A Single-blinded, Randomized Clinical Trial of How to Implement an Evidence-based Treatment for Generalized Anxiety Disorder [IMPLEMENT] — Effects of Three Different Strategies of Implementation

BACKGROUND: Despite long-standing calls to disseminate evidence-based treatments for generalized anxiety (GAD), modest progress has been made in the study of how such treatments should be implemented. The primary objective of this study was to test three competing strategies on how to implement a cognitive behavioral treatment (CBT) for out-patients with GAD (i.e., comparison of one compensation vs. two capitalization models). METHODS: For our three-arm, single-blinded, randomized controlled trial (implementation of CBT for GAD [IMPLEMENT]), we recruited adults with GAD using advertisements in high-circulation newspapers to participate in a 14-session cognitive behavioral treatment (Mastery of your Anxiety and Worry, MAW-packet). We randomly assigned eligible patients using a full randomization procedure (1:1:1) to three different conditions of implementation: adherence priming (compensation model), which had a systematized focus on patients' individual GAD symptoms and how to compensate for these symptoms within the MAW-packet, and resource priming and supportive resource priming (capitalization model), which had systematized focuses on patients' strengths and abilities and how these strengths can be capitalized within the same packet. In the intention-to-treat population an outcome composite of primary and secondary symptoms-related self-report questionnaires was analyzed based on a hierarchical linear growth model from intake to 6-month follow-up assessment. This trial is registered at ClinicalTrials.gov (identifier: NCT02039193) and is closed to new participants. FINDINGS: From June 2012 to Nov. 2014, from 411 participants that were screened, 57 eligible participants were recruited and randomly assigned to three conditions. Forty-nine patients (86%) provided outcome data at post-assessment (14% dropout rate). All three conditions showed a highly significant reduction of symptoms over time. However, compared with the adherence priming condition, both resource priming conditions indicated faster symptom reduction. The observer ratings of a sub-sample of recorded videos (n = 100) showed that the therapists in the resource priming conditions conducted more strength-oriented interventions in comparison with the adherence priming condition. No patients died or attempted suicide. INTERPRETATION: To our knowledge, this is the first trial that focuses on capitalization and compensation models during the implementation of one prescriptive treatment packet for GAD. We have shown that GAD related symptoms were significantly faster reduced by the resource priming conditions, although the limitations of our study included a well-educated population. If replicated, our results suggest that therapists who implement a mental health treatment for GAD might profit from a systematized focus on capitalization models. FUNDING: Swiss Science National Foundation (SNSF-Nr. PZ00P1_136937/1) awarded to CF. KEYWORDS: Cognitive behavioral therapy; Evidence-based treatment; Implementation strategies; Randomized controlled trial

Low-energy energetic neutral atom imaging of Io plasma and neutral tori

Io's plasma and neutral tori play significant roles in the Jovian magnetosphere. We present feasibility studies of measuring low-energy energetic neutral atoms (LENAs) generated from the Io tori. We calculate the LENA flux between 10 eV and 3 keV. The energy range includes the corotational plasma flow energy. The expected differential flux at Ganymede distance is typically 10(3)-10(5) cm(-2) s(-1) sr(-1) eV(-1) near the energy of the corotation. It is above the detection level of the planned LENA sensor that is to be flown to the Jupiter system with integration times of 0.01-1 s. The flux has strong asymmetry with respective to the Io phase. The observations will exhibit periodicities, which can be attributed to the Jovian magnetosphere rotation and the rotation of Io around Jupiter. The energy spectra will exhibit dispersion signatures, because of the non-negligible flight time of the LENAs from Io to the satellite. In 2030, the Jupiter exploration mission JUICE will conduct a LENA measurement with a LENA instrument, the Jovian Neutrals Analyzer (JNA). From the LENA observations collected by JNA, we will be able to derive characteristic quantities, such as the density, velocity, velocity distribution function, and composition of plasma-torus particles. We also discuss the possible physics to be explored by JNA in addition to the constraints for operating the sensor and analyzing the obtained dataset. (C) 2015 Elsevier Ltd. All rights reserved.

Age determinations from Bykovsky Peninsula, Siberia

A wide variety of environmental records is necessary for analysing and understanding the complex Late Quaternary dynamics of permafrost-dominated Arctic landscapes. A NE Siberian periglacial key region was studied in detail using sediment records, remote sensing data, and terrain modelling, all incorporated in a geographical information system (GIS). The study area consists of the Bykovsky Peninsula and the adjacent Khorogor Valley in the Kharaulakh Ridge situated a few kilometres southeast of the Lena Delta. In this study a comprehensive cryolithological database containing information from 176 sites was compiled. The information from these sites is based on the review of previously published borehole data, outcrop profiles, surface samples, and our own field data. These archives cover depositional records of three periods: from Pliocene to Early Pleistocene, the Late Pleistocene and the Holocene. The main sediment sequences on the Bykovsky Peninsula consist of up to 50 m thick ice-rich permafrost deposits (Ice Complex) that were accumulated during the Late Pleistocene. They were formed as a result of nival processes around extensive snowfields in the Kharaulakh Ridge, slope processes in these mountains (such as in the Khorogor Valley), and alluvial/proluvial sedimentation in a flat accumulation plain dominated by polygonal tundra in the mountain foreland (Bykovsky Peninsula). During the early to middle Holocene warming, a general landscape transformation occurred from an extensive Late Pleistocene accumulation plain to a strongly thermokarst-dominated relief dissected by numerous depressions. Thermokarst subsidence had an enormous influence on the periglacial hydrological patterns, the sediment deposition, and on the composition and distribution of habitats. Climate deterioration, lake drainage, and talik refreezing occurred during the middle to late Holocene. The investigated region was reached by the post-glacial sea level rise during the middle Holocene, triggering thermo-abrasion of ice-rich coasts and the marine inundation of thermokarst depressions.

