At The Gate Of Discovery

This is the story of how a mathematical problem was discovered. Although it was never solved, it gave great joy to the discoverer

Panic disorder in rural Tanzania: an explorative study

Objective: Common mental disorders constitute a considerable disease burden in low-income countries, and there is a need for acceptable and effective brief interventions for such disorders in low-income countries. This article examines cultural based interpretations of the diagnosis of panic disorder (PD) in a rural Tanzanian hospital setting through clinical work. It also examines how to adapt and apply brief cognitive behaviour therapy (CBT) interventions to this setting. Method: A qualitative analysis of clinical data from ten participants in a hospital-setting in rural Tanzania. Results: The analysis suggests that the diagnosis of PD is relevant to this rural Tanzanian setting. Patients, relatives, and health personnel at the hospital accepted brief CBT interventions for PD and regarded psychoeducational information to patients as especially useful. Conclusion: A manual for brief interventions for PD may be adapted to a rural Tanzanian setting, also taking into consideration the limited financial and human resources in a rural low-income country setting.Keywords: Panic disorder; Culture; Cognitive behaviour therapy; Low-income countr

Predicting Treatment Outcomes in Guided Internet-Delivered Therapy for Anxiety Disorders—The Role of Treatment Self-Efficacy

Aim: Guided Internet-delivered therapy has shown to be an effective treatment format for anxiety disorders. However, not all patients experience improvement, and although predictors of treatment outcome have been identified, few are consistent over time and across studies. The current study aimed to examine whether treatment self-efficacy (self-efficacy regarding the mastery of obstacles during treatment) in guided Internet-delivered therapy for anxiety disorders in adults could be a predictor of lower dropout rates and greater symptom reduction. Method: The analyzed data comes from an open effectiveness study including 575 patients receiving guided Internet-delivered therapy for panic disorder or social anxiety disorder. Treatment self-efficacy was measured at pre-treatment. Symptom reduction was measured at 10 measurement points, including a 6-month follow-up. A mixed linear model was applied in the analysis. Results: The results showed that high treatment self-efficacy was a predictor of both lower dropout rates and greater symptom reduction. Significant interaction effects between time and treatment self-efficacy were found for several of the nine modules that constitutes the treatment program, suggesting that treatment self-efficacy could be a moderator of symptom reduction. Three of nine modules in the panic disorder treatment and six of nine in the social anxiety disorder treatment showed significant interaction effects. Conclusion: The results suggest that measuring treatment self-efficacy may be a valuable tool to identify patients at risk of dropping out, and that treatment self-efficacy could be a predictor and moderator of symptom reduction in guided Internet-delivered therapy. The implications of the results are discussed.publishedVersio

A holistic approach to development of diets for Ballan wrasse (Labrus berggylta) – a new species in aquaculture

Wild wrasses are used for delousing of farmed salmon but increasing demands have prompted the salmon industry to develop cultures of Ballan wrasse. One of the bottlenecks has been nutrition and feed intake in the juvenile phase, while broodstock nutrition is considered critical for production of viable offspring. The present study was aimed at developing functioning ongrowing and broodstock diets for Ballan wrasse. In juveniles the best lengthwise growth was identified at 65% dietary protein, 12% lipid and 16% carbohydrate. To investigate if the requirements for the other nutrients were covered by the diets developed for the species, the nutrient composition in juveniles (whole body) and broodstock (female gonad) were analyzed and compared to the composition in wild fish. We found that the levels of the lipid soluble Vitamins A, K and D were lower in cultured than in wild fish, however, the requirements for these nutrients in Ballan wrasse are not known. Other candidate nutrients for more in-depth investigation are the bone minerals, zinc, taurine and fatty acids

Increasing the levels of the essential trace elements Se, Zn, Cu and Mn in rotifers (Brachionus plicatilis) used as live feed

