Supported Education and Supported Employment for Individuals at Clinical-High Risk of Psychosis:A Pilot Study

Deteriorated functioning is a part of the clinical-high risk (CHR) criteria for psychosis. Diminished social, educational and occupational functioning in the phase of late adolescence and early adulthood are associated with long-term social, economic and health consequences, which stresses the importance of early intervention to stimulate functioning. This pilot study examines the effectiveness and feasibility of the choose-get-keep model of Supported Education and Supported Employment (SEE) to improve educational and occupational functioning of individuals at CHR for a psychosis. A single blind randomized controlled pilot study combined SEE with treatment as usual (TAU) versus TAU among adolescents and early adults at CHR. School performance and job status as well as global functioning scales were assessed at twelve months. Of the 78 eligible participants, 20 individuals consented to participate in this study. At follow-up, participants in the intervention condition (n = 9) did not start an education more often than the participants in the control condition (n = 11) and the school results for both conditions were similar. However, in the intervention condition there were no school dropouts, more participants gained a job and worked longer hours. Two participants quit the intervention. This pilot study provides preliminary evidence that a SEE intervention is effective and feasible in sustaining and improving the level of both educational and occupational functioning of individuals at CHR for psychosis by supporting them in attaining, keeping and elaborating of their education or employment.</p

Supported Education and Supported Employment for Individuals at Clinical-High Risk of Psychosis:A Pilot Study

Deteriorated functioning is a part of the clinical-high risk (CHR) criteria for psychosis. Diminished social, educational and occupational functioning in the phase of late adolescence and early adulthood are associated with long-term social, economic and health consequences, which stresses the importance of early intervention to stimulate functioning. This pilot study examines the effectiveness and feasibility of the choose-get-keep model of Supported Education and Supported Employment (SEE) to improve educational and occupational functioning of individuals at CHR for a psychosis. A single blind randomized controlled pilot study combined SEE with treatment as usual (TAU) versus TAU among adolescents and early adults at CHR. School performance and job status as well as global functioning scales were assessed at twelve months. Of the 78 eligible participants, 20 individuals consented to participate in this study. At follow-up, participants in the intervention condition (n = 9) did not start an education more often than the participants in the control condition (n = 11) and the school results for both conditions were similar. However, in the intervention condition there were no school dropouts, more participants gained a job and worked longer hours. Two participants quit the intervention. This pilot study provides preliminary evidence that a SEE intervention is effective and feasible in sustaining and improving the level of both educational and occupational functioning of individuals at CHR for psychosis by supporting them in attaining, keeping and elaborating of their education or employment.</p

A cognitive remediation training for young adults with psychotic disorders to support their participation in education - study protocol for a pilot randomized controlled trial

Background: Most severe mental disorders have their onset between the age of 17 and 27, a time when many young adults begin participating in secondary or post-secondary education. The cognitive deficits typically associated with psychiatric disorders, especially psychotic disorders, increase the risk of leaving school early, which can lead to a reduction in employment opportunities later on in life and, in turn, a poorer long-term prognosis. Therefore, specific interventions aiming to improve these cognitive functions are needed. Cognitive remediation (CR) aims to improve cognitive functioning and may increase real-world functioning in educational performance. This study aims to examine the feasibility and applicability of a CR training named Mindset for students with psychotic disorders in the Netherlands. Methods/design: Sixty students diagnosed with a psychotic disorder and currently reporting cognitive deficits will be included from four Dutch Mental Health Care institutes. Half of the participants (N = 30) will be randomly assigned to the CR training consisting of twelve, individual, weekly 1-h meetings. The other half will be assigned to an active control condition consisting of twelve weekly assignments that will be sent by email aiming to improve school performance. Students will be evaluated at baseline (T0), directly after finishing the CR training or control intervention (T1), and 6 months later (T2). Treatment feasibility will be the primary outcome, using evaluation forms, interviews with trainers and participants, number of study drop outs, and patient eligibility and recruitment rates. School functioning, cognitive functioning, and strategy use will also be assessed to get a preliminary idea of the potential effectiveness of the intervention. Discussion: The CR training in this study will provide real-world examples and exercises aimed to teach useful strategies to cope with the cognitive deficits experienced by students with psychotic disorders. Furthermore, since students with other psychiatric disorders might also experience cognitive deficits, the results of this study may also provide some further implications for future studies on the effect of this CR training for students with these disorders. Trial registration: The study was registered with Trialregister.nl, no. NL6590 (NTR6764), date registered: September 7, 2017. Register name: Mindset. A cognitive rehabilitation training for young adults with psychotic spectrum disorder in an educational setting: A pilot study.Protocol version: 3, date December 23, 2019

