The EVIDENT-trial: protocol and rationale of a multicenter randomized controlled trial testing the effectiveness of an online-based psychological intervention

Klein JP, Berger T, Schroeder J, et al. The EVIDENT-trial: protocol and rationale of a multicenter randomized controlled trial testing the effectiveness of an online-based psychological intervention. BMC Psychiatry. 2013;13(1): 239.Background: Depressive disorders are among the leading causes of worldwide disability with mild to moderate forms of depression being particularly common. Low-intensity treatments such as online psychological treatments may be an effective way to treat mild to moderate depressive symptoms and prevent the emergence or relapse of major depression. Methods/Design: This study is a currently recruiting multicentre parallel-groups pragmatic randomized-controlled single-blind trial. A total of 1000 participants with mild to moderate symptoms of depression from various settings including in-and outpatient services will be randomized to an online psychological treatment or care as usual (CAU). We hypothesize that the intervention will be superior to CAU in reducing depressive symptoms assessed with the Personal Health Questionnaire (PHQ-9, primary outcome measure) following the intervention (12 wks) and at follow-up (24 and 48 wks). Further outcome parameters include quality of life, use of health care resources and attitude towards online psychological treatments. Discussion: The study will yield meaningful answers to the question of whether online psychological treatment can contribute to the effective and efficient prevention and treatment of mild to moderate depression on a population level with a low barrier to entry

Double-Blind Single-Session Neurofeedback Training in Upper-Alpha for Cognitive Enhancement of Healthy Subjects

Abstract — This paper reports on a single-session neurofeedback (NF) training procedure on the user-specific upper alpha band for cognitive enhancement in healthy users. A doubleblind study was designed using a NF group and an active control group. Control group performed as the NF group but received sham feedback, minimizing the non-specific factors of training. This design aimed to (i) investigate upper alpha as a NF parameter, (ii) evaluate the NF effects on upper alpha during the execution of a cognitive task, and (iii) evaluate the effects on cognitive performance by means of a cognitive task and a battery of psychological tests. Results of EEG analysis show the key role of the feedback: only the NF group enhanced upper alpha during the training, and it led to a desynchronization increase during the execution of the cognitive task. Regarding the behavioral results, a strong learning effect was observed, with the NF group performing better in almost all measurements but many of them without statistical significance. I

Del Ciborg al Humobile. El teléfono móvil en el transporte público de Zaragoza (España)

La relación entre ser humano y máquina ha dado lugar a la aparición de conceptos como el de cíborg. Se trata de un concepto que ha ido modificando su significado inicial, hasta llegar a definir al individuo que surge como interacción entre el humano y la máquina. La presente investigación analiza el papel que están desempeñando en la actualidad los teléfonos móviles, como principal nexo de unión entre nuestra parte biológica y nuestra parte tecnológica. La importancia que han logrado estos dispositivos, fruto de su proliferación, ha llegado hasta tal punto que el actual cíborg puede considerarse un auténtico humobile, producto de la interacción del ser humano (human) con los teléfonos móviles (mobile). Para demostrarlo se investigó el papel de estos dispositivos en un ámbito cotidiano (el transporte público) en la ciudad de Zaragoza (España). La investigación demuestra la gran importancia que los teléfonos móviles manifiestan en este espacio público

The efficacy of mindfulness-based interventions in primary care: A meta-analytic review.

PURPOSE Positive effects have been reported after mindfulness-based interventions (MBIs) in diverse clinical and nonclinical populations. Primary care is a key health care setting for addressing common chronic conditions, and an effective MBI designed for this setting could benefit countless people worldwide. Metaanalyses of MBIs have become popular, but little is known about their efficacy in primary care. Our aim was to investigate the application and efficacy of MBIs that address primary care patients. METHODS We performed a meta-analytic review of randomized controlled trials addressing the effect of MBIs in adult patients recruited from primary care settings. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta- Analyses) and Cochrane guidelines were followed. Effect sizes were calculated with the Hedges g in random effects models. RESULTS The meta-analyses were based on 6 trials having a total of 553 patients. The overall effect size of MBI compared with a control condition for improving general health was moderate (g = 0.48; P = .002), with moderate heterogeneity (

“Good” and “Bad” Urban Wildlife

Urban environments offer habitat for many species of animals. Although some of those are ubiquitous and/or undesirable, others are native and in some cases, of conservation value. In many cases, urban wildlife populations are a source of enjoyment for human residents, who sometimes invest considerable amounts in attracting them to yards and public spaces. Their presence there can serve an important educational role that helps protect non-urban habitats and species. Nonetheless, urban wildlife must survive what has been termed a landscape of fear. Although some of the urban wildlife that do well in this environment are benign, other populations - sometimes of a species that, in other locations, is iconic and desirable - can become problematic. Some species can serve as vectors that carry important zoonosis, such as the plague or diseases that affect other wildlife. Others can create noise or olfactory nuisances and degrade structures or usability of public spaces. Some pose hazards at busy airports, whereas still others may present an envenomation or predation risk on unwary humans. Here, we review the role that reptiles, birds, and mammals play in urban environments and discuss how urban wildlife rehabilitation centers help address some related issues. We close by looking ahead and trying to predict how global patterns such as increased urbanization and population growth may affect urban wildlife and its value for conservation

Stoma-free survival after anastomotic leak following rectal cancer resection: worldwide cohort of 2470 patients

Background: The optimal treatment of anastomotic leak after rectal cancer resection is unclear. This worldwide cohort study aimed to provide an overview of four treatment strategies applied. Methods: Patients from 216 centres and 45 countries with anastomotic leak after rectal cancer resection between 2014 and 2018 were included. Treatment was categorized as salvage surgery, faecal diversion with passive or active (vacuum) drainage, and no primary/secondary faecal diversion. The primary outcome was 1-year stoma-free survival. In addition, passive and active drainage were compared using propensity score matching (2: 1). Results: Of 2470 evaluable patients, 388 (16.0 per cent) underwent salvage surgery, 1524 (62.0 per cent) passive drainage, 278 (11.0 per cent) active drainage, and 280 (11.0 per cent) had no faecal diversion. One-year stoma-free survival rates were 13.7, 48.3, 48.2, and 65.4 per cent respectively. Propensity score matching resulted in 556 patients with passive and 278 with active drainage. There was no statistically significant difference between these groups in 1-year stoma-free survival (OR 0.95, 95 per cent c.i. 0.66 to 1.33), with a risk difference of -1.1 (95 per cent c.i. -9.0 to 7.0) per cent. After active drainage, more patients required secondary salvage surgery (OR 2.32, 1.49 to 3.59), prolonged hospital admission (an additional 6 (95 per cent c.i. 2 to 10) days), and ICU admission (OR 1.41, 1.02 to 1.94). Mean duration of leak healing did not differ significantly (an additional 12 (-28 to 52) days). Conclusion: Primary salvage surgery or omission of faecal diversion likely correspond to the most severe and least severe leaks respectively. In patients with diverted leaks, stoma-free survival did not differ statistically between passive and active drainage, although the increased risk of secondary salvage surgery and ICU admission suggests residual confounding