"CAN Stop" - Implementation and evaluation of a secondary group prevention for adolescent and young adult cannabis users in various contexts - study protocol

<p>Abstract</p> <p>Background</p> <p>Current research shows that overall numbers for cannabis use among adolescents and young adults dropped in recent years. However, this trend is much less pronounced in continuous cannabis use. With regard to the heightened risk for detrimental health- and development-related outcomes, adolescents and young adults with continuous cannabis use need special attention. The health services structure for adolescents and young adults with substance related problems in Germany, is multifaceted, because different communal, medical and judicial agencies are involved. This results in a rather decentralized organizational structure of the help system. This and further system-inherent characteristics make the threshold for young cannabis users rather high. Because of this, there is a need to establish evidence-based low-threshold help options for young cannabis users, which can be easily disseminated. Therefore, a training programme for young cannabis users (age 14-21) was developed in the "CAN Stop" project. Within the project, we seek to implement and evaluate the training programme within different institutions of the help system. The evaluation is sensitive to the different help systems and their specific prerequisites. Moreover, within this study, we also test the practicability of a training provision through laypersons.</p> <p>Methods/Design</p> <p>The CAN Stop study is a four-armed randomized wait-list controlled trial. The four arms are needed for the different help system settings, in which the CAN Stop training programme is evaluated: (a) the drug addiction aid and youth welfare system, (b) the out-patient medical system, (c) the in-patient medical system and (d) prisons for juvenile offenders. Data are collected at three points, before and after the training or a treatment as usual, and six months after the end of either intervention.</p> <p>Discussion</p> <p>The CAN Stop study is expected to provide an evidence-based programme for young cannabis users seeking to reduce or quit their cannabis use. Moreover, we seek to gain knowledge about the programme's utility within different settings of the German help system for young cannabis users and information about the settings' specific clientele. The study protocol is discussed with regard to potential difficulties within the different settings.</p> <p>Trial registration</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/ISRCTN57036983">ISRCTN57036983</a></p

Spatial distribution of hydroxylamine and its role to aerobic N2O formation in a Norway spruce forest soil

Hydroxylamine (HA) is potentially involved in soil N2O formation as a crucial intermediate in the oxidation of ammonium to nitrite. However, the determination of HA concentration in natural soil samples has not been reported until now. Here, we determined the HA concentrations in organic (Oh) and mineral (Ah) layers of 110 soil samples collected from a spruce forest (Wüstebach, Eifel National Park, Germany) using a novel approach, based on the fast extraction of HA from the soil at a pH of 1.7, the oxidation of HA to N2O with Fe3+, and the analysis of produced N2O using gas chromatography (GC-ECD). In a second step, N2O emission rates were determined by means of aerobic laboratory incubations of 3 g soil in 22-mL vials. Subsequently, the spatial distribution of soil HA concentrations and N2O emission rates in the Oh and Ah layers of the whole sampling area were analyzed using a geostatistical approach. The correlations among soil HA, N2O emission rate, pH, soil C, N, Fe, Mn and soil water content (SWC) were further explored. The HA concentrations ranged from 0.3–37.0 μg N kg-1 and 0.02–11.4 μg N kg-1 dry soil in the Oh and the Ah layer, respectively. The spatial distribution of HA was similar in both layers, with substantial spatial variability dependent on soil type, tree density and distance to a stream, e.g., HA concentration was greater at locations with a thick litter layer or at locations close to the stream. N2O emission rates showed a similar pattern as soil HA concentrations, with higher rates in the Oh layer than in the Ah layer. N2O emission rate exhibited the highest correlation with soil HA content in the Oh layer, while soil NO3- content explained N2O emissions best in the Ah layer, associated with SWC, Mn and C content. HA concentration was negatively correlated with pH and positively correlated with SWC in the Oh layer, while positively correlated with C and N as well as NO3- content in the Ah layer. Moreover, Mn content was the most important factor for HA recovery at the specific extraction conditions. The results demonstrated that HA is a crucial component for aerobic N2O formation and emission in spruce forest soils. Mn may also play a key role to the aerobic N2O emission due to the chemical reaction with HA. Further studies should focus to the relationships between HA, Mn and aerobic N2O emission in other ecosystems

Spatial distribution of hydroxylamine and its role to aerobic N2_{2}O formation in a Norway spruce forest soil

