The UniWellbeing course: A randomised controlled trial of a transdiagnostic internet-delivered cognitive behavioural therapy (CBT) programme for university students with symptoms of anxiety and depression

AbstractAnxiety and depression are prevalent among university students and many universities offer psychological services to assist students. Unfortunately, students can experience barriers that prevent access to these services and many university services experience difficulties meeting demand. The present pragmatic randomised controlled trial examined the preliminary efficacy and acceptability of a transdiagnostic and internet-delivered cognitive behavioural therapy (CBT) programme for university students seeking help with anxiety and depression. Participants were randomly allocated to either a treatment group (n=30) or a waitlist-control group (n=23). The treatment group received weekly contact with a therapist, via telephone or a secure messaging system, as well as automated emails that guided their progress through the programme. Significant reductions were found on standard measures of anxiety (Cohen's d=0.66; 95% CI: 0.13 to 1.17) and depression (Cohen's d=0.81; 95% CI: 0.27 to 1.32) among the treatment group participants, but no significant differences were found between the treatment and control groups at post-treatment. However, more pronounced reductions were found among treatment group participants with clinical level symptoms of anxiety (Cohen's d=1.33; 95% CI: 0.62 to 1.99) and depression (Cohen's d=1.59; 95% CI: 0.81 to 2.30), who reported significantly lower levels of symptoms than control group participants at post-treatment. These reductions were maintained at 3-month follow-up and participants rated the intervention as acceptable. The results provide preliminary support for the potential of iCBT for university students with anxiety and depression. However, larger scale implementation trials considering a broader range of outcomes are required.Trial registrationAustralian and New Zealand Clinical Trials Registry: ACTRN12612000212853

Disseminated \u3ci\u3eLeishmania infantum\u3c/i\u3e infection in two sibling foxhounds due to possible vertical transmission

Two sibling foxhounds born to a Leishmania seropositive bitch were presented after testing seropositive for Leishmania. Leishmania infantum infection was detected via histopathology, culture, and quantitative polymerase chain reaction (q-PCR). This is the first report of natural infection with Leishmania infantum with the possibility for vertical transmission in North America. Infection disséminée à Leishmania infantum chez deux chiots Fox hound d’une même portée reliée possiblement à une transmission verticale. Deux chiots Fox hound d’une même portée nés d’une mère séropositive à Leishmania ont été présentés après un contrôle sérologique positif. Une infection à Leishmania infantum a été détectée par histopathologie, culture et amplification en chaîne par polymérase quantitative (ACP-q). Il s’agit du premier rapport d’infection naturelle par Leishmania infantum possiblement relié à une transmission verticale en Amérique du Nord

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Transdiagnostic internet CBT for university students

Theoretical thesis.Bibliography: pages 116-143.Chapter one. Literature review -- Chapter two. Study 1 : a randomised controlled trial of transdiagnostic internet delivered cognitive behavioural therapy for tertiary students with symptoms of anxiety and depression -- Chapter three. Study 2 : an open trial of self-guided transdiagnostic internet delivered cognitive behavioural therapy for tertiary students with symptoms of anxiety and depression -- Chapter four. Stduy 3 : evaluation of the implementation of a transdiagnostic internet treatment for students with syptoms of anxiety and depression in a university student counselling service -- Chapter five. General discussion.Anxiety and mood disorders are prevalent among university students, but many do not seek treatment. The first two studies of the present thesis aimed to evaluate whether a transdiagnostic internet-delivered cognitive behavioural therapy intervention (iCBT), the UniWellbeing Course, is efficacious and acceptable to students with symptoms of anxiety and depression. Study III evaluated the implementation of iCBT in a student counselling service (SCS). In Study I university students (n = 52) with symptoms of anxiety or depression were randomly allocated to receive therapist-guided iCBT or to a waitlist-control group. At post-treatment mixed models analyses revealed outcomes for the treatment group were statistically and clinically superior to those of the waitlist-control group on the primary outcome measures, the Patient Health Questionnaire 9-Item (PHQ-9) and the Generalized Anxiety Disorder 7-Item (GAD-7), with gains sustained at 3-month follow-up. Clinically significant reductions in the number of diagnoses of anxiety and depression were also found, with a mean total of 27 minutes of clinician time required per participant during the program. In Study II, the waitlist-control group from Study I received a self-guided version of the UniWellbeing Course, using an open trial design. Outcomes were consistent with those from the treatment group in Study I. In Study III, the UniWellbeing Course was offered to students attending a SCS as an alternative to treatment as usual. This small open trial (n = 6) found no statistically significant improvements as measured by the primary outcome measures, the PHQ-9 and GAD-7. Study III also explored the implementation of iCBT at the SCS using a structured methodology which identified several barriers to implementation including clinician attitudes and student treatment preferences. Notwithstanding these challenges, students, as well as managers and clinicians of the SCS who used the intervention rated it as highly acceptable. The results provide preliminary support that transdiagnostic iCBT for university students has the potential to be clinically effective, and acceptable to consumers, therapists, and service managers.Mode of access: World wide web1 online resource (155 pages

