Integrated motivational interviewing and cognitive behavioural therapy for people with psychosis and comorbid substance misuse: randomised controlled trial

Objectives To evaluate the effectiveness of integrated motivational interviewing and cognitive behaviour therapy in addition to standard care for patients with psychosis and a co-morbid substance use problem. Design Two-centre, open, rater-blind randomised controlled trial Setting UK Secondary Care Participants 327 patients with clinical diagnoses of schizophrenia, schizophreniform or schizoaffective disorder and DSM-IV diagnoses of drug and/or alcohol dependence or abuse Interventions Participants were randomly allocated to integrated motivational interviewing and cognitive behaviour therapy or standard care. Therapy has two phases. Phase one – “motivation building” – concerns engaging the patient, then exploring and resolving ambivalence for change in substance use. Phase two –“Action” – supports and facilitates change using cognitive behavioural approaches. Up to 26 therapy sessions were delivered over one year. Main outcomes The primary outcome was death from any cause or admission to hospital in the 12 months after therapy. Secondary outcomes were frequency and amount of substance use (Timeline Followback), readiness to change, perceived negative consequences of use, psychotic symptom ratings, number and duration of relapses, global assessment of functioning and deliberate self harm, at 12 and 24 months, with additional Timeline Followback assessments at 6 and 18 months. Analysis was by intention-to-treat with robust treatment effect estimates. Results 327 participants were randomised. 326 (99.7%) were assessed on the primary outcome, 246 (75.2%) on main secondary outcomes at 24 months. Regarding the primary outcome, there was no beneficial treatment effect on hospital admissions/ death during follow-up, with 20.2% (33/163) of controls and 23.3% (38/163) of the therapy group deceased or admitted (adjusted odds-ratio 1.16; P= 0.579; 95% confidence interval 0.68 to 1.99). For secondary outcomes there was no treatment effect on frequency of substance use or perceived negative consequences, but a statistically significant effect of therapy on amount used per substance-using day (adjusted odds-ratios: (a) for main substance 1.50; P=0.016; 1.08 to 2.09, (b) all substances 1.48; P=0.017; 1.07 to 2.05). There was a statistically significant treatment effect on readiness to change use at 12 months (adjusted odds-ratio 2.05; P=0.004; 1.26 to 3.31), not maintained at 24 months. There were no treatment effects on assessed clinical outcomes. Conclusions Integrated motivational interviewing and cognitive behaviour therapy for people with psychosis and substance misuse does not improve outcome in terms of hospitalisation, symptom outcomes or functioning. It does result in a reduction in amount of substance use which is maintained over the year’s follow up. Trial registration Current Controlled Trials: ISRCTN1440448

An attempt to partition stomatal and non-stomatal ozone deposition parts on a short grassland

To evaluate the damaging effect of tropospheric ozone on vegetation, it is important to evaluate the stomatal uptake of ozone. Although the stomatal flux is a dominant pathway of ozone deposition onto vegetated surfaces, non-stomatal uptake mechanisms such as soil and cuticular deposition also play a vital role, especially when the leaf area index LAI<4. In this study, we partitioned the canopy conductance into stomatal and non-stomatal components. To calculate the stomatal conductance of water vapour for sparse vegetation, we firstly partitioned the latent heat flux into effects of transpiration and evaporation using the Shuttleworth–Wallace (SW) model. We then derived the stomatal conductance of ozone using the Penman–Monteith (PM) theory based on the similarity to water vapour conductance. The non-stomatal conductance was calculated by subtracting the stomatal conductance from the canopy conductance derived from directly-measured fluxes. Our results show that for short vegetation (LAI=0.25) dry deposition of ozone was dominated by the non-stomatal flux, which exceeded the stomatal flux even during the daytime. At night the stomatal uptake of ozone was found to be negligibly small. In the case of vegetation with LAI≈1, the daytime stomatal and non-stomatal fluxes were of the same order of magnitude. These results emphasize that non-stomatal processes must be considered even in the case of well-developed vegetation where cuticular uptake is comparable in magnitude with stomatal uptake, and especially in the case of vegetated surfaces with LAI<4 where soil uptake also has a role in ozone deposition

