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The present study investigated the structure of the Spanish version of the Iowa-Netherlands Comparison Orientation Measure (INCOM-E), an 11-item measure that assesses individual differences in social comparison orientation (SCO), i.e., the extent to which people compare themselves with others. Data came from samples from Spain (n = 1,133) and Chile (n = 2,757). Confirmatory Factor Analyses and Mokken Scale Analyses supported in both samples not the assumed two-factor structure, but a single factor structure, consisting of eight items. The resulting eight-item version of the INCOM-E was reliable in both samples, according the Gutmann’s lambda–2 (.82 in Spain and .83 in Chile), and correlated very strongly with the full-length INCOM-E (.93 in Spain and .97 in Chile). In both samples, there were significant sex differences, ps < .001 with small effect sizes, ƞ2 in both samples = .01,but in the Spanish sample women scored higher, and in the Chilean sample men scored higher in SCO. The relationship with age was negative and significant (ps < .001) in both samples, albeit small (r = .22 in Spain and .13 in Chile) Based on the present research, it is advised to use the shortened eight-item version of the INCOM-E in Spanish speaking countries.
To explore the relationship between cannabis use and self-report dimensions of psychosis in a population of university students presenting for any reason to primary care.
Method
One thousand and forty-nine students attending the Student Health Unit, National University of Ireland, Galway, completed self-report questionnaires on alcohol and substance misuse, non-clinical dimensions of psychosis (Community Assessmemnt of Psychic Experiences), anxiety and depression (Hospital Anxiety and Depression Scale). Association of cannabis use with psychiatric symptoms was explored whilst controlling for confounds.
Results
More frequent cannabis use was independently associated with greater intensity of positive, negative and depressive psychotic symptoms. The earlier the age of onset of cannabis use, the more positive psychotic symptoms were reported.
Conclusion
These findings support the hypothesis that cannabis use increases the risk of developing psychotic symptoms and that this risk is further increased in those individuals who use cannabis more heavily and commence it at a younger age.
Traumatic brain injuries (TBI) may lead to persistent depression symptoms. We conducted several pilot studies to examine the efficacy of mindfulness-based interventions to deal with this issue; all showed strong effect sizes. The logical next step was to conduct a randomized controlled trial (RCT).
Objective
We sought to determine the efficacy of mindfulness-based cognitive therapy for people with depression symptoms post-TBI (MBCT-TBI).
Methods
Using a multi-site RCT design, participants (mean age = 47) were randomized to intervention or control arms. Treatment participants received a group-based, 10-week intervention; control participants waited. Outcome measures, administered pre- and post-intervention, and after three months, included: Beck Depression Inventory-II (BDI-II), Patient Health Questionnaire-9 (PHQ-9), and Symptom Checklist-90-Revised (SCL-90-R). The Philadelphia Mindfulness Scale (PHLMS) captured present moment awareness and acceptance.
Results
BDI-II scores decreased from 25.47 to 18.84 in treatment groups while they stayed relatively stable in control groups (respectively 27.13 to 25.00; p = .029). We did not find statistically significant differences on the PHQ-9 and SCL-90R post- treatment. However, after three months, all scores were statistically significantly lower than at baseline (ps < .01). Increases in mindfulness were associated with decreases in BDI-II scores (r[29] = -.401, p = .025).
Conclusions
MBCT-TBI may alleviate depression symptoms up to three months post-intervention. Greater mindfulness may have contributed to the reduction in depression symptoms although the association does not confirm causality. More work is required to replicate these findings, identify subgroups that may better respond to the intervention, and refine the intervention to maximize its effectiveness.
Psychoeducation for service users has been shown in several recent meta-analyses to improve adherence with treatment, decrease rehospitalization rates and improve various measures of quality of life. The 8-week EOLAS Programme for service users with schizophrenia or bipolar disorder is unique in being designed, co-facilitated and evaluated collaboratively by both clinician and peer representatives. EOLAS forms part of the service plan of the national Health Service in Ireland.
Aims and objectives
To evaluate the impact of the EOLAS programme on participants’ perceived knowledge, confidence, advocacy, recovery attitudes and hope.
Methodology
Anonymised questionnaires were administered to participants before and after completion of the EOLAS Programme.
All survey participants were invited to attend for interview to examine qualitatively their experience of the programme. Interviews were recorded and subjected to thematic analysis.
Significant improvements (P < 0.05) were identified across each of the 5 domains examined (i.e. perceived knowledge, confidence, advocacy, recovery attitudes, hope). Expressed satisfaction with the programme was high (95%).
At interview, participants (n = 12) particularly valued:
– the opportunity to ask questions of the psychiatrist e.g. about medication;
– improving self-care skills e.g. monitoring early warning signs of relapse;
– co-facilitation by a peer, which provided extra credibility and inspired hope;
– sharing experiences with peers.
