Protocol for an RCT on cognitive bias modification for alcohol use disorders in a religion-based rehabilitation program

INTRODUCTION: Alcohol-related cues trigger relapse in patients with alcohol use disorders (AUDs). These cues may automatically activate motivational approach tendencies. Through computerised cognitive bias modification (CBM), the tendencies of patients with AUD to approach alcohol can be reduced. The present protocol describes a training intervention with approach bias modification (ApBM) incorporating religion-related stimuli as an alternative to alcohol to improve the effectiveness of CBM in a religion-based rehabilitation centre. AUD is often related to patients’ religious attitudes in this treatment context. The religion-adapted ApBM, therefore, combines training in avoidance of alcohol-related motivational cues and an approach to religion-based motivational cues. This combination’s effectiveness will be compared with a standard ApBM and to a sham ApBM. METHODS AND ANALYSIS: Using a double-blind multiarm parallel randomised controlled trial procedure (ratio 1:1:1), 120 patients with AUD will be randomised into 1 of 3 conditions (religion-adapted ApBM, standard ApBM or sham ApBM) with personalised stimuli. The interventions are delivered over 4 consecutive days during an inpatient detoxification programme in addition to treatment as usual. Assessments occur before the start of the training and after the fourth training session, with follow-up assessments after 1 and 4 months. A multivariate analysis of variance will be used with the primary outcomes, the percentage of days abstinent and meaning in life 4-month follow-up. Secondary outcomes include differences in reported training satisfaction and symptoms of AUD. ETHICS AND DISSEMINATION: This study has been reviewed and approved by the Medical Research Ethics Committee Academic Medical Center Amsterdam (Reference number: 2020_251). Further, study results will be published in peer-reviewed journals and presented at international conferences. TRIAL REGISTRATION NUMBER: NL75499.018.20

Circumstances, outcome and quality of cardiopulmonary resuscitation by lifeboat crews

Background: Little is known regarding circumstances, outcomes and quality of cardiopulmonary resuscitation (CPR) and the use of automated external defibrillators (AEDs) performed by operational lifeboat crews. Our aim is to evaluate circumstances, outcomes and quality of CPR performed by the Royal Dutch Lifeboat Institution (KNRM) in out-of-hospital cardiac arrest (OHCA). Methods: The internal KNRM database has been used to identify and analyse all OHCA cases between July 2011 and December 2017. A limited set of AED data was available to study the quality of CPR. Results: In 37 patients the lifeboat crew members have performed CPR, of which 29 (78.4%) occurred under hostile conditions. The median response time to arrive at the location was 15 min. In 11 (29.7%) patients return of spontaneous circulation was achieved at any moment during CPR and 3 (8.1%) patients were still alive after one month. The lifeboat AED was used in 12 patients. Their recordings show a high median compression frequency (120, IQR 111–131) and prolonged median interruption periods (pre-analysis pause 11s (IQR 10–13), post-analysis pause 4s (IQR 3–8), pre-shock pause 24s (IQR 19–26), post-shock pause 6s (IQR 6–11), ventilation pause 6s (IQR 4–8) and other pauses 9s (IQR 4–17)). Conclusions: Compared to most out-of-hospital resuscitations, resuscitations by lifeboat crews have a low incidence, occur under difficult circumstances and in a younger population. AED's on lifeboats have not contributed to any of the survivals. Analysis of AED information can be used to study the quality of CPR and provide input for improving future training of lifeboat crews

Protocol for an RCT on cognitive bias modification for alcohol use disorders in a religion-based rehabilitation program