Middleborns disadvantaged? testing birth-order effects on fitness in pre-industrial finns

Parental investment is a limited resource for which offspring compete in order to increase their own survival and reproductive success. However, parents might be selected to influence the outcome of sibling competition through differential investment. While evidence for this is widespread in egg-laying species, whether or not this may also be the case in viviparous species is more difficult to determine. We use pre-industrial Finns as our model system and an equal investment model as our null hypothesis, which predicts that (all else being equal) middleborns should be disadvantaged through competition. We found no overall evidence to suggest that middleborns in a family are disadvantaged in terms of their survival, age at first reproduction or lifetime reproductive success. However, when considering birth-order only among same-sexed siblings, first-, middle-and lastborn sons significantly differed in the number of offspring they were able to rear to adulthood, although there was no similar effect among females. Middleborn sons appeared to produce significantly less offspring than first-or lastborn sons, but they did not significantly differ from lastborn sons in the number of offspring reared to adulthood. Our results thus show that taking sex differences into account is important when modelling birth-order effects. We found clear evidence of firstborn sons being advantaged over other sons in the family, and over firstborn daughters. Therefore, our results suggest that parents invest differentially in their offspring in order to both preferentially favour particular offspring or reduce offspring inequalities arising from sibling competition

Migratory Urge and Gill Na(+),K(+)-ATPase Activity of Hatchery-Reared Atlantic Salmon Smolts from the Dennys and Penobscot River Stocks, Maine

Hatchery-reared Atlantic salmon Salmo salar smolts produced from captive-reared Dennys River and sea-run Penobscot River broodstock are released into their source rivers in Maine. The adult return rate of Dennys smolts is comparatively low, and disparity in smolt quality between stocks resulting from genetic or broodstock rearing effects is plausible. Smolt behavior and physiology were assessed during sequential 14-d trials conducted in seminatural annular tanks with circular flow. Migratory urge\u27\u27 (downstream movement) was monitored remotely using passive integrated transponder tags, and gill Na(+),K(+)-ATPase activity was measured at the beginning and end of the trials to provide an index of smolt development. The migratory urge of both stocks was low in early April, increased 20-fold through late May, and declined by the end of June. The frequency and seasonal distribution of downstream movement were independent of stock. In March and April, initial gill Na(+),K(+)-ATPase activities of Penobscot River smolts were lower than those of Dennys River smolts. For these trials, however, Penobscot River smolts increased enzyme activity after exposure to the tank, whereas Dennys River smolts did not, resulting in similar activities between stocks at the end of all trials. There was no clear relationship between migratory urge and gill Na(+),K(+)-ATPase activity. Gill Na(+),K(+)-ATPase activity of both stocks increased in advance of migratory urge and then declined while migratory urge was increasing. Maximum movement was observed from 2 h after sunset through 1 h after sunrise but varied seasonally. Dennys River smolts were slightly more nocturnal than Penobscot River smolts. These data suggest that Dennys and Penobscot River stocks are not markedly different in either physiological or behavioral expression of smolting

The professionals speak: Practitioners’ perspectives on professional election campaigning

Faced with some fundamental changes in the socio-cultural, political and media environment, political parties in post-industrialized democracies have started to initiate substantial transformations of both their organizational structures and communicative practices. Those innovations, described as professionalization, become most obvious during election campaigns. In recent times, the number of empirical studies measuring the degree of political parties’ campaign professionalism has grown. They have relied on a broad spectrum of indicators derived from theory which have not been tested for their validity. For the first time, we put these indicators to a ‘reality check’ by asking top-ranked party secretaries and campaign managers in 12 European countries to offer their perceptions of professional election campaigning. Furthermore, we investigate whether any differences in understanding professionalism among party campaign practitioners can be explained by macro (country) and meso (party) factors. By and large, our results confirm the validity of most indicators applied in empirical studies on campaign professionalism so far. There are some party- and country-related differences in assessing campaign professionalism too, but the influence of most factors on practitioners’ evaluations is weak. Therefore, we conclude that largely there is a far-reaching European Union-wide common understanding of professional election campaigning