12 research outputs found

    Clinical outcomes and cost-effectiveness of brief guided parent-delivered cognitive behavioural therapy and solution-focused brief therapy for treatment of childhood anxiety disorders: a randomised controlled trial

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    Background—Half of lifetime anxiety disorders emerge before 12 years of age, however access to evidence-based psychological therapies for affected children is poor. This Randomised Controlled Trial (RCT) compared the clinical outcome and cost-effectiveness of two brief psychological treatments for anxious children referred to routine child mental health settings. Methods—Children (5-12 years) referred to Primary Child and Mental Health Services across Oxfordshire, UK, for anxiety difficulties were randomly allocated (1:1) to brief Guided Parent-Delivered Cognitive Behavior Therapy (GPD-CBT) or Solution Focused Brief Therapy (SFBT). The primary outcome was Clinical Global Impressions of Improvement (CGI-I). Secondary outcomes were absence of primary anxiety diagnosis and all anxiety disorder diagnoses, self- and parent-reported anxiety symptoms and interference. Parents recorded patient level resource use. Quality Adjusted Life Years (QALYs) were derived from the CHU9D. Assessments were conducted pre-, post- (primary endpoint), and 6- months after treatment. Findings—136 patients were assigned to GPD-CBT (n=68) or SFBT (n=68). Analyses were conducted with the intent to treat population. No significant differences were observed on any clinical (CGI-I; Relative Risk (RR) = 1·01 (0·86, 1·19), p = 0·95) or economic (QALY mean difference = 0·006 (-0·009- 0·02), p = 0·42) outcome measure. However, the GPD-CBT treatment was associated with lower costs (mean difference: -£448; 95% CI: -£934, £37; p=0.070). Interpretation— There was no evidence of clinical superiority, however brief GPD-CBT is likely to be a cost-effective alternative to brief psychological treatment (SFBT) and could be considered as a first-line treatment for children with anxiety problems

    Behavioural and physiological correlates of impulsivity in the domestic dog (Canis familiaris)

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    Impulsivity is a trait related to inhibitory control which is expressed in a range of behaviours. Impulsive individuals show a decreased ability to tolerate delay of reinforcement, and more impulsive behaviour has been linked to decreased levels of serotonin and dopamine in a number of species. In domestic dogs, impulsivity is implicated in problem behaviours that result from a lack of self control, but currently there are no published studies that assess behavioural and physiological measures of impulsivity in relation to this trait. Impulsivity scores were calculated for 41 dogs using an owner-report assessment, the Dog Impulsivity Assessment Scale (DIAS). Twenty-three of these subjects completed an operant choice task based on a delayed reward paradigm, to assess their tolerance to delay of reinforcement. High Pressure Liquid Chromatography (HPLC) with Fluorometric Detection was used to detect levels of the metabolites of serotonin (5-HIAA) and dopamine (HVA) in the urine of 17 of the subjects. Higher impulsivity scores were found to be significantly correlated with more impulsive behaviour (reduced tolerance to delay of reinforcement) in the behaviour tests and lower levels of urinary 5-HIAA and 5-HIAA/HVA ratio. The results demonstrate convergent validity between impulsivity (as assessed by the DIAS) and behavioural and physiological parameters

    Systematic Conservation Planning in the Face of Climate Change: Bet-Hedging on the Columbia Plateau

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    Systematic conservation planning efforts typically focus on protecting current patterns of biodiversity. Climate change is poised to shift species distributions, reshuffle communities, and alter ecosystem functioning. In such a dynamic environment, lands selected to protect today's biodiversity may fail to do so in the future. One proposed approach to designing reserve networks that are robust to climate change involves protecting the diversity of abiotic conditions that in part determine species distributions and ecological processes. A set of abiotically diverse areas will likely support a diversity of ecological systems both today and into the future, although those two sets of systems might be dramatically different. Here, we demonstrate a conservation planning approach based on representing unique combinations of abiotic factors. We prioritize sites that represent the diversity of soils, topographies, and current climates of the Columbia Plateau. We then compare these sites to sites prioritized to protect current biodiversity. This comparison highlights places that are important for protecting both today's biodiversity and the diversity of abiotic factors that will likely determine biodiversity patterns in the future. It also highlights places where a reserve network designed solely to protect today's biodiversity would fail to capture the diversity of abiotic conditions and where such a network could be augmented to be more robust to climate-change impacts

    Linguistic and Motor Aspects of Stuttering

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