A Randomized Waitlist-controlled Trial of Voice Over Internet Protocol-delivered Behavior Therapy for Chronic Tic Disorders

Videoconferencing is efficacious, acceptable and equivalent to face to face for a range of psychotherapies, including a Comprehensive Behavioral Interventions for Tics (CBIT), but limited due to lack of portability, and restricted accessibility. An alternative is Voice over Internet Protocol (VoIP) transmission, allowing home delivery of treatment. The present study examined the preliminary efficacy, feasibility, and acceptability of CBIT-VoIP. Twenty youth (8-17) with CTDs participated in a randomized, waitlist-controlled trial of CBIT. Assessments were conducted via VoIP and internet surveys. Significantly greater reductions in total clinician-rated and parent-reported tic severity were found in the CBIT relative to the waitlist-control group, with 33.3% of those in CBIT considered treatment responders. Treatment satisfaction and the therapeutic alliance were high. Higher parent satisfaction with videoconferencing was associated with higher decreases in clinician-rated tic severity. Positive relationships were found between child computer usage at baseline and satisfaction with videoconferencing at post-assessment. VoIP was generally feasible, with some challenges due to audio and visual disruptions

Pilot Open Case Series of Voice over Internet Protocol-Delivered Assessment and Behavior Therapy for Chronic Tic Disorders

Comprehensive Behavioral Intervention for Tics (CBIT) is an efficacious treatment for children with chronic tic disorders (CTDs). Nevertheless, many families of children with CTDs are unable to access CBIT due to a lack of adequately trained treatment providers, time commitment, and travel distance. This study established the interrater reliability between in-person and Voice over Internet Protocol (VoIP) administrations of the Yale Global Tic Severity Scale (YGTSS), and examined the preliminary efficacy, feasibility, and acceptability of VoIP-delivered CBIT for reducing tics in children with CTDs in an open case series. Across in-person and VoIP administrations of the YGTSS, results showed mean agreement of 91%, 96%, and 95% for motor, phonic, and total tic severity subscales. In the pilot feasibility study, 4 children received 8 weekly sessions of CBIT via VoIP and were assessed at pre- and posttreatment by an independent evaluator. Results showed a 29.44% decrease in clinician-rated tic severity from pre- to posttreatment on the YGTSS. Two of the 4 patients were considered treatment responders at posttreatment, using Clinical Global Impressions–Improvement ratings. Therapeutic alliance, parent and child treatment satisfaction, and videoconferencing satisfaction ratings were high. CBIT was considered feasible to implement via VoIP, although further testing is recommended

Working at the intersection of research and practice:The love to read project

There is growing interest in the use of research-practice partnerships in education, in an attempt to narrow the widely recognized gap between educational research and practice. However, there is a tendency for partnership research to be weighted towards first-person accounts and the majority of literature comes from the US. This article describes the process of researcher-teacher collaboration to co-design an educational program, and teachers’ evaluation of this process, set within the context of a longer-term research-practice partnership in the UK. This paper discusses the benefits, challenges and methodological considerations associated with research-practice partnerships. Implications for future research-practice partnerships are highlighted, as are lessons learnt for those interested in working collaboratively and productively at the intersection of research and practice

Critical Thinking Dispositions of Agricultural Communications Students

Critical thinking, a reasoned, purposive, and introspective approach to solving problems, has received increased attention from agricultural educators. This study of agricultural communications students utilized a directly administered survey to investigate critical thinking dispositions of agricultural communications students at 12 universities. Results indicated that agricultural communications student respondents tend to be highly innovative in their thinking, an important trait in the field of communications. Results also indicated that few agricultural communication students would be classified as having a strong disposition toward critical thinking, while a larger number would be classified as weak in critical thinking dispositions

Pilot Testing Behavior Therapy for Chronic Tic Disorders in Neurology and Developmental Pediatrics Clinics

