The effect of five years versus two years of specialised assertive intervention for first episode psychosis - OPUS II: study protocol for a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>The Danish OPUS I trial randomized 547 patients with first-episode psychosis to a two-year early-specialised assertive treatment programme (OPUS) versus standard treatment. The two years OPUS treatment had significant positive effects on psychotic and negative symptoms, secondary substance abuse, treatment adherence, lower dosage of antipsychotic medication, and a higher treatment satisfaction. However, three years after end of the OPUS treatment, the positive clinical effects were not sustained, except that OPUS-treated patients were significantly less likely to be institutionalised compared with standard-treated patients. The major objective of the OPUS II trial is to evaluate the effects of five years of OPUS treatment versus two years of OPUS treatment.</p> <p>Methods</p> <p>The OPUS II trial is designed as a randomized, open label, parallel group trial with blinded outcome assessment. Based on our sample size estimation, 400 patients treated in OPUS for two years will be randomized to further three years of OPUS treatment versus standard treatment. The specialized assertive OPUS treatment consists of three core elements: assertive community treatment, psycho-educational family treatment, and social skills training.</p> <p>Discussion</p> <p>It has been hypothesized that there is a critical period from onset up to five years, which represents a window of opportunity where a long-term course can be influenced. Extending the specialized assertive OPUS treatment up to five years may allow the beneficial effects to continue beyond the high-risk period, through consolidation of improved social and functional outcome.</p> <p>Trial registration</p> <p>Clinical Trial.gov <a href="http://www.clinicaltrials.gov/ct2/show/NCT00914238">NCT00914238</a></p

Electronic Cigarettes Regulation in the UK: A Case Study in Evidence Informed Policy Making

This chapter argues that policy debates on electronic cigarettes (e-cigarettes) are structured around competing evidence claims between proponents and sceptics, who remain bitterly divided on the issue. The confusion and intransigence which has emerged between these camps is, in part, the result of an insufficiently nuanced understanding of the value-centred and highly political nature of the policy process, and the highly circumscribed (yet nonetheless important) role which evidence can play within this. Key policy actors, often from biomedical backgrounds, or trained in the natural sciences, have been unable to recognise the limits of evidence to resolve protracted policy controversies such as that surrounding e-cigarettes. The chapter highlights the value of insights, derived from interpretative social science, about the multiple potential framings of an issue and the need for reflexivity on the part of policy actors to move beyond the current impasse

Traveling waves and pattern formation for spatially discrete bistable reaction-diffusion equations (survey)

Analysis and Stochastic

A model of grain refinement and strengthening of Al alloys due to cold severe plastic deformation

This paper presents a model which quantitatively predicts grain refinement and strength/hardness of Al alloys after very high levels of cold deformation through processes including cold rolling, equal channel angular pressing (ECAP), multiple forging (MF), accumulative rolling bonding (ARB) and embossing. The model deals with materials in which plastic deformation is exclusively due to dislocation movement, which is in good approximation the case for aluminium alloys. In the early stages of deformation, the generated dislocations are stored in grains and contribute to overall strength. With increase in strain, excess dislocations form and/or move to new cell walls/grain boundaries and grains are refined. We examine this model using both our own data as well as the data in the literature. It is shown that grain size and strength/hardness are predicted to a good accuracy.<br/