Development and evaluation of a Europrean daily high-resolution gridded dataset of surface temperature and precipitation for 1950-2006

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Impacts of population growth, urbanisation and sanitation changes on global human Cryptosporidium emissions to surface water

Cryptosporidium is a pathogenic protozoan parasite and is a leading cause of diarrhoea worldwide. The concentration of Cryptosporidium in the surface water is a determinant for probability of exposure and the risk of disease. Surface water concentrations are expected to change with population growth, urbanisation and changes in sanitation. The objective of this paper is to assess the importance of future changes in population, urbanisation and sanitation on global human emissions of Cryptosporidium to surface water. The GloWPa-Crypto H1 (the Global Waterborne Pathogen model for Human Cryptosporidium emissions version 1) model is presented and run for 2010 and with scenarios for 2050. The new scenarios are based on the Shared Socio-economic Pathways (SSPs) developed for the climate community. The scenarios comprise assumptions on sanitation changes in line with the storylines and population and urbanisation changes from the SSPs. In SSP1 population growth is limited, urbanisation large and sanitation and waste water treatment strongly improve. SSP1* is the same as SSP1, but waste water treatment does not improve. SSP3 sees large population growth, moderate urbanisation and sanitation and waste water treatment fractions that are the same as in 2010. Total global Cryptosporidium emissions to surface water for 2010 are estimated to be 1.6 × 1017 oocysts per year, with hotspots in the most urbanised parts of the world. In 2050 emissions are expected to decrease by 24% or increase by 52% and 70% for SSP1, SSP3 and SSP1* respectively. The emissions increase in all scenarios for countries in the Middle East and Africa (MAF) region, while emissions in large parts in Europe decrease in scenarios SSP1 and SSP3. Improving sanitation by connecting the population to sewers, should be combined with waste water treatment, otherwise (SSP1*) emissions in 2050 are expected to be much larger than in a situation with strong population growth and slow development of safe water and improved sanitation (SSP3). The results show that population increase, urbanisation and changes in sanitation should be considered when water quality and resulting health risks are estimated by water managers or public health specialists.</p

Present and future human emissions of rotavirus and Escherichia coli to Uganda's surface waters

Rotavirus (RV) and diarrheagenic Escherichia coli are waterborne pathogens commonly causing diarrhea in children below five years old worldwide. Our study is a first step toward a loads-concentrations-risk modeling and scenario analysis framework. We analyzed current and future human RV and indicator E. Coli (EC) emissions from sanitation facilities to surface waters in Uganda using two process-based models. Emissions were estimated for the baseline year 2015 and for three scenarios in 2030 using population, excretion rates, sanitation types, and wastewater treatment. The first model is a downscaled GloWPa-Rota H1 version, producing emissions at a 1-km2 resolution. The second model is newly developed for Kampala and adds emissions from pit latrines and septic tanks excluded in the first model. The scenarios Business as Usual, Industrious, and Low Emissions reflect government prospects in sanitation coverage and wastewater treatment. For the first model, 6.14 ? 1014 RV particles d-1 and 1.31 ? 1012 EC colony-forming units (CFU) d-1 are emitted to surface waters in 2015. The RV emissions are expected to increase in 2030 by 75% for Business as Usual and 212% for Industrious and decrease by 58% in Low Emissions. Emissions from the second model are higher for Kampala than in the first model, at 3.74 ? 1014 vs. 5.95 ? 1013 RV particles d-1 and 8.18 ? 1011 vs. 1.75 ? 1011 EC CFU d-1 in 2015, most of which come from the onsite-not-contained category. Simulated emissions for Kampala show the importance of including onsite sanitation in our modeling. Our study is replicable in other locations and helps identify key emission sources, their hotspots, and the importance of wastewater treatment. The scenarios can guide future sanitation safety planning. Copyright c</p

To tell or not to tell about your mental health problems?:An intervention for students.