Reduced Hamster Usage and Stress in Propagating \u3ci\u3eLeishmania chagasi\u3c/i\u3e Promastigotes Using Cryopreservation and Saphenous Vein Inoculation

Leishmania chagasi, a causal agent of visceral leishmaniasis, requires passage through lab animals such as hamsters to maintain its virulence. Hamster infection is typically accomplished via cardiac puncture or intraperitoneal injection, procedures accompanied by risks of increased animal stress and death. The use of the hamster model also necessitates a regular supply of infected animals, because L. chagasi parasites newly isolated from an infected hamster can be grown in culture for only several weeks before loss of function/phenotype occurs. In an effort to decrease animal usage and animal stress, experiments were performed to assess a more gentle inoculation procedure (saphenous vein inoculation) and the use of cryopreserved parasite cells for research experiments. Of 81 hamsters inoculated by the saphenous vein, 80 became infected as determined ante mortem, by display of clinical symptoms of leishmaniasis (onset of symptoms at 105 ± 22 days post-inoculation), and postmortem by the presence of parasites within the spleen. Splenic parasite load calculated for a subset (n 5 34) of infected hamsters was 124 to 26,177 Leishmania donovani infection units. Cryopreserved, and never-stored, cells were equivalent in all properties evaluated, including developmental changes in morphology during culture, culture growth rates, parasite resistance to serum-mediated lysis, and expression of developmentally regulated surface proteins major surface protease and promastigote surface antigen

The transverse trapping force of an optical trap: factors affecting its measurement

We report new observations that question the validity of using the escape method to deduce optical trapping forces in optical tweezers. The results were obtained by measuring the minimum beam power required to trap a particle subject to fluid flow, created by movement of the sample stage. The power was found to increase by approximately 50% over the range of amplitudes of movement used. This suggests that the measured trapping force is not solely dependent upon the velocity of the fluid past the trapped particle, as commonly assumed. These effects were observed at all fluid velocities and accelerations employed. We consider various causes for the observed effects but an explanation remains an outstanding challenge

Immunologic Indicators of Clinical Progression during Canine \u3ci\u3eLeishmania infantum\u3c/i\u3e Infection

In both dogs and humans Leishmania infantum infection is more prevalent than disease, as infection often does not equate with clinical disease. Previous studies additively indicate that advanced clinical visceral leishmaniasis is characterized by increased production of anti-Leishmania antibodies, Leishmania-specific lymphoproliferative unresponsiveness, and decreased production of gamma interferon (IFN-γ) with a concomitant increase of interleukin-10 (IL-10). In order to differentiate infection versus progressive disease for better disease prognostication, we temporally evaluated humoral and cellular immunologic parameters of naturally infected dogs. The work presented here describes for the first time the temporal immune response to natural autochthonous L. infantum infection in foxhounds within the United States. Several key changes in immunological parameters should be considered when differentiating infection versus clinical disease, including a dramatic rise in IgG production, progressive increases in antigen-specific peripheral blood mononuclear cell proliferation, and IFN-γ production. Polysymptomatic disease is precluded by increased IL-10 production and consistent detection of parasite kinetoplast DNA in whole blood. This clinical presentation and the immuno-dysregulation mirror those observed in human patients, indicating that this animal model will be very useful for testing immunomodulatory anti-IL-10 and other therapies

The UniWellbeing course: A randomised controlled trial of a transdiagnostic internet-delivered cognitive behavioural therapy (CBT) programme for university students with symptoms of anxiety and depression

Anxiety and depression are prevalent among university students and many universities offer psychological services to assist students. Unfortunately, students can experience barriers that prevent access to these services and many university services experience difficulties meeting demand. The present pragmatic randomised controlled trial examined the preliminary efficacy and acceptability of a transdiagnostic and internet-delivered cognitive behavioural therapy (CBT) programme for university students seeking help with anxiety and depression. Participants were randomly allocated to either a treatment group (n = 30) or a waitlist-control group (n = 23). The treatment group received weekly contact with a therapist, via telephone or a secure messaging system, as well as automated emails that guided their progress through the programme. Significant reductions were found on standard measures of anxiety (Cohen's d = 0.66; 95% CI: 0.13 to 1.17) and depression (Cohen's d = 0.81; 95% CI: 0.27 to 1.32) among the treatment group participants, but no significant differences were found between the treatment and control groups at post-treatment. However, more pronounced reductions were found among treatment group participants with clinical level symptoms of anxiety (Cohen's d = 1.33; 95% CI: 0.62 to 1.99) and depression (Cohen's d = 1.59; 95% CI: 0.81 to 2.30), who reported significantly lower levels of symptoms than control group participants at post-treatment. These reductions were maintained at 3-month follow-up and participants rated the intervention as acceptable. The results provide preliminary support for the potential of iCBT for university students with anxiety and depression. However, larger scale implementation trials considering a broader range of outcomes are required