Rotifers are a common first feeding diet for rearing marine fish larvae. However, the levels of Mn, Cu, Zn, Se and iodine found in rotifers are low and may be insufficient to meet larval fish requirements. This study investigates increasing the concentration of Mn, Cu, Zn, Se and iodine simultaneously in rotifers (Brachionus plicatilis) in both short term enrichments (3 h) or during batch cultures (6 days), using either organically bound or inorganic mineral sources. This study demonstrates that rotifers can simultaneously be produced with Mn, Cu, Zn and Se concentrations up to and higher than the known requirements of fish, while increasing the level of iodine in rotifers was ineffective at the concentrations tested. To produce rotifers with copepod levels of Mn, Cu, Zn and Se, only 6% of a commercial rotifer enrichment diet had to be replaced with organically bound minerals, leaving a large percentage of the rotifer diet free to deliver other important nutrients such as lipid and proteins. Rotifers enriched to copepod mineral levels and stored for 18 h retained 75–110% of their Se, Zn and Mn and 50% of their Cu. Overall, increasing rotifer mineral levels appears to be most effective when the mineral is available in an insoluble and hence ingestible form.publishedVersio

An open pilot study of an internet-delivered intervention targeting self-perceived residual cognitive symptoms after major depressive disorder

Residual cognitive symptoms are associated with reduced daily life functioning, quality of life and represent a risk factor for relapse of major depressive disorder (MDD). There are few studies targeting self-perceived residual cognitive symptoms after MDD. The current open pilot study examines clinical outcomes and feasibility of a novel internet-delivered cognitive enhancement treatment for mood disorders specifically tailored to target self-perceived residual cognitive symptoms after MDD. A total of 43 adults with self-perceived residual cognitive symptoms after MDD were included. Participants were assessed pre- and post-treatment and at 6-month follow-up. The intervention consists of 10 modules that includes psychoeducation, cognitive strategies, and attention training, coupled with weekly therapist guidance. Results showed a significant reduction from pre- to post-treatment in self-perceived residual cognitive symptoms (d = 0.98) and rumination (d = 0.63). Results remained significant at the 6-month follow-up (d = 1.06; d = 0.86). Reliable change in self-perceived residual cognitive symptoms were obtained in 60% of the participants from pre- to post-treatment. Completion rates (86%) and treatment satisfaction (97%) were high. This open pilot study supports that targeting self-perceived residual cognitive symptoms after MDD through internet-delivered cognitive enhancement therapy for mood disorders may be feasible and provide stable reductions in self-perceived residual cognitive symptoms and rumination.publishedVersio

A self-guided Internet-delivered intervention for adults with ADHD: a protocol for a randomized controlled trial

Background Attention-deficit/hyperactivity disorder (ADHD) in adulthood, with an estimated prevalence of 2–3%, is associated with several challenges in daily life functioning. The availability of evidence-based psychological interventions for adults with ADHD is still poor. Interventions delivered over the Internet on smartphones or personal computers may help to increase the availability of effective psychological interventions. The primary aim of this randomized controlled trial is to examine the efficacy of a self-guided Internet-delivered intervention on severity levels of ADHD symptomatology and quality of life. Methods We aim to include 118 participants with a self-reported ADHD diagnosis in a randomized controlled trial with two arms: 1) self-guided Internet-delivered intervention for coping with ADHD (N = 59); 2) self-guided online psychoeducation (control group, N = 59). After 3 months, the control group will be given access to the intervention. The primary clinical outcomes are inattention and quality of life. Secondary clinical outcomes are hyperactivity, stress and depression. Measures will be obtained at three time points: before (baseline), immediately after (8 weeks) and 3 months after the intervention. Uptake, usage, adherence and satisfaction will be explored. Discussion This RCT will provide valuable information on the clinical effectiveness of an Internet-delivered intervention for adults with ADHD. This study is, to our knowledge, one of the first randomized control trials that investigates the effects of a self-guided Internet-delivered psychological intervention in a fairly large group of adults with ADHD.publishedVersio

Views of young people with psychosis on using virtual reality assisted therapy. A qualitative study