Dissolved organic carbon (DOC) in Arctic ground ice, from northwest Canada, east Siberia, and Alaska

Thermal permafrost degradation and coastal erosion in the Arctic remobilize substantial amounts of organic carbon (OC) and nutrients which have accumulated in late Pleistocene and Holocene unconsolidated deposits. Permafrost vulnerability to thaw subsidence, collapsing coastlines and irreversible landscape change are largely due to the presence of large amounts of massive ground ice such as ice wedges. However, ground ice has not, until now, been considered to be a source of dissolved organic carbon (DOC), dissolved inorganic carbon (DIC) and other elements which are important for ecosystems and carbon cycling. Here we show, using biogeochemical data from a large number of different ice bodies throughout the Arctic, that ice wedges have the greatest potential for DOC storage, with a maximum of 28.6 mg/L (mean: 9.6 mg/L). Variation in DOC concentration is positively correlated with and explained by the concentrations and relative amounts of typically terrestrial cations such as Mg2+ and K+. DOC sequestration into ground ice was more effective during the late Pleistocene than during the Holocene, which can be explained by rapid sediment and OC accumulation, the prevalence of more easily degradable vegetation and immediate incorporation into permafrost. We assume that pristine snowmelt is able to leach considerable amounts of well-preserved and highly bioavailable DOC as well as other elements from surface sediments, which are rapidly frozen and stored in ground ice, especially in ice wedges, even before further degradation. We found that ice wedges in the Yedoma region represent a significant DOC (45.2 Tg) and DIC (33.6 Tg) pool in permafrost areas and a freshwater reservoir of 4200 km**3. This study underlines the need to discriminate between particulate OC and DOC to assess the availability and vulnerability of the permafrost carbon pool for ecosystems and climate feedback upon mobilization.

Clay mineralogy and multi-element chemistry of surface sediments on the Aiberian-Arctic Shelf

Clay mineral and bulk chemical (Si, Al, K, Mg, Sr, La, Ce, Nd) analyses of terrigenous surface sediments on the Siberian-Arctic shelf indicate that there are five regions with distinct, or endmember, sedimentary compositions. The formation of these geochemical endmembers is controlled by sediment provenance and grain size sorting. (1) The shale endmember (Al, K and REE rich sediment) is eroded from fine-grained marine sedimentary rocks of the Verkhoyansk Mountains and Kolyma-Omolon superterrain, and discharged to the shelf by the Lena, Yana, Indigirka and Kolyma Rivers. (2) The basalt endmember (Mg rich) originates from NE Siberia's Okhotsk-Chukotsk volcanic belt and Bering Strait inflow, and is prevalent in Chukchi Sea Sediments. Concentrations of the volcanically derived clay mineral smectite are elevated in Chukchi fine-fraction sediments, corroborating the conclusion that Chukchi sediments are volcanic in origin. (3) The mature sandstone endmember (Si rich) is found proximal to Wrangel Island and sections of the Chukchi Sea's Siberian coast and is derived from the sedimentary Chukotka terrain that comprises these landmasses. (4) The immature sandstone endmember (Sr rich) is abundant in the New Siberian Island region and reflects inputs from sedimentary rocks that comprise the islands. (5) The immature sandstone endmember is also prevalent in the western Laptev Sea, where it is eroded from sedimentary deposits blanketing the Siberian platform that are compositionally similar to those on the New Siberian Islands. Western Laptev can be distinguished from New Siberian Island region sediments by their comparatively elevated smectite concentrations and the presence of the basalt endmember, which indicate Siberian platform flood basalts are also a source of western Laptev sediments. In certain locations grain size sorting noticeably affects shelf sediment chemistry. (1) Erosion of fines by currents and sediment ice rafting contributes to the formation of the coarse-grained sandstone endmembers. (2) Bathymetrically controlled grain size sorting, in which fines preferentially accumulate offshore in deeper, less energetic water, helps distribute the fine-grained shale and basalt endmembers. An important implication of these results is that the observed sedimentary geochemical endmembers provide new markers of sediment provenance, which can be used to track sediment transport, ice-rafted debris dispersal or the movement of particle-reactive contaminants.

Novela y teatralidad en Leopoldo Marechal

Leopoldo Marechal ha producido un teatro de gran relevancia, que como toda su obra expone una problemática trascendente. Mas el sentido de lo teatral está implícito en toda su novelística, tanto por la caracterización de personajes como por la utilización de recursos netamente escénicos. Inclusive el escritor es consciente de esto y en sus novelas siempre inserta reflexiones sobre el teatro. Por esto, resulta muy significativo el hecho de que en el sainete “a lo divino", La Batalla de José Luna, se prefigure la novela Megafón o la guerra.