Hydroxylamine (HA) is potentially involved in soil N2O formation as a crucial intermediate in the oxidation of ammonium to nitrite. However, the determination of HA concentration in natural soil samples has not been reported until now. Here, we determined the HA concentrations in organic (Oh) and mineral (Ah) layers of 110 soil samples collected from a spruce forest (Wüstebach, Eifel National Park, Germany) using a novel approach, based on the fast extraction of HA from the soil at a pH of 1.7, the oxidation of HA to N2O with Fe3+, and the analysis of produced N2O using gas chromatography (GC-ECD). In a second step, N2O emission rates were determined by means of aerobic laboratory incubations of 3 g soil in 22-mL vials. Subsequently, the spatial distribution of soil HA concentrations and N2O emission rates in the Oh and Ah layers of the whole sampling area were analyzed using a geostatistical approach. The correlations among soil HA, N2O emission rate, pH, soil C, N, Fe, Mn and soil water content (SWC) were further explored. The HA concentrations ranged from 0.3–37.0 μg N kg-1 and 0.02–11.4 μg N kg-1 dry soil in the Oh and the Ah layer, respectively. The spatial distribution of HA was similar in both layers, with substantial spatial variability dependent on soil type, tree density and distance to a stream, e.g., HA concentration was greater at locations with a thick litter layer or at locations close to the stream. N2O emission rates showed a similar pattern as soil HA concentrations, with higher rates in the Oh layer than in the Ah layer. N2O emission rate exhibited the highest correlation with soil HA content in the Oh layer, while soil NO3- content explained N2O emissions best in the Ah layer, associated with SWC, Mn and C content. HA concentration was negatively correlated with pH and positively correlated with SWC in the Oh layer, while positively correlated with C and N as well as NO3- content in the Ah layer. Moreover, Mn content was the most important factor for HA recovery at the specific extraction conditions. The results demonstrated that HA is a crucial component for aerobic N2O formation and emission in spruce forest soils. Mn may also play a key role to the aerobic N2O emission due to the chemical reaction with HA. Further studies should focus to the relationships between HA, Mn and aerobic N2O emission in other ecosystems

Telefongestützte Verhaltenstherapie als niedrigschwellige Intervention bei Depression: Ein Behandlungsprogramm für den deutschen Sprachraum

Hintergrund: Telefongestützte Psychotherapie (TPT) bei Depression kann als alleinige niedrigschwellige Behandlung z.B. im Rahmen eines Stepped-Care-Behandlungsansatzes, in Kombination mit Psychopharmaka oder als Überbrückung bis zum Beginn einer Face-to-Face-Psychotherapie eingesetzt werden. Erste internationale Studien weisen auf die Wirksamkeit von TPT hin. Material und Methoden: Dieser Beitrag gibt eine Übersicht zur bisherigen Umsetzung und Evidenz von TPT und stellt ein telefongestütztes, manualisiertes verhaltenstherapeutisches Interventionsprogramm für depressive Störungen für den deutschen Sprachraum vor. Ergebnisse: Das Programm besteht aus einem persönlichen Vorgespräch und 8-12 etwa 30-minütigen Telefonsitzungen über 3-5 Monate. Ein dazugehöriges Therapeutenmanual und Patientenarbeitsbuch wurden aus dem US-Amerikanischen übersetzt und vor allem in kultureller Hinsicht adaptiert. Schlussfolgerungen: Es werden Besonderheiten des Settings, klinische und organisatorische Implikationen sowie Voraussetzungen und Rahmenbedingungen für die Implementierung im deutschen Gesundheitssystem diskutier

The contribution of hydroxylamine content to spatial variability of N2O formation in soil of a Norway spruce forest

Hydroxylamine (NH2OH), a reactive intermediate of several microbial nitrogen turnover processes, is a potential precursor of nitrous oxide (N2O) formation in the soil. However, the contribution of soil NH2OH to soil N2O emission rates in natural ecosystems is unclear. Here, we determined the spatial variability of NH2OH content and potential N2O emission rates of organic (Oh) and mineral (Ah) soil layers of a Norway spruce forest, using a recently developed analytical method for the determination of soil NH2OH content, combined with a geostatistical Kriging approach. Potential soil N2O emission rates were determined by laboratory incubations under oxic conditions, followed by gas chromatographic analysis and complemented by ancillary measurements of soil characteristics. Stepwise multiple regressions demonstrated that the potential N2O emission rates, NH2OH and nitrate (NO3−) content were spatially highly correlated, with hotspots for all three parameters observed in the headwater of a small creek flowing through the sampling area. In contrast, soil ammonium (NH4+) was only weakly correlated with potential N2O emission rates, and was excluded from the multiple regression models. While soil NH2OH content explained the potential soil N2O emission rates best for both layers, also NO3− and Mn content turned out to be significant parameters explaining N2O formation in both soil layers. The Kriging approach was improved markedly by the addition of the co-variable information of soil NH2OH and NO3− content. The results indicate that determination of soil NH2OH content could provide crucial information for the prediction of the spatial variability of soil N2O emissions