Aim Service disengagement is a challenge in young individuals struggling with psychosis. Combining cognitive behavioural therapy for psychosis (CBTp) with virtual reality (VR) has proven acceptable and potentially effective for symptoms and social functioning in adults with psychosis. However, studies focusing on young adolescents are lacking. The aim of the present study was to investigate the acceptability of VR-assisted CBTp among adolescents with psychosis. Methods A qualitative study investigating the acceptability of VR during exposure-based social training among adolescents with early onset psychosis. Thematic analysis was used to identify, analyse, interpret and report patterns from the qualitative interviews. Results A total of 27 adolescents with psychosis were invited to participate, 11 declined and 16 were enrolled (59%), and all completed the study. The participants were from 13 until 18 years old, mean age 16 years. None of them had previous experience with use of VR in therapy, but 10 out of 16 participants had prior experience with VR from playing video games. Regarding acceptability, 14 out of 16 had positive expectations towards using VR in CBTp, and they would prefer using VR during exposure-based social training to real-life training only. Conclusions VR-assisted CBTp can be an acceptable intervention for adolescents with psychosis, given their comfort with technology and the opportunity to confront their fears in less threatening virtual social settings with fewer social risks. The present study yields support to continue developing VR-assisted therapy for adolescents, and focusing on VR-interventions for early onset psychosis.publishedVersio

Iodine nutrition and toxicity in Atlantic cod (Gadus morhua) larvae

-Copepods as feed promote better growth and development in marine fish larvae than rotifers. However, unlike rotifers, copepods contain several minerals such as iodine (I), at potentially toxic levels. Iodine is an essential trace element and both under and over supply of I can inhibit the production of the I containing thyroid hormones. It is unknown whether marine fish larvae require copepod levels of I or if mechanisms are present that prevent I toxicity. In this study, larval Atlantic cod (Gadus morhua) were fed rotifers enriched to intermediate (26 mg I kg-1 dry weight; MI group) or copepod (129 mg I kg-1 DW; HI group) I levels and compared to cod larvae fed control rotifers (0.6 mg I kg-1 DW). Larval I concentrations were increased by 3 (MI) and 7 (HI) fold compared to controls during the rotifer feeding period. No differences in growth were observed, but the HI diet increased thyroid follicle colloid to epithelium ratios, and affected the essential element concentrations of larvae compared to the other groups. The thyroid follicle morphology in the HI larvae is typical of colloid goitre, a condition resulting from excessive I intake, even though whole body I levels were below those found previously in copepod fed cod larvae. This is the first observation of dietary induced I toxicity in fish, and suggests I toxicity may be determined to a greater extent by bioavailability and nutrient interactions than by total body I concentrations in fish larvae. Rotifers with 0.6 mg I kg-1 DW appeared sufficient to prevent gross signs of I deficiency in cod larvae reared with continuous water exchange, while modelling of cod larvae versus rotifer I levels suggests that optimum I levels in rotifers for cod larvae is 3.5 mg I kg-1 DW

A novel behavioral fish model of nociception for testing analgesics

Pain is a major symptom in many medical conditions, and often interferes significantly with a person's quality of life. Although a priority topic in medical research for many years, there are still few analgesic drugs approved for clinical use. One reason is the lack of appropriate animal models that faithfully represent relevant hallmarks associated with human pain. Here we propose zebrafish (Danio rerio) as a novel short-term behavioral model of nociception, and analyse its sensitivity and robustness. Firstly, we injected two different doses of acetic acid as the noxious stimulus. We studied individual locomotor responses of fish to a threshold level of nociception using two recording systems: a video tracking system and an electric biosensor (the MOBS system). We showed that an injection dose of 10% acetic acid resulted in a change in behavior that could be used to study nociception. Secondly, we validated our behavioral model by investigating the effect of the analgesic morphine. In time-course studies, first we looked at the dose-response relationship of morphine and then tested whether the effect of morphine could be modulated by naloxone, an opioid antagonist. Our results suggest that a change in behavioral responses of zebrafish to acetic acid is a reasonable model to test analgesics. The response scales with stimulus intensity, is attenuated by morphine, and the analgesic effect of morphine is blocked with naloxone. The change in behavior of zebrafish associated with the noxious stimulus can be monitored with an electric biosensor that measures changes in water impedance. © 2011 by the authors; licensee MDPI, Basel, Switzerland