© Introduction Alcohol-related cues trigger relapse in patients with alcohol use disorders (AUDs). These cues may automatically activate motivational approach tendencies. Through computerised cognitive bias modification (CBM), the tendencies of patients with AUD to approach alcohol can be reduced. The present protocol describes a training intervention with approach bias modification (ApBM) incorporating religion-related stimuli as an alternative to alcohol to improve the effectiveness of CBM in a religion-based rehabilitation centre. AUD is often related to patients' religious attitudes in this treatment context. The religion-Adapted ApBM, therefore, combines training in avoidance of alcohol-related motivational cues and an approach to religion-based motivational cues. This combination's effectiveness will be compared with a standard ApBM and to a sham ApBM. Methods and analysis Using a double-blind multiarm parallel randomised controlled trial procedure (ratio 1:1:1), 120 patients with AUD will be randomised into 1 of 3 conditions (religion-Adapted ApBM, standard ApBM or sham ApBM) with personalised stimuli. The interventions are delivered over 4 consecutive days during an inpatient detoxification programme in addition to treatment as usual. Assessments occur before the start of the training and after the fourth training session, with follow-up assessments after 1 and 4 months. A multivariate analysis of variance will be used with the primary outcomes, the percentage of days abstinent and meaning in life 4-month follow-up. Secondary outcomes include differences in reported training satisfaction and symptoms of AUD. Ethics and dissemination This study has been reviewed and approved by the Medical Research Ethics Committee Academic Medical Center Amsterdam (Reference number: 2020_251). Further, study results will be published in peer-reviewed journals and presented at international conferences. Trial registration number NL75499.018.20

De samenhang tussen religieuze coping­stijlen en psychische klachten in een christelijke bevolkingsgroep

Achtergrond Religieuze copingstijlen laten zien hoe mensen omgaan met stressvolle gebeurtenissen vanuit hun religieuze achtergrond en geloofsrelatie met God.  Doel Inzicht krijgen in hoe het religieuze copingproces samenhangt met de mentale gezondheid en toetsen of het gebruik van de copingstijlen verschilt voor christenen die wel/niet ggz-cliënt zijn. Methode De onderzoeksgroep bestond uit 655 Nederlandse personen met een christelijke levensbeschouwing. De leeftijd varieerde van 18 tot 79 jaar (M: 42,6; SD: 14,2), 60,9% was vrouw en 49,5% had minimaal een hbo-opleiding. Intra- en extramurale ggz-cliënten waren betrokken. Het betrof een crosssectionele online-enquête, gecombineerd met een bestaand cliëntendatabestand.  Resultaten Een meer samenwerkende copingstijl ging gepaard met minder psychische klachten. Hoe meer de (passief-)afwachtende en zelfbesturende copingstijl werd gebruikt, hoe meer psychische klachten. Christelijke ggz-cliënten maakten significant minder gebruik van de samenwerkende en afwachtende religieuze copingstijl dan christelijke niet-ggz-cliënten.  Conclusie De samenwerkende religieuze copingstijl hangt samen met een betere mentale gezondheid. Ggz-cliënten hanteren deze stijl minder dan niet-ggz-cliënten. Bewustwording van religieuze copingstijlen bij en passende ondersteuning door ggz-professionals zijn geïndiceerd

The association between religious coping styles and psychopathological symptomatology within a Christian population

Achtergrond Religieuze copingstijlen laten zien hoe mensen omgaan met stressvolle gebeurtenissen vanuit hun religieuze achtergrond en geloofsrelatie met God. Doel Inzicht krijgen in hoe het religieuze copingproces samenhangt met de mentale gezondheid en toetsen of het gebruik van de copingstijlen verschilt voor christenen die wel/niet ggz-cliënt zijn.Methode De onderzoeksgroep bestond uit 655 Nederlandse personen met een christelijke levensbeschouwing. De leeftijd varieerde van 18 tot 79 jaar (M: 42,6; SD: 14,2), 60,9% was vrouw en 49,5% had minimaal een hbo-opleiding. Intra- en extramurale ggz-cliënten waren betrokken. Het betrof een crosssectionele online-enquête, gecombineerd met een bestaand cliëntendatabestand. Resultaten Een meer samenwerkende copingstijl ging gepaard met minder psychische klachten. Hoe meer de (passief-)afwachtende en zelfbesturende copingstijl werd gebruikt, hoe meer psychische klachten. Christelijke ggz-cliënten maakten significant minder gebruik van de samenwerkende en afwachtende religieuze copingstijl dan christelijke niet-ggz-cliënten. Conclusie De samenwerkende religieuze copingstijl hangt samen met een betere mentale gezondheid. Ggz-cliënten hanteren deze stijl minder dan niet-ggz-cliënten. Bewustwording van religieuze copingstijlen bij en passende ondersteuning door ggz-professionals zijn geïndiceerd

Agriculture, water, and ecosystems: avoiding the costs of going too far

In Molden, David (Ed.). Water for food, water for life: a Comprehensive Assessment of Water Management in Agriculture. London, UK: Earthscan; Colombo, Sri Lanka: International Water Management Institute (IWMI)