain-derived neurotrophic factor, between both groups; and 3) to analyse the efficacy of online training of psychotherapists. Methods/design: This is a single-blind randomised clinical trial including patients with first episode psychosis from hospitals across Spain, randomly assigned to either a control group with pharmacotherapy and regular sessions with their psychiatrist (treatment as usual) or an intervention group with integrated care including treatment as usual plus a psychoeducational intervention (14 sessions). Training for professionals involved at each participating centre was provided by the coordinating centre (University Hospital of Alava) through video conferences. Patients are evaluated with an extensive battery of tests assessing clinical and sociodemographic characteristics (Positive and Negative Syndrome Scale, State-Trait Anxiety Inventory, Liebowitz Social Anxiety Scale, Hamilton Rating Scale for Depression, Scale to Assess Unawareness of Mental Disorders, Strauss and Carpenter Prognostic Scale, Global Assessment of Functioning Scale, Morisky Green Adherence Scale, Functioning Assessment Short Test, World Health Organization Quality of Life instrument WHOQOL-BREF (an abbreviated version of the WHOQOL-100), and EuroQoL questionnaire), and brain-derived neurotrophic factor levels are measured in peripheral blood at baseline and at 6 months. The statistical analysis, including bivariate analysis, linear and logistic regression models, will be performed using SPSS. Discussion: This is an innovative study that includes the assessment of an integrated intervention for patients with first episode psychosis provided by professionals who are trained online, potentially making it possible to offer the intervention to more patients.

Statistical inference about the relative efficiency of a new survey protocol, based on paired-tow survey calibration data

Paired-tow calibration studies provide information on changes in survey catchability that may occur because of some necessary change in protocols (e.g., change in vessel or vessel gear) in a fish stock survey. This information is important to ensure the continuity of annual time-series of survey indices of stock size that provide the basis for fish stock assessments. There are several statistical models used to analyze the paired-catch data from calibration studies. Our main contributions are results from simulation experiments designed to measure the accuracy of statistical inferences derived from some of these models. Our results show that a model commonly used to analyze calibration data can provide unreliable statistical results when there is between-tow spatial variation in the stock densities at each paired-tow site. However, a generalized linear mixed-effects model gave very reliable results over a wide range of spatial variations in densities and we recommend it for the analysis of paired-tow survey calibration data. This conclusion also applies if there is between-tow variation in catchability.

Efficacy of a cognitive and behavioural psychotherapy applied by primary care psychologists in patients with mixed anxiety-depressive disorder: a research protocol

Background: In contrast with the recommendations of clinical practice guidelines, the most common treatment for anxiety and depressive disorders in primary care is pharmacological. The aim of this study is to assess the efficacy of a cognitive-behavioural psychological intervention, delivered by primary care psychologists in patients with mixed anxiety-depressive disorder compared to usual care. Methods/Design: This is an open-label, multicentre, randomized, and controlled study with two parallel groups. A random sample of 246 patients will be recruited with mild-to-moderate mixed anxiety-depressive disorder, from the target population on the lists of 41 primary care doctors. Patients will be randomly assigned to the intervention group, who will receive standardised cognitive-behavioural therapy delivered by psychologists together with usual care, or to a control group, who will receive usual care alone. The cognitive-behavioural therapy intervention is composed of eight individual 60-minute face-to face sessions conducted in eight consecutive weeks. A follow-up session will be conducted over the telephone, for reinforcement or referral as appropriate, 6 months after the intervention, as required. The primary outcome variable will be the change in scores on the Short Form-36 General Health Survey. We will also measure the change in the frequency and intensity of anxiety symptoms (State-Trait Anxiety Inventory) and depression (Beck Depression Inventory) at baseline, and 3, 6 and 12 months later. Additionally, we will collect information on the use of drugs and health care services. Discussion: The aim of this study is to assess the efficacy of a primary care-based cognitive-behavioural psychological intervention in patients with mixed anxiety-depressive disorder. The international scientific evidence has demonstrated the need for psychologists in primary care. However, given the differences between health policies and health services, it is important to test the effect of these psychological interventions in our geographical setting.

A global protocol for monitoring of coral bleaching

Coral bleaching and subsequent mortality represent a major threat to the future health and productivity of coral reefs. However a lack of reliable data on occurrence, severity and other characteristics of bleaching events hampers research on the causes and consequences of this important phenomenon. This article describes a global protocol for monitoring coral bleaching events, which addresses this problem and can be used by people with different levels of expertise and resources.

Development of Beluga, Delphinapterus leucas, Capture and Satellite Tagging Protocol in Cook Inlet, Alaska

Attempts to capture and place satellite tags on belugas, Delphinapterus leucas, in Cook Inlet, Alaska were conducted during late spring and summer of 1995, 1997, and 1999. In 1995, capture attempts using a hoop net proved impractical in Cook Inlet. In 1997, capture efforts focused on driving belugas into nets. Although this method had been successful in the Canadian High Arctic, it failed in Cook Inlet due to the ability of the whales to detect and avoid nets in shallow and very turbid water. In 1999, belugas were successfully captured using a gillnet encirclement technique. A satellite tag was attached to a juvenile male, which subsequently provided the first documentation of this species’ movements within Cook Inlet during the summer months (31 May–17 September).

Methodologies and mechanisms for management of cumulative coastal environmental impacts. Part I: Synthesis, with annotated bibliography; Part II: Development and application of a cumulative impacts assessment protocol

What Are ~umulat iveE ffects? Coastal managers now recognize that many of the most serious resource degradation problems have built up gradually as the combined outcome of numerous actions and choices which alone may have had relatively minor impacts. For example, alteration of essential habitat through wetland loss, degradation of water quality from nonpoint source pollution, and changes in salinity of estuarine waters from water diversion projects can be attributed to numerous small actions and choices. These incremental losses have broad spatial and temporal dimensions, resulting in the gradual alteration of structure and functioning of biophysical systems. In the environmental management field, the term "cumulative effects" is generally used to describe this phenomenon of changes in the environment that result from numerous, small-scale alterations.

Survey protocol for invasive species

This protocol was developed by the Biogeography Branch of NOAA’s Center for Coastal Monitoring and Assessment to support invasive species research by the Papahānaumokuākea Marine National Monument. The protocol’s objective is to detect Carijoa riisei and Hypnea musciformis in deepwater habitats using visual surveys by technical divers. Note: This protocol is designed to detect the presence or absence of invasive species. A distinct protocol is required to collect information on abundance and impact, or monitor changes over time.