A hybrid ecological momentary compassion-focused intervention for enhancing resilience in help-seeking young people:A prospective study of baseline characteristics in the EMIcompass trial

BACKGROUND: Young people are a target population for mental health–related early intervention and prevention. Although evidence for early intervention is promising, availability of and access to youth mental health services remain limited. Therefore, the development of an evidence-based hybrid intervention is urgently needed. OBJECTIVE: This study aimed to present a manual for a hybrid intervention, combining an ecological momentary intervention and face-to-face sessions aimed for enhancing resilience in help-seeking young people based on compassion-focused interventions, and explore whether participants’ baseline characteristics are associated with putative mechanisms and outcomes of the EMIcompass intervention. Specifically, we aimed to explore initial signals as to whether participants’ sociodemographic, clinical, and functional characteristics at baseline are associated with putative mechanisms (ie, change in self-compassion, change in emotion regulation, working alliance, training frequency); and whether participants’ sociodemographic, clinical, and functional characteristics, self-compassion, and emotion regulation at baseline are associated with clinical outcomes (ie, psychological distress and general psychopathology at postintervention and 4-week follow-ups) in the experimental condition and obtain first parameter estimates. METHODS: We recruited young people aged 14 to 25 years, with psychological distress, Clinical High At-Risk Mental State, or first episodes of severe mental disorder for an exploratory randomized controlled trial with assessments at baseline and postintervention and 4-week follow-ups. A structured manual was developed and optimized based on a pilot study’s manual, a scoping review of existing literature and manuals, exchange with experts, the team’s clinical experience of working with compassion-focused interventions, and the principles of ecological momentary interventions. This analysis focuses on the experimental condition receiving the EMIcompass intervention. RESULTS: A total of 46 young individuals were randomized to the experimental condition. There was evidence for initial signals of effects of age (B=0.11, 95% CI 0.00-0.22), general psychopathology (B=0.08, 95% CI −0.01 to 0.16), and clinical stage (B=1.50, 95% CI 0.06-2.93) on change in momentary self-compassion and change in emotion regulation from baseline to postintervention assessments. There was no evidence for associations of other baseline characteristics (eg, gender, minority status, and level of functioning) and putative mechanisms (eg, overall self-compassion, working alliance, and training frequency). In addition, except for an initial signal for an association of momentary self-compassion at baseline and psychological distress (B=−2.83, 95% CI −5.66 to 0.00), we found no evidence that baseline characteristics related to clinical outcomes. CONCLUSIONS: The findings indicated the reach of participants by the intervention largely independent of sociodemographic, clinical, and functional baseline characteristics. The findings need to be confirmed in a definitive trial. TRIAL REGISTRATION: German Clinical Trials Register NDRKS00017265; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00017265 INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/2746

Popular attitudes to memory, the body, and social identity : the rise of external commemoration in Britain, Ireland, and New England

A comparative analysis of samples of external memorials from burial grounds in Britain, Ireland and New England reveals a widespread pattern of change in monument style and content, and exponential growth in the number of permanent memorials from the 18th century onwards. Although manifested in regionally distinctive styles on which most academic attention has so far been directed, the expansion reflects global changes in social relationships and concepts of memory and the body. An archaeological perspective reveals the importance of external memorials in articulating these changing attitudes in a world of increasing material consumption

Dihydrodinophysistoxin-1 produced by Dinophysis norvegica in the Gulf of Maine, USA and its accumulation in shellfish