Conclusions
The EOLAS programme succeeds in meeting the needs of the participants across the target domains. This success depends on the unique collaboration between clinicians and peer experts on which EOLAS is based.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The co-production and co-facilitation of recovery-focused education programmes is one way in which service users may be meaningfully involved as partners.
Objectives:
To evaluate the impact of a clinician and peer co-facilitated information programme on service users’ knowledge, confidence, recovery attitudes, advocacy and hope, and to explore their experience of the programme.
Methods:
A sequential design was used involving a pre–post survey to assess changes in knowledge, confidence, advocacy, recovery attitudes and hope following programme participation. In addition, semi-structured interviews with programme participants were completed. Fifty-three participants completed both pre- and post-surveys and twelve individuals consented to interviews.
Results:
The results demonstrated statistically significant changes in service users’ knowledge about mental health issues, confidence and advocacy. These improvements were reflected in the themes which emerged from the interviews with participants (n = 12), who reported enhanced knowledge and awareness of distress and wellness, and a greater sense of hope. In addition, the peer influence helped to normalise experiences for participants, while the dual facilitation engendered equality of participation and increased the opportunity for meaningful collaboration between service users and practitioners.
Conclusions:
The evaluation highlights the potential strengths of a service user and clinician co-facilitated education programme that acknowledges and respects the difference between the knowledge gained through self-experience and the knowledge gained through formal learning.
In this paper, we summarise and critique a network meta-analysis (NMA) of antidepressant efficacy and tolerability for paediatric depression and an accompanying editorial. Although we agree that many of the extant studies are flawed, this meta-analysis showed clear efficacy of fluoxetine in the NMA, and for sertraline and escitalopram in pairwise analyses. Consequently, these papers underestimate the benefits of antidepressants for paediatric depression, and provide support for current practice guideline, which recommends the use of an antidepressant if the patient does not respond to psychotherapy. In these circumstances, fluoxetine should be the first choice, with escitalopram and sertraline as alternatives.
Declaration of interest
D.A.B. receives royalties from Guilford Press, has or will receive royalties from the electronic self-rated version of the C-SSRS from eResearch Technology, Inc., is on the editorial board of UpToDate, and is a reviewer for Healthwise. R.D.G. serves as an expert witness for the US Department of Justice, Pfizer, Wyeth and GSK; and is the founder of Adaptive Testing Technologies. P.W. receives personal fees from Lundbeck and Takeda. B.D. reports a licensing agreement with Lundbeck for a psychosocial treatment manual for depression. No other disclosures were reported.
Low-Reynolds-number polymer solutions exhibit a chaotic behaviour known as ‘elastic turbulence’ when the Weissenberg number exceeds a critical value. The two-dimensional Oldroyd-B model is the simplest constitutive model that reproduces this phenomenon. To make a practical estimate of the resolution scale of the dynamics, one requires the assumption that an attractor of the Oldroyd-B model exists; numerical simulations show that the quantities on which this assumption is based are bounded. We estimate the Lyapunov dimension of this assumed attractor as a function of the Weissenberg number by combining a mathematical analysis of the model with direct numerical simulations.
We consider the time dependence of a hierarchy of scaled $L^{2m}$-norms $D_{m,\unicode[STIX]{x1D714}}$ and $D_{m,\unicode[STIX]{x1D703}}$ of the vorticity $\unicode[STIX]{x1D74E}=\unicode[STIX]{x1D735}\times \boldsymbol{u}$ and the density gradient $\unicode[STIX]{x1D735}\unicode[STIX]{x1D703}$, where $\unicode[STIX]{x1D703}=\log (\unicode[STIX]{x1D70C}^{\ast }/\unicode[STIX]{x1D70C}_{0}^{\ast })$, in a buoyancy-driven turbulent flow as simulated by Livescu & Ristorcelli (J. Fluid Mech., vol. 591, 2007, pp. 43–71). Here, $\unicode[STIX]{x1D70C}^{\ast }(\boldsymbol{x},t)$ is the composition density of a mixture of two incompressible miscible fluids with fluid densities $\unicode[STIX]{x1D70C}_{2}^{\ast }>\unicode[STIX]{x1D70C}_{1}^{\ast }$, and $\unicode[STIX]{x1D70C}_{0}^{\ast }$ is a reference normalization density. Using data from the publicly available Johns Hopkins turbulence database, we present evidence that the $L^{2}$-spatial average of the density gradient $\unicode[STIX]{x1D735}\unicode[STIX]{x1D703}$ can reach extremely large values at intermediate times, even in flows with low Atwood number $At=(\unicode[STIX]{x1D70C}_{2}^{\ast }-\unicode[STIX]{x1D70C}_{1}^{\ast })/(\unicode[STIX]{x1D70C}_{2}^{\ast }+\unicode[STIX]{x1D70C}_{1}^{\ast })=0.05$, implying that very strong mixing of the density field at small scales can arise in buoyancy-driven turbulence. This large growth raises the possibility that the density gradient $\unicode[STIX]{x1D735}\unicode[STIX]{x1D703}$ might blow up in a finite time.
