The likely suspect’s framework: the need for a life cycle approach for managing Atlantic salmon (Salmo salar) stocks across multiple scales

Publication history: Accepted - 10 May 2022: Published online - 8 June 2022The ongoing declines in Atlantic salmon populations across its range underscore the need for co-ordinated scientific-based knowledge to support management and decisions for their conservation. Current salmon management actions remain largely focused on addressing bottlenecks to production in the freshwater phase of the life-cycle, whereas the continued declines observed in the recent decades are thought to be driven primarily by constraints on the marine phase. The challenges brought by global warming and other emerging stressors require immediate actions, requiring us to re-think the methods behind stock assessment and forge stronger linkages between data, models and policies to promote more effective management actions. We outline a scientific framework that takes a wider ecosystem view, designed to evaluate holistically a suite of indicators and potential drivers of salmon mortality at key phases of the life cycle. The aims of the proposed “Likely Suspects Framework” are to enhance cross-fertilisation of ideas between assessment processes at the stock-complex scale and stock-specific focused management activities, and to develop new decision support tools to improve management efficiencies and scenario testing. Adopting such an approach provides a new way to catalyse the acquisition and deployment of both existing and new data and models that are urgently needed for assisting the conservation and future stewardship of salmon stocks on both sides of the Atlantic.This work was supported largely by funding from the UK Missing Salmon Allianc

Cognitive-Behavioral Therapy in Depressed Primary Care Patients with Co-Occurring Problematic Alcohol Use: Effect of Telephone-Administered vs. Face-to-Face Treatment—A Secondary Analysis

This secondary analysis of a larger study compared adherence to telephone-administered cognitive-behavioral therapy (T-CBT) vs. face-to-face CBT and depression outcomes in depressed primary care patients with co-occurring problematic alcohol use. To our knowledge, T-CBT has never been directly compared to face-to-face CBT in such a sample of primary care patients. Participants were randomized in a 1:1 ratio to face-to-face CBT or T-CBT for depression. Participants receiving T-CBT (n = 50) and face-to-face CBT (n = 53) were compared at baseline, end of treatment (week 18), and 3-month and 6-month follow-ups. Face-to-face CBT and T-CBT groups did not significantly differ in age, sex, ethnicity, marital status, educational level, severity of depression, antidepressant use and total score on the Alcohol Use Disorders Identification Test. Face-to-face CBT and T-CBT groups were similar on all treatment adherence outcomes and depression outcomes at all timepoints. In conclusion, T-CBT and face-to-face CBT had similar treatment adherence and efficacy for the treatment of depression in depressed primary care patients with co-occurring problematic alcohol use. When targeting patients who might have difficulties in accessing care, primary care clinicians may consider both types of CBT delivery when treating depression in patients with co-occurring problematic alcohol use

Contradictory effects for prevention of depression and anxiety in residents in homes for the elderly: a pragmatic randomized controlled trial

Background: The aim of this study was to evaluate the effectiveness of a stepped-care program to prevent the onset of depression and anxiety disorders in elderly people living in residential homes. Methods: A pragmatic randomized controlled trial was conducted to compare the intervention with usual care in 14 residential homes in the Netherlands. A total of 185 residents with a minimum score of 8 on the Centre for Epidemiologic Studies Depression Scale, who did not meet the diagnostic criteria for a depressive or anxiety disorder, and were not suffering from severe cognitive impairment, were recruited between April 2007 and December 2008. They were randomized to a stepped-care program (N = 93) or to usual care (N = 92). The stepped-care participants sequentially underwent watchful waiting, a self-help intervention, life review, and a consultation with the general practitioner. The primary outcome measure was the incidence of a major depressive disorder (MDD) or anxiety disorder during a period of one year according to the Mini International Neuropsychiatric Interview. Results: The intervention was not effective in reducing the incidence of the combined outcome of depression and anxiety (incidence rate ratio (IRR) = 0.50; 95% confidence interval (CI) = 0.23-1.12). However, the intervention was superior to usual care in reducing the risk of MDD incidence (IRR = 0.26; 95% CI = 0.12-0.80) contrary to anxiety incidence (IRR = 1.32; 95% CI = 0.48-3.62). Conclusions: These results suggest that the stepped-care program is effective in reducing the incidence of depression, but is not effective in preventing the onset of anxiety disorders in elderly people living in residential homes. © 2012 International Psychogeriatric Association

Prevention of late-life anxiety and depression has sustained effects over 24 months: A pragmatic randomized trial.

Objective: Depressive and anxiety disorders in later life have a high incidence and are associated with reduced quality of life. Elsewhere, we demonstrated that a stepped-care prevention approach was successful in halving the incidence of these disorders over a period of 12 months. As a decreasing effect over time is to be expected, our aim was to investigate the longer-term effects. Design: Randomized controlled trial. Setting: Thirty-three primary care practices in the Netherlands. Participants: One hundred seventy consenting individuals, age 75 years and older, presenting with subthreshold depression or anxiety, not meeting the diagnostic criteria. Intervention: Participants were randomized to a preventive intervention or usual care. In the first 12 months, the preventive intervention entailed watchful waiting, minimally supported CBT-based self-help intervention, problem-solving treatment, and referral to a primary care physician for medication, if required. In the last 12 months, 95% of the participants ceased to receive such support. Measurements: Mini International Neuropsychiatric Interview. Results: The cumulative incidence rate of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, major depression or anxiety disorder over a period of 24 months was halved by the intervention, from 33 of 84 (39.3%) in the usual care group to 17 of 86 (19.8%) in the intervention group (odds ratio = 0.38; 95% confidence interval = 0.19-0.76), which was significant (z = 2.75; p = 0.006). The corresponding number needed to treat was 5 (95% confidence interval = 3-16). Conclusions: A stepped-care approach to the prevention of depression and anxiety in late life was not only successful in halving the incidence of depressive and anxiety disorders after 1 year, but these favorable effects were also sustained over 24 months. © 2011 American Association for Geriatric Psychiatry