© The Author(s), 2020. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Deeds, J. R., Stutts, W. L., Celiz, M. D., MacLeod, J., Hamilton, A. E., Lewis, B. J., Miller, D. W., Kanwit, K., Smith, J. L., Kulis, D. M., McCarron, P., Rauschenberg, C. D., Burnell, C. A., Archer, S. D., Borchert, J., & Lankford, S. K. Dihydrodinophysistoxin-1 produced by Dinophysis norvegica in the Gulf of Maine, USA and its accumulation in shellfish. Toxins, 12(9), (2020): E533, doi:10.3390/toxins12090533.Dihydrodinophysistoxin-1 (dihydro-DTX1, (M-H)−m/z 819.5), described previously from a marine sponge but never identified as to its biological source or described in shellfish, was detected in multiple species of commercial shellfish collected from the central coast of the Gulf of Maine, USA in 2016 and in 2018 during blooms of the dinoflagellate Dinophysis norvegica. Toxin screening by protein phosphatase inhibition (PPIA) first detected the presence of diarrhetic shellfish poisoning-like bioactivity; however, confirmatory analysis using liquid chromatography-tandem mass spectrometry (LC-MS/MS) failed to detect okadaic acid (OA, (M-H)−m/z 803.5), dinophysistoxin-1 (DTX1, (M-H)−m/z 817.5), or dinophysistoxin-2 (DTX2, (M-H)−m/z 803.5) in samples collected during the bloom. Bioactivity-guided fractionation followed by liquid chromatography-high resolution mass spectrometry (LC-HRMS) tentatively identified dihydro-DTX1 in the PPIA active fraction. LC-MS/MS measurements showed an absence of OA, DTX1, and DTX2, but confirmed the presence of dihydro-DTX1 in shellfish during blooms of D. norvegica in both years, with results correlating well with PPIA testing. Two laboratory cultures of D. norvegica isolated from the 2018 bloom were found to produce dihydro-DTX1 as the sole DSP toxin, confirming the source of this compound in shellfish. Estimated concentrations of dihydro-DTX1 were >0.16 ppm in multiple shellfish species (max. 1.1 ppm) during the blooms in 2016 and 2018. Assuming an equivalent potency and molar response to DTX1, the authority initiated precautionary shellfish harvesting closures in both years. To date, no illnesses have been associated with the presence of dihydro-DTX1 in shellfish in the Gulf of Maine region and studies are underway to determine the potency of this new toxin relative to the currently regulated DSP toxins in order to develop appropriate management guidance.Partial support for this research was received from the National Oceanic and Atmospheric Administration, National Centers for Coastal Ocean Science Competitive Research, Ecology and Oceanography of Harmful Algal Blooms Program under awards NA17NOS4780184 and NA19NOS4780182 to Juliette Smith (VIMS) and Jonathan Deeds (US FDA), and Prevention, Control, and Mitigation of Harmful Algal Blooms program award NA17NOS4780179 to Stephen Archer. This paper is ECOHAB publication number EC0956

The influence of environmental variability on the biogeography of coccolithophores and diatoms in the Great Calcite Belt

The Great Calcite Belt (GCB) of the Southern Ocean is a region of elevated summertime upper ocean calcite concentration derived from coccolithophores, despite the region being known for its diatom predominance. The overlap of two major phytoplankton groups, coccolithophores and diatoms, in the dynamic frontal systems characteristic of this region, provides an ideal setting to study environmental influences on the distribution of different species within these taxonomic groups. Water samples for phytoplankton enumeration were collected from the upper 30 m during two cruises, the first to the South Atlantic sector (Jan–Feb 2011; 60 °W–15 °E and 36–60 °S) and the second in the South Indian sector (Feb–Mar 2012; 40–120 °E and 36–60 °S). The species composition of coccolithophores and diatoms was examined using scanning electron microscopy at 27 stations across the Sub-Tropical, Polar, and Sub-Antarctic Fronts. The influence of environmental parameters, such as sea-surface temperature (SST), salinity, carbonate chemistry (i.e., pH, partial pressure of CO2 (pCO2), alkalinity, dissolved inorganic carbon), macro-nutrients (i.e., nitrate + nitrite, phosphate, silicic acid, ammonia), and mixed layer average irradiance, on species composition across the GCB, was assessed statistically. Nanophytoplankton (cells 2–20 μm) were the numerically abundant size group of biomineralizing phytoplankton across the GCB, the coccolithophore Emiliania huxleyi and the diatoms Fragilariopsis nana, F. pseudonana and Pseudonitzschia sp. were the most dominant and widely distributed species. A combination of SST, macro-nutrient concentrations and pCO2 were the best statistical descriptors of biogeographic variability of biomineralizing species composition between stations. Emiliania huxleyi occurred in the silicic acid-depleted waters between the Sub-Antarctic Front and the Polar Front, indicating a favorable environment for this coccolithophore in the GCB after spring diatom blooms remove silicic acid to limiting levels. After full consideration of variability in carbonate chemistry and temperature on the distribution of nanoplankton in the GCB, we find that temperature remains the dominant driver of biogeography in a large proportion of the modern Southern Ocean

