Integrated treatment of first episode psychosis with online training (e-learning): study protocol for a randomised controlled trial

BackgroundThe 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/designThis 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 Álava) 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.DiscussionThis 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.Trial registrationNCT01783457 clinical trials.gov. Date of registration in primary registry 23 January 2013

A global multinational survey of cefotaxime-resistant coliforms in urban wastewater treatment plants

The World Health Organization Global Action Plan recommends integrated surveillance programs as crucial strategies for monitoring antibiotic resistance. Although several national surveillance programs are in place for clinical and veterinary settings, no such schemes exist for monitoring antibiotic-resistant bacteria in the environment. In this transnational study, we developed, validated, and tested a low-cost surveillance and easy to implement approach to evaluate antibiotic resistance in wastewater treatment plants (WWTPs) by targeting cefotaxime-resistant (CTX-R) coliforms as indicators. The rationale for this approach was: i) coliform quantification methods are internationally accepted as indicators of fecal contamination in recreational waters and are therefore routinely applied in analytical labs; ii) CTX-R coliforms are clinically relevant, associated with extended-spectrum β-lactamases (ESBLs), and are rare in pristine environments. We analyzed 57 WWTPs in 22 countries across Europe, Asia, Africa, Australia, and North America. CTX-R coliforms were ubiquitous in raw sewage and their relative abundance varied significantly (<0.1% to 38.3%), being positively correlated (p < 0.001) with regional atmospheric temperatures. Although most WWTPs removed large proportions of CTX-R coliforms, loads over 10 colony-forming units per mL were occasionally observed in final effluents. We demonstrate that CTX-R coliform monitoring is a feasible and affordable approach to assess wastewater antibiotic resistance status. [Abstract copyright: Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.

Complement component C4 structural variation and quantitative traits contribute to sex-biased vulnerability in systemic sclerosis

Altres ajuts: Fondo Europeo de Desarrollo Regional (FEDER), "A way of making Europe".Copy number (CN) polymorphisms of complement C4 play distinct roles in many conditions, including immune-mediated diseases. We investigated the association of C4 CN with systemic sclerosis (SSc) risk. Imputed total C4, C4A, C4B, and HERV-K CN were analyzed in 26,633 individuals and validated in an independent cohort. Our results showed that higher C4 CN confers protection to SSc, and deviations from CN parity of C4A and C4B augmented risk. The protection contributed per copy of C4A and C4B differed by sex. Stronger protection was afforded by C4A in men and by C4B in women. C4 CN correlated well with its gene expression and serum protein levels, and less C4 was detected for both in SSc patients. Conditioned analysis suggests that C4 genetics strongly contributes to the SSc association within the major histocompatibility complex locus and highlights classical alleles and amino acid variants of HLA-DRB1 and HLA-DPB1 as C4-independent signals

Relación entre productividad y eficiencia de los programas de doctorado en Psicología

Algunos estudios han demostrado que la financiaci&oacute;n que reciben los programas de doctorado y las universidades influye directamente en su productividad cient&iacute;fica. As&iacute;, el objetivo de esta investigaci&oacute;n es analizar la distribuci&oacute;n de los programas de doctorado en Psicolog&iacute;a con Menci&oacute;n de Calidad ofrecidos por las universidades espa&ntilde;olas en funci&oacute;n de la productividad cient&iacute;fica de los profesores que participan en ellos y de la financiaci&oacute;n que reciben para fomentar la movilidad de profesores y alumnos. Para ello, se calcul&oacute;, por una parte, la productividad cient&iacute;fica en art&iacute;culos publicados en revistas del Journal Citation Reports y en tesis doctorales dirigidas por los profesores que participan en esos programas. Por otra, la financiaci&oacute;n que ha recibido cada programa en funci&oacute;n de sus profesores. De esta manera, se distribuyeron los programas en varios grupos seg&uacute;n la eficiencia de sus recursos y su productividadinfluir directamente en las decisiones que los futuros alumnos de doctorado, especialmente de Latinoam&eacute;rica, tomen para elegir qu&eacute; programas cursar y d&oacute;nde hacerlo. cient&iacute;fica. Estos resultados son muy relevantes y puede

Psychophysiological and fine motor skill differences of elite and non-elite soldiers in an urban combat simulation

Soldiers´ training and experience can influence the outcome of military missions, as well as soldiers physical integrity. The aim of this research was to analyze the psychophysiological and specific fine motor skills response of elite and non-elite soldiers in a combat simulation according to current conflict deployment zones. Rates of perceived exertion, heart rate, blood oxygen saturation, blood lactate, hand and leg strength, cortical arousal, anxiety, autonomic modulation and fine motor skills were analyzed in 20 Elite (EG) and 24 non-elite (NEG) soldiers of the Spanish Army, before and immediately after a close quarter combat in an asymmetrical combat maneuver. As a consequence of the maneuver, elite soldiers presented a higher metabolic, cardiovascular and anxiogenic response than non-elite soldiers, as well as an anticipatory anxiety response, showed in the increased sympathetic modulation. Non-elite soldiers improved their fine motor skills after the combat maneuver (−8.34% Vs −11.23% of change in gun reloading time of Elite Group and Non-Elite Group). Finally, experience in international-armed conflicts disposes soldiers toward better self-confidence when facing risk maneuvers (p = .001).Sin financiación0.819 JCR (2019) Q4, Psychology, Multidisciplinary0.512 SJR (2019) Q2, 109/263 Psychology (miscellaneous), 159/588 Social Sciences (miscellaneous); Q3, 93/154 Experimental and Cognitive PsychologyNo data IDR 2019UE