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.

Mechanisms involved in Escherichia coli and Serratia marcescens removal during activated sludge wastewater treatment

Wastewater treatment reduces environmental contamination by removing gross solids and mitigating the effects of pollution. Treatment also reduces the number of indicator organisms and pathogens. In this work, the fates of two coliform bacteria, Escherichia coli and Serratia marcescens, were analyzed in an activated sludge process to determine the main mechanisms involved in the reduction of pathogenic microorganisms during wastewater treatment. These bacteria, modified to express green fluorescent protein, were inoculated in an activated sludge unit and in batch systems containing wastewater. The results suggested that, among the different biological factors implied in bacterial removal, bacterivorous protozoa play a key role. Moreover, a representative number of bacteria persisted in the system as free-living or embedded cells, but their distribution into liquid or solid fractions varied depending on the bacterium tested, questioning the real value of bacterial indicators for the control of wastewater treatment process. Additionally, viable but nonculturable cells constituted an important part of the bacterial population adhered to solid fractions, what can be derived from the competition relationships with native bacteria, present in high densities in this environment. These facts, taken together, emphasize the need for reliable quantitative and qualitative analysis tools for the evaluation of pathogenic microbial composition in sludge, which could represent an undefined risk to public health and ecosystem functions when considering its recycling.

Influence of heat treatment on spectroscopic properties of Er3+ in multicomponent ZrF4-ZnF2-AlF3-YF3-MF2 (M = Ca, Sr, Ba) based glass

Er3+ doped multicomponent fluoride based glass was prepared. These precursor fluoride glass samples were then heated using different schedules. Crystalline phase particles were successfully precipitated in the multicomponent fluoride glass samples after heat treatment. The influence of heat treatment on the spectroscopic properties of Er3+ in multicomponent fluoride based glass samples were discussed. Small changes of the Judd-Ofelt parameters Omega(i) (i = 2,4,6) were found in multicomponent fluoride glass samples before and after heat treatment compared to oxyfluoride telluride glass. Preparation conditions used to produce transparent multicomponent fluoride glass ceramics doped with rare-earth ions are discussed. (c) 2007 Elsevier B.V. All rights reserved.

Avaliação do potencial antimalárico de Norantea brasiliensis Choisy (Marcgraviaceae) cultivada in vitro e in vivo

A malária é uma doença infecciosa causada por protozoários do gênero Plasmodium, transmitidos ao homem, principalmente, através da picada do mosquito infectado. O tratamento é realizado por meio do uso de drogas, como a cloroquina, uma vez que não há vacina eficiente contra a doença. Porém, a resistência dos parasitos aos medicamentos tem levado à busca por novas substâncias com atividade antimalárica, inclusive de origem vegetal. Nesse contexto, o presente trabalho teve por objetivo avaliar a atividade antimalárica de extratos metanólicos de Norantea brasiliensis cultivada sob condições in vivo e in vitro, espécie nativa ocorrente em restingas, com potencial medicinal já comprovado para várias atividades. Foram desenvolvidos protocolos de calogênese e cultura de raízes da espécie visando à definição de um sistema de produção de metabólitos. Para a cultura in vitro, explantes foram inoculados em meio líquido e sólido contendo diferentes fitorreguladores e concentrações. A partir da cultura de tecidos, foram testados extratos do material produzido biotecnologicamente para comparação com o material botânico cultivado no campo. Os testes sobre o potencial antimalárico foram realizados in vivo, utilizando-se camundongos infectados pelo Plasmodium berghei ANKA, e in vitro utilizando o Plasmodium falciparum. Em seguida foram administrados a cloroquina e os extratos vegetais. A parasitemia foi observada seguindo os protocolos já estabelecidos pelo Laboratório de Imunofarmacologia do Instituto Oswaldo Cruz (IOC). Resultados mostraram que explantes foliares e caulinares de plantas germinadas in vitro, inoculados em meio sólido B5 suplementado com 2,0 mg.mL-1 de ANA, são as melhores fontes para a produção de raízes, apresentando maiores valores de peso fresco e peso seco, mostrando-se um sistema promissor para a produção in vitro de metabólitos da espécie. A avaliação da atividade antimalárica in vivo revelou seu potencial a partir de extrato de raízes de planta cultivada in vivo, na concentração de 50 mg/kg apresentando redução significativa da parasitemia quando comparada com o controle não tratado. Paralelamente, nos testes in vitro a concentração de 100 μg/kg do extrato de raízes de planta cultivada in vivo apresentou diferença significativa quando comparada com as outras concentrações testadas e o controle negativo. Além disso, há uma tendência de aumento do efeito inibitório conforme o aumento da concentração do extrato. Os resultados indicam o potencial de atividade antimalárica em raízes de N. brasiliensis, sendo este estudo o primeiro realizado para a espécie

Effects of thermal treatment on broadband near-infrared emission from Bi-doped chalcohalide glasses

GeGaSKBr glass with Bi ions as emission centers were fabricated. An intense emission centered at around 1230 nm with the width of more than 175 nm was observed by 808 nm photo-excitation of the glass. Lower quenching rate and thermal treatment promote micro-crystallization process, thus strengthening the emission. Crown Copyright (c) 2008 Published by Elsevier Ltd. All rights reserved.

Effects of surface treatment on sapphire substrates

The influence of mechanical polishing, chemo-mechanical polishing (CMP), as well as CMP and subsequent chemical etching on the properties of sapphire substrate surfaces has been studied. The sapphire substrates have been investigated by means of polarizing microscopy, atomic force microscopy (AFM). X-ray diffraction rocking curves (XRCs) and micro-Raman spectroscopy. The results show that CMP with subsequent chemically etching yields the best-quality sapphire substrate surfaces. (C) 2004 Elsevier B.V. All rights reserved.

An investigation into the potential losses of fish on the filter plates at the Hodder Water Treatment Works Stocks Reservoir

Stocks Reservoir is situated amidst the Forest of Bowland in the upper reaches of the old river valley of the Hodder. The reservoir was built in 1927 for the Fylde Water Board who primarily supplied water to Blackpool. The objective of this study is to assess the degree and likelihood of fish ingress onto the fish plates at the present and proposed stocking densities. An additional aim is to evaluate the operational implications, and if necessary suggest methods of alleviating the problem. Three spheres of study have been undertaken to achieve these objectives, these being: 1. To selectively stock the reservoir and monitor the angling club catches in order to assess the total population, relating it to fish plate losses and proposed stocking densities. 2. To monitor the fish taken from the fish plates and assess the reasons for their ingress. 3. To study the draw off tower and fish plates, and suggest ways of ameliorating or halting the loss of fish and consequent operational problems.