An ecological momentary compassion-focused intervention for enhancing resilience in help-seeking youths: a pilot study

Digital interventions offer new avenues for prevention and treatment in youth. Ecological momentary interventions (EMIs) allow for adaptive and real-time delivery of intervention components in daily life. Compassion-focused interventions may be particularly amenable to translation into an EMI to strengthen emotional resilience in youth. We aimed to investigate initial therapeutic effects, feasibility, and safety of a novel, accessible, transdiagnostic, ecological momentary, compassion-focused intervention for improving emotional resilience (‘EMIcompass’) in an uncontrolled pilot study including help-seeking youth with psychotic, depressive, and/or anxiety symptoms. The EMIcompass intervention consisted of three sessions with a trained psychologist and a 3-week EMI administered through a mobile health app. In total, ten individuals (Mage=20.3 years) were included. Reduced stress sensitivity, momentary negative affect, and psychotic experiences as well as increased positive affect were found at post-intervention and 4-week follow-up. Further, reductions in psychotic, anxiety, and depressive symptoms of medium to large effect size were found (r=0.30-0.65). Most participants were satisfied (80%) and reported low burden of app usage. No adverse events were observed. Our findings provide initial evidence on beneficial effects, feasibility, and safety of the EMIcompass intervention in help-seeking youth. An exploratory randomised controlled trial is warranted to establish feasibility and preliminary evidence of efficacy

The effects of a novel, transdiagnostic, hybrid ecological momentary intervention for improving resilience in youth (EMIcompass): study protocol for an exploratory randomized controlled trial

Background: Most mental disorders first emerge in youth and, in their early stages, surface as subthreshold expressions of symptoms comprising a transdiagnostic phenotype of psychosis, mania, depression and anxiety. Elevated stress reactivity is one of the most widely studied mechanisms underlying psychotic and affective mental health problems. Thus, targeting stress reactivity in youth is a promising indicated and translational preventive strategy for adverse mental health outcomes later in life and for improving resilience. Compassion-focused interventions (CFIs) offer a wide range of innovative therapeutic techniques particularly amenable to being implemented as Ecological Momentary Interventions (EMIs), a specific type of mHealth intervention, to enable youth to access interventions in a given moment and context in daily life. This approach may bridge a gap in current youth mental health care. Objectives: The aim of this study will be to investigate the clinical feasibility, candidate underlying mechanisms and initial signals of efficacy of a novel, transdiagnostic, hybrid EMI for improving resilience to stress in youth (EMIcompass). Methods: In an exploratory randomized controlled trial (RCT), youth aged 14-25 with current distress, a broad Clinical High At-Risk Mental State (CHARMS) or a first episode of a severe mental disorder will be randomly allocated to the EMIcompass intervention (EMI plus face-to-face training sessions) in addition to treatment as usual (TAU) or a control condition of TAU only. Primary (stress reactivity) and secondary candidate mechanisms (resilience, interpersonal sensitivity, threat anticipation, negative affective appraisals, momentary physiological markers of stress reactivity) as well as primary (psychological distress) and secondary outcomes (primary psychiatric symptoms, general psychopathology) will be assessed at baseline, post-intervention and 4-week follow-up. Results: The first enrolment was in August 2019 and as of May 2021, enrolment and randomization has been completed (n = 92 participants). We expect the end of data collection in August 2021. Conclusions: The current study is the first to establish feasibility, evidence on underlying mechanisms, and preliminary signals of efficacy of a compassion-focused EMI in youth. If successful, a confirmatory RCT will be warranted. Overall, our approach has the potential to significantly advance preventive interventions in youth mental health provision. Trial registration: German Clinical Trials Register (DRKS), DRKS00017265; Date of registration: 31.07.2019

