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.

Redesenho urbanístico de assentamentos informais com vistas à conservação da água e sustentabilidade ambiental.

Essa Tese apresenta um framework para implementação de redesenho urbanístico de assentamentos informais no contexto da corrente atual do planejamento urbano integrado aos dos recursos hídricos, focado na conservação da água e na sustentabilidade ambiental. Entre outros, sugere-se a implantação do desenho urbanístico de forma participativa e colaborativa. Apresenta-se, de forma ilustrativa proposta de redesenho para a comunidade da Vila Cascatinha localizada na Baixada de Jacarepaguá, Rio de Janeiro, região de expansão da cidade, que serviu como objeto de estudo. A área do assentamento é de indefinição fundiária e atualmente é ocupada por aproximadamente 900 famílias. O framework baseia-se na corrente do urbanismo de baixo impacto, sobretudo do Low Impact Urban Design and Devolopment (LIUDD). Os dispositivos são implantados na escala local, de forma descentralizada para a conservação e manejo das águas pluviais no meio urbano. A pesquisa está inserida no Projeto HIDROCIDADES, desenvolvido dentro dos princícpios da metodologia de pesquisa-ação proposta por Thiollent. Foi realizado trabalho de campo e entrevistas guiadas, tendo sido identificado um percentual expressivo de moradores descendentes de antigos pequenos produtores agrícolas. Na pesquisa, moradores elencaram os principais problemas do assentamento. Além disso, foram diagnosticadas potencialidades dos moradores, dentro do conceito de Tecnologia Social. A prospecção entre os moradores também procurou verificar, em um contexto de colaboração, o conhecimento e a aderência dos moradores às estruturas urbanísticas praticadas no contexto da corrente Desenho Urbano de Baixo Impacto. Ao final deste processo foi gerada proposta de reurbanização sustentável do assentamento estudado, bem como proposta de moradias coletivas sustentáveis. Guardando as devidas especificidades, espera-se que a proposta apresentada possa ser aplicada a outros assentamentos de paisagem similar.

Criação e trajetória de uma Agência no âmbito do Estado integral : o caso do SEBRAE

Este trabalho procura investigar o processo que deu origem ao Serviço Brasileiro de Apoio às Micro e Pequenas Empresas (SEBRAE), assim como a sua trajetória desde a criação até os dias atuais. O SEBRAE foi constituído, em 1972, no âmbito do Ministério de Planejamento e Coordenação Geral (MPCG) do governo Garrastazu Médici (1969-1974). A partir do fim dos anos 70, quando a crise do capital começou a produzir efeitos no país, a agência iniciou um processo paulatino de transformação, culminando na sua privatização, ocorrida no primeiro ano do governo Collor de Mello (1990-1992). Este processo consolidou a sua passagem definitiva da sociedade política para a sociedade civil e alterou, em grande medida, a função da agência junto ao bloco no poder. Ainda que algumas operações não tenham sofrido mudanças significativas, os seus agentes incorporaram definitivamente o papel de formuladores e de disseminadores de ideologia em apoio à consolidação de uma nova fase do capital. Neste sentido, o SEBRAE cumpre, nos dias atuais, o papel de produzir consenso na sociedade em torno da importância econômica e social das micro e pequenas empresas, auxilia a formulação de políticas públicas e leis voltadas para esta questão e, por fim, assume a função ética do Estado, através da qual realiza a tarefa educativa dos indivíduos visando ao "universal". A história da agência é analisada à luz das reflexões de Gramsci sobre hegemonia e Estado integral, capazes de, entre outros aspectos, auxiliar a compreensão das relações mediatas estabelecidas entre agências da sociedade civil e o bloco no poder

Integrated assessment of environmental pollution using diverse sentinel organisms within Basque marine environments

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Measurements of light scattering from glass substrates by total integrated scattering

A total integrated scattering (TIS) measurement was performed to investigate the surface and volume scattering of K9 glass substrates with low reflectance. Ag layers with thicknesses of 60 nm were deposited on the front and back surfaces of the K9 glass substrates by the magnetron sputtering technique. Surface scattering of the K9 glass substrate was obtained by the TIS measurement of the Ag layers on the assumption that the Ag layers and the K9 substrate had the same surface profile. Volume scattering of the substrates was deduced by subtracting the front and back surface scattering from the total scattering of the substrates. (c) 2005 Optical Society of America.

Towards integrated island management: lessons from Lau, Malaita, for the implementation of a national approach to resource management in Solomon Islands: final report

Solomon Islands has recently developed substantial policy aiming to support inshore fisheries management, conservation, climate change adaptation and ecosystem approaches to resource management. A large body of experience in community based approaches to management has developed but “upscaling” and particularly the implementation of nation-wide approaches has received little attention so far. With the emerging challenges posed by climate change and the need for ecosystem wide and integrated approaches attracting serious donor attention, a national debate on the most effective approaches to implementation is urgently needed. This report discusses potential implementation of “a cost-effective and integrated approach to resource management that is consistent with national policy and needs” based on a review of current policy and institutional structures and examination of a recent case study from Lau, Malaita using stakeholder, transaction and financial cost analyses.

Design and implementation of fishery modules in integrated household surveys in developing countries

Fish and other aquatic animals contribute to the food security of citizens of developing countries, both as a source of income and as a component of healthy diets, yet fishing is not currently captured in most integrated household surveys. This sourcebook provides essential technical guidance on the design of statistical modules and questionnaires aimed at collecting fishery data at the household level. Background on the main policies important to the fishery sector, information on the data needed to analyze issues of policy relevance, and methodology on the construction of survey questions to collect necessary data are also provided. The document is organized to provide essential technical guidance on how to design statistical modules and questionnaires aimed at collecting fishery data at the household level. It includes an overview of the main technical and statistical challenges related to sampling fishery-dependent households. The document starts with an introductory section identifying the potential reasons why fisheries and in particular small-scale fisheries have not been adequately included in national statistical systems in a large number of countries. The report then proposes a succinct review of what is known (and what remains unknown) about small-scale fisheries and their contribution to the livelihoods of households in sub-Saharan Africa. It also provides readers with background on the main policies that are important to the fishery sector, information on the data needed to analyze issues of policy relevance, and methodology on the construction of survey questions to collect necessary data.