A multi-element psychosocial intervention for early psychosis (GET UP PIANO TRIAL) conducted in a catchment area of 10 million inhabitants: study protocol for a pragmatic cluster randomized controlled trial

Multi-element interventions for first-episode psychosis (FEP) are promising, but have mostly been conducted in non-epidemiologically representative samples, thereby raising the risk of underestimating the complexities involved in treating FEP in 'real-world' services

Aboriginal Women Caregivers of the Elderly

Introduction: The purpose of this qualitative study was to develop a comprehensive understanding of Aboriginal women\u27s experiences and perceptions of providing care to the elderly in geographically isolated communities (GIC). Research with Aboriginal women caregivers is essential as the population of Aboriginal elders is increasing, and Aboriginal women represent the majority of caregivers in their communities. Methods: This study was guided by focused ethnography, which seeks an understanding of a sub-group within a cultural group by uncovering the less obvious expressions and behaviours of the sub-group members. Using one-on-one open-ended interviews and participant observation, 13 women from a number of Aboriginal communities in northern and southern Ontario participated in this study. Data analysis was conducted by reviewing transcripts of interviews to identify codes and themes. Results: Study findings revealed that four concentric circles represent the caring experiences of the Aboriginal women participants: the healers, the family, the Aboriginal community, and the non-Aboriginal community. Cultural values greatly informed participants\u27 perceptions about caring for elderly persons in GIC. These values are represented in five themes: passing on traditions, being chosen to care, supporting the circle of healers, (re)establishing the circles of care, and accepting/refusing external resources. Conclusion: The findings from this study have significant implications for healthcare practice and future research

Effects of river floodplain lowering and vegetation cover

The current river management policy in the Netherlands is to give rivers more space, mainly by main channel widening and floodplain lowering. The aim is to reduce flood water levels and to create more favourable conditions for river ecology. However, the effect on water levels gradually disappears due to sedimentation and vegetation growth on floodplains. The key questions are how effective these measures are and how long the desired effect remains. A two-dimensional, depthaveraged, morphological model was applied to the Meers pilot project on the Common Meuse River. The project consisted of channel widening by floodplain excavation, carried out over a short reach. Spatially varying floodplain vegetation was included. The results showed that the pilot project would be effective in lowering local water levels during a period of 20 years for floods having a return period of 1–4 years but not for floods having a return period of 100 years. In the latter case, water levels would be dominated by a restriction in floodplain width, causing backwater effects. Floodplain vegetation was found to shorten the lifetime of the project by enhancing sedimentation.Hydraulic EngineeringCivil Engineering and Geoscience