Biogeochemical cycling of dissolved zinc in the Western Arctic (Arctic GEOTRACES GN01)

The biogeochemical cycling of dissolved zinc (dZn) was investigated in the Western Arctic along the U.S. GEOTRACES GN01 section. Vertical profiles of dZn in the Arctic are strikingly different than the classic “nutrient‐type” profile commonly seen in the Atlantic and Pacific Oceans, instead exhibiting higher surface concentrations (~1.1 nmol/kg), a shallow subsurface absolute maximum (~4–6 nmol/kg) at 200 m coincident with a macronutrient maximum, and low deep water concentrations (~1.3 nmol/kg) that are homogeneous (sp.) with depth. In contrast to other ocean basins, typical inputs such as rivers, atmospheric inputs, and especially deep remineralization are insignificant in the Arctic. Instead, we demonstrate that dZn distributions in the Arctic are controlled primarily by (1) shelf fluxes following the sediment remineralization of high Zn:C and Zn:Si cells and the seaward advection of those fluxes and (2) mixing of dZn from source waters such as the Atlantic and Pacific Oceans rather than vertical biological regeneration of dZn. This results in both the unique profile shapes and the largely decoupled relationship between dZn and Si found in the Arctic. We found a weak dZn:Si regression in the full water column (0.077 nmol/μmol, r2 = 0.58) that is higher than the global slope (0.059 nmol/μmol, r2 = 0.94) because of the shelf‐derived halocline dZn enrichments. We hypothesize that the decoupling of Zn:Si in Western Arctic deep waters results primarily from a past ventilation event with unique preformed Zn:Si stoichiometries

Effects of a novel, transdiagnostic ecological momentary intervention for prevention and early intervention of severe mental disorder in youth (EMIcompass):findings from an exploratory randomized controlled trial

Background/Hypothesis: Digital interventions targeting transdiagnostic mechanisms in daily life may be a promising translational strategy for prevention and early intervention of psychotic and other severe mental disorders. We aimed to investigate the feasibility and initial signals of efficacy of a transdiagnostic, compassion-focused, hybrid ecological momentary intervention for improving resilience (ie, EMIcompass) in youth with early mental health problems.Study Design: In an exploratory, assessor-blind randomized controlled trial, youth aged 14–25 with current distress, broad at-risk mental state, or first episode of severe mental disorder were randomly allocated to experimental (EMIcompass+treatment as usual [TAU]) or control condition (TAU). Data on primary (stress reactivity) and secondary candidate mechanisms as well as candidate primary (psychological distress) and secondary outcomes were collected.Study Results: Criteria for the feasibility of trial methodology and intervention delivery were met (n = 92 randomized participants). No serious adverse events were observed. Initial outcome signals were evident for reduced momentary stress reactivity (stress×time×condition, B = −0.10 95%CI −0.16–−0.03, d = −0.10), aberrant salience (condition, B = −0.38, 95%CI −0.57–−0.18, d = −0.56) as well as enhanced momentary resilience (condition, B = 0.55, 95%CI 0.18–0.92, d = 0.33) and quality of life (condition, B = 0.82, 95%CI 0.10–1.55, d = 0.60) across post-intervention and 4-week follow-up. No outcome signals were observed for self-reported psychological distress (condition, B = 0.57, 95%CI −1.59–2.72, d = 0.09), but there was suggestive evidence of reduced observer-rated symptoms at the 4-week follow-up (B = −1.41, 95%CI −2.85–0.02, d = −0.41).Conclusions: Our findings provide evidence of feasibility and initial signals that EMIcompass may reduce stress reactivity and improve quality of life. A definitive trial is now warranted