Comprehensive Behavioral Intervention for Tics (CBIT) is an efficacious treatment with limited regional availability. As neurology and pediatric clinics are often the first point of therapeutic contact for individuals with tics, the present study assessed preliminary treatment response, acceptability, and feasibility of an abbreviated version, modified for child neurology and developmental pediatrics clinics. Fourteen youth (9-17) with Tourette disorder across 2 child neurology clinics and one developmental pediatrics clinic participated in a small case series. Clinician-rated tic severity (Yale Global Tic Severity Scale) decreased from pre- to posttreatment, z = –2.0, P \u3c .05, r = –.48, as did tic-related impairment, z = –2.4, P \u3c .05, r = –.57. Five of the 9 completers (56%) were classified as treatment responders. Satisfaction ratings were high, and therapeutic alliance ratings were moderately high. Results provide guidance for refinement of this modified CBIT protocol

A Multicenter Examination and Strategic Revisions of the Yale Global Tic Severity Scale

Objective To examine the internal consistency and distribution of the Yale Global Tic Severity Scale (YGTSS) scores to inform modification of the measure. Methods This cross-sectional study included 617 participants with a tic disorder (516 children and 101 adults), who completed an age-appropriate diagnostic interview and the YGTSS to evaluate tic symptom severity. The distributions of scores on YGTSS dimensions were evaluated for normality and skewness. For dimensions that were skewed across motor and phonic tics, a modified Delphi consensus process was used to revise selected anchor points. Results Children and adults had similar clinical characteristics, including tic symptom severity. All participants were examined together. Strong internal consistency was identified for the YGTSS Motor Tic score (α = 0.80), YGTSS Phonic Tic score (α = 0.87), and YGTSS Total Tic score (α = 0.82). The YGTSS Total Tic and Impairment scores exhibited relatively normal distributions. Several subscales and individual item scales departed from a normal distribution. Higher scores were more often used on the Motor Tic Number, Frequency, and Intensity dimensions and the Phonic Tic Frequency dimension. By contrast, lower scores were more often used on Motor Tic Complexity and Interference, and Phonic Tic Number, Intensity, Complexity, and Interference. Conclusions The YGTSS exhibits good internal consistency across children and adults. The parallel findings across Motor and Phonic Frequency, Complexity, and Interference dimensions prompted minor revisions to the anchor point description to promote use of the full range of scores in each dimension. Specific minor revisions to the YGTSS Phonic Tic Symptom Checklist were also proposed

A Latent Profile Analysis of Age of Onset in Pathological Skin Picking

Background Pathological Skin Picking (PSP) may begin at any age, but the most common age of onset is during adolescence. Age of onset is a potentially useful clinical marker to delineate subtypes of psychiatric disorders. The present study sought to examine empirically defined age of onset groups in adults with PSP and assess whether groups differed on clinical characteristics. Method Participants were 701 adult respondents to an internet survey, who endorsed recurrent skin picking with tissue damage and impairment. Latent profile analysis (LPA) was conducted to identify subtypes of PSP based on age of onset. Then subgroups were compared on demographic and clinical characteristics. Results The best fitting LPA model was a two-class solution comprised of a large group with average age of onset in adolescence (n = 650; 92.9% of the sample; Mean age of onset = 13.6 years) and a small group with average onset in middle adulthood (n = 50; 7.1% of the sample; Mean age of onset = 42.8 years). Relative to the early onset group, the late onset group reported significantly less focused picking, less skin picking-related impairment, lower rates of co-occurring body-focused repetitive behaviors, and trends towards reduced family history of PSP. Individuals in the late onset group also reported increased rates of comorbid depression, anxiety and posttraumatic stress disorder, and were more likely to report that initial picking onset seemed related to or followed depression/anxiety and physical illness. Conclusion Findings suggest the presence of two distinct PSP age of onset groups: (1) an early onset group with average onset in adolescence, clinical characteristics suggestive of greater picking-related burden and familiality, and a profile more representative of the general PSP population; and (2) a late onset group with average onset in middle adulthood, increased co-occurring affective and trauma conditions, and initial onset associated with or following other mental health and physical problems. Future replication is needed to assess the validity and clinical utility of these subgroups

