Obsessive Compulsive Treatment Efficacy Trial (OCTET) comparing the clinical and cost effectiveness of self-managed therapies: study protocol for a randomised controlled trial

Background: UK National Institute of Health and Clinical Excellence guidelines for obsessive compulsive disorder (OCD) specify recommendations for the treatment and management of OCD using a stepped care approach. Steps three to six of this model recommend treatment options for people with OCD that range from low-intensity guided self-help (GSH) to more intensive psychological and pharmacological interventions. Cognitive behavioural therapy (CBT), including exposure and response prevention, is the recommended psychological treatment. However, whilst there is some preliminary evidence that self-managed therapy packages for OCD can be effective, a more robust evidence base of their clinical and cost effectiveness and acceptability is required. Methods/Design: Our proposed study will test two different self-help treatments for OCD: 1) computerised CBT (cCBT) using OCFighter, an internet-delivered OCD treatment package; and 2) GSH using a book. Both treatments will be accompanied by email or telephone support from a mental health professional. We will evaluate the effectiveness, cost and patient and health professional acceptability of the treatments. Discussion: This study will provide more robust evidence of efficacy, cost effectiveness and acceptability of self-help treatments for OCD. If cCBT and/or GSH prove effective, it will provide additional, more accessible treatment options for people with OCD.

Time is of the essence: a selective review of the fall and rise of brief therapy research

For compelling reasons of equity and the advance of public health, brief psychotherapy has become the dominant format in both practice and research. One consequence of this is the apparent decline of a distinct stream of brief therapy research. However, much of the agenda formerly identified with that research stream is of increasing importance to the field. Time is indeed of the essence in current psychotherapy research. For example, factors conducive to the time efficiency of brief psychodynamic therapy have been described recently. The important question ‘How much therapy is enough?’ has been addressed by studies inspired by the dose-response analysis of Howard and colleagues. The value of ultra-brief interventions has been examined. These issues are considered in a selective review, drawing in particular on the work of the Sheffield/Leeds psychotherapy of depression research group. This research treats the number of treatment sessions as an independent variable, thereby providing a causal analysis of the dose-response relationship over a range from two to 16 sessions, illuminated by a comparative analysis of change processes in treatments of different durations. Its results enable some specification of the extent and nature of incremental benefit derived from additional sessions in the psychotherapy of depression.

The book of the fly; a nature study of the house-fly and its kin, the fly plague and a cure.

Mode of access: Internet.

Argumentos duales: el principio de dualidad como una estructura argumentativa

El objetivo de la tesis es identificar una familia de argumentos que comparten una estructura con el principio de dualidad de la geometría proyectiva. Esta familia la denomino "argumentos duales". Para lograr este objetivo, tomo cuatro argumentos importantes de la filosofía analítica e identifico en ellos la estructura que comparten. Los cuatro argumentos son: (i) el acertijo de la inducción de Goodman; (ii) la indeterminación de la referencia Putnam; (iii) la indeterminación de la traducción de Quine; (iv) la paradoja del seguimiento de reglas de Wittgenstein.

Apologia delle scienze e belle arti, in confutazione del discorso di G. Giacomo Rousseau.

Mode of access: Internet.

Association between the -174 G/C promoter polymorphism of the interleukin-6 gene and cardiovascular disease risk factors in Brazilian older women

In worldwide studies, interleukin-6 (IL-6) is implicated in age-related disturbances. The aim of the present report was to determine the possible association of IL-6 -174 C/G promoter polymorphism with the cytokine profile as well as with the presence of selected cardiovascular risk features. This was a cross-sectional study on Brazilian women aged 60 years or older. A sample of 193 subjects was investigated for impaired glucose regulation, diabetes, hypertension, and dyslipidemia. Genotyping was done by direct sequencing of PCR products. IL-6 and C-reactive protein were quantified by high-sensitivity assays. General linear regression models or the Student t-test were used to compare continuous variables among genotypes, followed by adjustments for confounding variables. The chi-square test was used to compare categorical variables. The genotypes were consistent with Hardy-Weinberg equilibrium proportions. In a recessive model, mean waist-to-hip ratio, serum glycated hemoglobin and serum glucose were markedly lower in C homozygotes (P = 0.001, 0.028, and 0.047, respectively). In a dominant hypothesis, G homozygotes displayed a trend towards higher levels of circulating IL-6 (P = 0.092). Non-parametric analysis revealed that impaired fasting glucose and hypertension were findings approximately 2-fold more frequent among G homozygous subjects (P = 0.042 and 0.043, respectively). Taken together, our results show that the IL-6 -174 G-allele is implicated in a greater cardiovascular risk. To our knowledge, this is the first investigation of IL-6 promoter variants and age-related disturbances in the Brazilian elderly population.

Intervention infirmière auprès des familles afin de prévenir le délirium chez un proche âgé admis dans une salle d’urgence

Rapport de stage présenté à la Faculté des sciences infirmières en vue de l’obtention du grade de Maître ès sciences (M. Sc.) option expertise-conseil en soins infirmiers

Short fiction of Thomas Hardy: an exploration and assessment

Hardy's novels and poetry have received extensive criticism, in due proportion to their merit. Hardy's short stories, however, have been virtually excluded from the annals of Hardy criticism, even though Hardy wrote over forty short stories, several of which are truly outstanding. In part, the reason for this neglect is because of the neglected state of the short story in Victorian England. Short fiction, published mainly only in periodicals and never collected in volume form, was obscured to a large extent by the highly popular serial novel. This thesis examines Thomas Hardy's short stories in the context of both the Victorian period and the Victorian short story genre, and explores the ways in which Thomas Hardy improved upon and deviated from some of the common types of short fiction being written in his day.

Abundance of Cnidaria and Ctenophora taxa in the North Atlantic sampled during the G. O. Sars Cruise in May 2013

In recent years a global increase in jellyfish (i.e. Cnidarians and Ctenophores) abundance and a rise in the recurrence of jellyfish outbreak events have been largely debated, but a general consensus on this matter has not been achieved yet. Within this debate, it has been generally recognized that there is a lack of reliable data that could be analyzed and compared to clarify whether indeed jellyfish are increasing throughout the world ocean as a consequence of anthropogenic impact and hydroclimatic variability. During the G.O. Sars cruise jellyfish were collected at different depths in the 0-1000m layer using a standard 1 m**2 Multiple Opening/Closing Net and Environmental Sensing System (MOCNESS) (quantitative data), Harstad and macroplankton trawls (qualitative data). The comparison of records collected with different nets during the G.O. Sars transatlantic cruise shows that different sampling gears might provide very different information on jellyfish diversity. Indeed, the big trawls mostly collect relatively large scyphozoan and hydrozoan species such as Atolla, Pelagia, Praya, Vogtia, while small hydrozoans (e.g. Clytia, Gilia, Muggiaea) and early stages of ctenophora are only caught by the smaller nets.