Worldwide, an increasing number of students in higher education have mental health problems. Talking about these problems at the university is often not that easy. Students fear to be stigmatised if they disclose their problems to others. However, if they do not disclose their problems, they may not get the support they often need. Existing interventions to help people with this disclosure-dilemma are not specifically aimed at students, and lack certain important aspects. Therefore, we developed an intervention to help students with making a personal, well-informed decision regarding whether or not to disclose their problems. We examined the experiences of students and professionals with the new intervention. Moreover, we studied whether the students were less concerned about disclosure and experienced less decisional conflicts after using the intervention. Students with mental health problems from three universities of applied sciences in the Netherlands completed questionnaires prior to the intervention, directly after and three months after. In addition, the educational professionals reported their experiences with applying the intervention. Both students and professionals appreciated the contents and structure of the intervention and students’ level of concern about disclosure and level of decisional conflicts were lower after using the intervention

Impacts of Climate and Management Variables on the Contamination of Preharvest Leafy Greens with Escherichia coli

The observed seasonality of foodborne disease suggests that climatic conditions play a role and that changes in the climate may affect the presence of pathogens. However, it is hard to determine whether this effect is direct or whether it works indirectly through other factors, such as farm management. This study aimed to identify the climate and management variables that are associated with the contamination (presence and concentration) of leafy green vegetables with E. coli. This study used data about E. coli contamination from 562 leafy green vegetables (lettuce and spinach) samples taken between 2011 and 2013 from 23 open-ield farms in Belgium, Brazil, Egypt, Norway, and Spain. Mixed-effect logistic and linear regression models were used to study the statistical relationship between the dependent and independent variables. Climate variables and agricultural management practices together had a systematic influence on E. coli presence and concentration. The variables important for E. coli presence included the minimum temperature of the sampling day (odds ratio =1.47), region, and application of inorganic fertilizer. The variables important for concentration (R2 = 0.75) were the maximum temperature during the 3 days before sampling and the region. Temperature had a stronger influence (had a significant parameter estimate and the highest R2) than did management practices on E. coli presence and concentration. Region was a variable that masked many management variables, including rainwater, surface water, manure, inorganic fertilizer, and spray irrigation. Climate variables had a positive relationship with E. coli presence and concentration. Temperature, irrigation water type, fertilizer type, and irrigation method should be systematically considered in future studies of fresh produce safety.</p

Modeling Escherichia coli fate and transport in the Kabul River Basin using SWAT

Access to safe water is the primary goal of all development plans, yet population increase, urbanization lead to contamination of water resources. This paper focuses on microbial contamination and aims to analyze the fate and transport of Escherichia coli in the Kabul River Basin using SWAT model to evaluate the contribution of different sources. The SWAT is calibrated and validated for the monthly time step using observed E. coli concentrations for April 2013–July 2015. The model skill score; coefficients of determination (R2) equal 0.72 and 0.70, Nash–Sutcliffe efficiencies (NSE) equal 0.69 and 0.66, and percentages bias (PBIAS) equal 3.7 and 1.9 respond well for both calibration and validation, respectively. Regional measured and modeled concentrations are very high with peaks of up to 5.2 10log cfu/100 ml in the wet season. Overall, point sources that are comprised of human feces from the big cities and livestock manure from animal sheds, contribute most (44%) to the E. coli concentrations. During peak discharge the non-point sources become the most important contributors due to wash-off from the land and diluted point sources. Allthough such studies are lacking in developing countries, they can be helpful for sanitation management by developing and accessing regional sanitation scenarios.</p