Notes from the field: Lessons learned from using ecosystem service approaches to inform real-world decisions

While there have been rapid advances in assessments of biodiversity and ecosystem services (BES), a critical remaining challenge is how to move from scientific knowledge to real-world decision making. We offer 6 lessons from our experiences applying new approaches and tools for quantifying BES in 20 pilot demonstrations: (1) Applying a BES approach is most effective in leading to policy change as part of an iterative science-policy process; (2) simple ecological production function models have been useful in a diverse set of decision contexts, across a broad range of biophysical, social, and governance systems. Key limitations of simple models arise at very small scales, and in predicting specific future BES values; (3) training local experts in the approaches and tools is important for building local capacity, ownership, trust, and long-term success; (4) decision makers and stakeholders prefer to use a variety of BES value metrics, not only monetary values; (5) an important science gap exists in linking changes in BES to changes in livelihoods, health, cultural values, and other metrics of human wellbeing; and (6) communicating uncertainty in useful and transparent ways remains challenging

Coupling of pollination services and coffee suitability under climate change

Climate change will cause geographic range shifts for pollinators and major crops, with global implications for food security and rural livelihoods. However, little is known about the potential for coupled impacts of climate change on pollinators and crops. Coffee production exemplifies this issue, because large losses in areas suitable for coffee production have been projected due to climate change and because coffee production is dependent on bee pollination. We modeled the potential distributions of coffee and coffee pollinators under current and future climates in Latin America to understand whether future coffee-suitable areas will also be suitable for pollinators. Our results suggest that coffee-suitable areas will be reduced 73–88% by 2050 across warming scenarios, a decline 46–76% greater than estimated by global assessments. Mean bee richness will decline 8–18% within future coffee-suitable areas, but all are predicted to contain at least 5 bee species, and 46–59% of future coffee-suitable areas will contain 10 or more species. In our models, coffee suitability and bee richness each increase (i.e., positive coupling) in 10–22% of future coffee-suitable areas. Diminished coffee suitability and bee richness (i.e., negative coupling), however, occur in 34–51% of other areas. Finally, in 31–33% of the future coffee distribution areas, bee richness decreases and coffee suitability increases. Assessing coupled effects of climate change on crop suitability and pollination can help target appropriate management practices, including forest conservation, shade adjustment, crop rotation, or status quo, in different regions

Natural capital informing decisions: from promise to practice

This is the accepted manuscript of a paper that will be published in PNAS. It is currently under an infinite embargo.The central challenge of the 21st century is to develop economic, social, and governance systems capable of ending poverty and achieving sustainable levels of population and consumption while securing the life-support systems underpinning current and future human well-being. Essential to meeting this challenge is the incorporation of natural capital and the ecosystem services it provides into decision-making. Here, we explore progress and crucial gaps at this frontier, reflecting upon the 10 years since the Millennium Ecosystem Assessment. We focus on three key dimensions of progress and ongoing challenges: raising awareness of the interdependence of ecosystems and human well-being; advancing the fundamental, interdisciplinary science of ecosystem services; and implementing this science in decisions to restore natural capital and use it sustainably. Awareness of human dependence on nature is at an all-time high, the science of ecosystem services is rapidly advancing, and talk of natural capital is now common from governments to corporate boardrooms. However, successful implementation is still in early stages. We explore why ecosystem service information has yet to fundamentally change decision-making and suggest a path forward that emphasizes: 1) developing solid evidence linking decisions to impacts on natural capital and ecosystem services, and then to human well-being, 2) working closely with leaders in government, business, and civil society to develop the knowledge, tools, and practices necessary to integrate natural capital and ecosystem services into everyday decision-making; and 3) reforming institutions to change policy and practices to better align private short-term goals with societal long-term goals.http://dx.doi.org/10.1073/pnas.150375111