The present study evaluated the impact on psychosocial outcome of parallel clinician and peer-led information programmes for people with a diagnosis of schizophrenia and bipolar disorder and for family members within an Irish context.
Methods
A sequential mixed method design was used. Quantitative data were collected using pre- and post-programme questionnaires followed by an integrated qualitative component involving semi-structured interviews after the programme. The questionnaires assessed knowledge, attitudes towards recovery, hope, support, advocacy and well-being. Interviews with participants, facilitators and project workers explored their experiences and views of the programme.
Findings
While a number of the questionnaires did not show a statistically significant change, findings from the interviews suggest that the1 programmes had a number of positive outcomes, including increases in perceived knowledge, empowerment and support. Participants in both programmes valued the opportunity to meet people in similar circumstances, share their experiences, learn from each other and provide mutual support.
Conclusion
The EOLAS programmes offer a novel template for communication and information sharing in a way that embodies the principles of collaboration and offers users and families a meaningful opportunity to become involved in service design, delivery and evaluation.
The EOLAS programme is a peer and clinician-led mental health information programme on recovery from mental health difficulties, specifically for people with a diagnosis of schizophrenia spectrum or bipolar disorders, their family members and significant others.
Method
This article, the first of a two part series, outlines the background to and the rationale behind the EOLAS programme, and traces the participatory process used to inform the development and implementation of the pilot phase of the project. The aims of the programme, and the overarching principles that guided its development, delivery and evaluation, including the set-up of the project steering group are outlined and discussed.
Findings
Two separate programmes, one for family members and one for service users were designed. In addition, participant and facilitator handbooks were developed for each programme, including a training programme for facilitators.
Conclusion
Central to a recovery oriented service is the involvement of service users and families in the design and delivery of services. EOLAS is one potential model for achieving this aim.
Setting priorities in the field of infectious diseases requires evidence-based and robust baseline estimates of disease burden. Therefore, the European Centre for Disease Prevention and Control initiated the Burden of Communicable Diseases in Europe (BCoDE) project. The project uses an incidence- and pathogen-based approach to measure the impact of both acute illness and sequelae of infectious diseases expressed in disability-adjusted life years (DALYs). This study presents first estimates of disease burden for four pathogens in Germany. The number of reported incident cases adjusted for underestimation served as model input. For the study period 2005–2007, the average disease burden was estimated at 33 116 DALYs/year for influenza virus, 19 115 DALYs/year for Salmonella spp., 8708 DALYs/year for hepatitis B virus and 740 DALYs/year for measles virus. This methodology highlights the importance of sequelae, particularly for hepatitis B and salmonellosis, because if omitted, the burden would have been underestimated by 98% and 56%, respectively.
The issue of intermittency in numerical solutions of the 3D Navier–Stokes equations on a periodic box ${[0, L] }^{3} $ is addressed through four sets of numerical simulations that calculate a new set of variables defined by ${D}_{m} (t)= {({ \varpi }_{0}^{- 1} {\Omega }_{m} )}^{{\alpha }_{m} } $ for $1\leq m\leq \infty $ where ${\alpha }_{m} = 2m/ (4m- 3)$ and ${[{\Omega }_{m} (t)] }^{2m} = {L}^{- 3} \int \nolimits _{\mathscr{V}} {\vert \boldsymbol{\omega} \vert }^{2m} \hspace{0.167em} \mathrm{d} V$ with ${\varpi }_{0} = \nu {L}^{- 2} $. All four simulations unexpectedly show that the ${D}_{m} $ are ordered for $m= 1, \ldots , 9$ such that ${D}_{m+ 1} \lt {D}_{m} $. Moreover, the ${D}_{m} $ squeeze together such that ${D}_{m+ 1} / {D}_{m} \nearrow 1$ as $m$ increases. The values of ${D}_{1} $ lie far above the values of the rest of the ${D}_{m} $, giving rise to a suggestion that a depletion of nonlinearity is occurring which could be the cause of Navier–Stokes regularity. The first simulation is of very anisotropic decaying turbulence; the second and third are of decaying isotropic turbulence from random initial conditions and forced isotropic turbulence at fixed Grashof number respectively; the fourth is of very-high-Reynolds-number forced, stationary, isotropic turbulence at up to resolutions of $409{6}^{3} $.