Preventing depression and promoting resilience:Feasibility study of a school-based cognitive-behavioural intervention

BackgroundThe limited reach and effectiveness of psychological treatments for adolescent depression have fuelled interest in alternative approaches designed to promote resilience. Schools offer a convenient location for the widespread delivery of depression prevention programmes, although little research has evaluated the feasibility of delivering interventions in this setting.AimsTo investigate the feasibility of delivering and evaluating a universal school-based depression prevention programme for children aged 12-16 years.MethodA three-arm pilot study was conducted in one UK secondary SChOOl (n = 834).ResultsInterventions had good reach (96%), with high rates of consent (89%) and reasonable retention (78%). The majority of intervention sessions were delivered as intended, with 85% of students attending seven or more sessions. The programme was acceptable to students and teachers, with the specific content of the active intervention being rated differently from the control programmes.ConclusionsDelivering and undertaking methodologically robust evaluations of universal school-based depression programmes is feasible.</jats:sec

Streamlined and Abundant Bacterioplankton Thrive in Functional Cohorts

While fastidious microbes can be abundant and ubiquitous in their natural communities, many fail to grow axenically in laboratories due to auxotrophies or other dependencies. To overcome auxotrophies, these microbes rely on their surrounding cohort. A cohort may consist of kin (ecotypes) or more distantly related organisms (community) with the cooperation being reciprocal or nonreciprocal and expensive (Black Queen hypothesis) or costless (by-product). These metabolic partnerships (whether at single species population or community level) enable dominance by and coexistence of these lineages in nature. Here we examine the relevance of these cooperation models to explain the abundance and ubiquity of the dominant fastidious bacterioplankton of a dimictic mesotrophic freshwater lake. Using both culture-dependent (dilution mixed cultures) and culture-independent (small subunit [SSU] rRNA gene time series and environmental metagenomics) methods, we independently identified the primary cohorts of actinobacterial genera "Candidatus Planktophila" (acI-A) and "Candidatus Nanopelagicus" (acI-B) and the proteobacterial genus "Candidatus Fonsibacter" (LD12). While "Ca. Planktophila" and "Ca. Fonsibacter" had no correlation in their natural habitat, they have the potential to be complementary in laboratory settings. We also investigated the bifunctional catalase-peroxidase enzyme KatG (a common good which "Ca. Planktophila" is dependent upon) and its most likely providers in the lake. Further, we found that while ecotype and community cooperation combined may explain "Ca. Planktophila" population abundance, the success of "Ca. Nanopelagicus" and "Ca. Fonsibacter" is better explained as a community by-product. Ecotype differentiation of "Ca. Fonsibacter" as a means of escaping predation was supported but not for overcoming auxotrophies.IMPORTANCE This study examines evolutionary and ecological relationships of three of the most ubiquitous and abundant freshwater bacterial genera: "Ca. Planktophila" (acI-A), "Ca. Nanopelagicus" (acI-B), and "Ca. Fonsibacter" (LD12). Due to high abundance, these genera might have a significant influence on nutrient cycling in freshwaters worldwide, and this study adds a layer of understanding to how seemingly competing clades of bacteria can coexist by having different cooperation strategies. Our synthesis ties together network and ecological theory with empirical evidence and lays out a framework for how the functioning of populations within complex microbial communities can be studied

Common health problems, yellow flags and functioning in a community setting

Introduction Common health problems such as pain, depression and fatigue have a high impact on daily life, work and healthcare utilization. This study aimed to investigate the prevalence of these complaints in a UK community setting and to establish whether psychosocial risk factors, or ‘yellow flags’, moderate their impact on daily life and work. Methods 580 women and 420 men participated in a cross-sectional survey in the UK in 2007. 467 (57.2%) of the 816 working age adults in this sample reported complaints over the last month and were included in the moderator multivariate analysis. Results Women and the not employed group reported a higher number and greater extent (frequency × severity) of complaints. Statistically significant models emerged for interference with daily life (F 9,457 = 36.54, P < 0.001, adjusted R 2 = 0.407) and time off work (F 4,462 = 31.22, P < 0.001, adjusted R 2 = 0.213). Age (β = .238) and socio-economic status (β = −.216) were associated with time off work. Extent of complaints and number of yellow flags were independently associated with interference with daily life (extent β = .25, yellow flags β = .15) and time off work (extent β = .154, yellow flags β = .201). No moderating effect of yellow flags was found. Conclusions Common health problems and yellow flags can be briefly and simply assessed. A broader approach is needed in managing these complaints in community and work contexts, moving beyond reducing complaint severity. Interventions need to acknowledge and address people’s beliefs and affective responses to complaints, as well as wider socio-economic issues

Conditionality in context: Incapacity benefit and social deprivation in Merthyr Tydfil

2.1 The welfare contract..........................................................................

Protocol for a randomised controlled trial of a school based cognitive behaviour therapy (CBT) intervention to prevent depression in high risk adolescents (PROMISE)

<p>Abstract</p> <p>Background</p> <p>Depression in adolescents is a significant problem that impairs everyday functioning and increases the risk of severe mental health disorders in adulthood. Relatively few adolescents with depression are identified and referred for treatment indicating the need to investigate alternative preventive approaches.</p> <p>Study Design</p> <p>A pragmatic cluster randomised controlled trial evaluating the effectiveness of a school based prevention programme on symptoms of depression in "high risk" adolescents (aged 12-16). The unit of allocation is year groups (n = 28) which are assigned to one of three conditions: an active intervention based upon cognitive behaviour therapy, attention control or treatment as usual. Assessments will be undertaken at screening, baseline, 6 months and 12 months. The primary outcome measure is change on the Short Mood and Feeling Questionnaire at 12 months. Secondary outcome measures will assess changes in negative thoughts, self esteem, anxiety, school connectedness, peer attachment, alcohol and substance misuse, bullying and self harm.</p> <p>Discussion</p> <p>As of August 2010, all 28 year groups (n = 5023) had been recruited and the assigned interventions delivered. Final 12 month assessments are scheduled to be completed by March 2011.</p> <p>Trial Registration</p> <p>ISRCTN19083628</p