Search

Aim: Psychosis is associated with significant health and societal costs. Early intervention in psychosis services (EIP) are highly effective in promoting recovery, yet substantial proportions of young people disengage. The current study aimed to develop and evaluate a novel engagement intervention in EIP services., Method: A qualitative investigation of facilitators and barriers to engagement in 68 first episode psychosis patients, family members and young people, and a Delphi consultation with 27 regional and national youth and psychosis service leads informed the development of the intervention. A mixed-methods feasibility-pilot study then compared engagement outcomes in 298 EIP service users in two cohorts: standard EIP versus standard EIP plus the novel early youth-engagement (EYE) intervention. A qualitative study explored intervention experiences in 22 randomly selected service users, carers and clinicians. A process evaluation explored delivery., Results: Disengagement was 24% in the standard EIP cohort compared to 14.5% in the standard EIP plus EYE intervention cohort. A 95% Bayesian credibility interval revealed a 95% probability that the true reduction in disengagement lay somewhere between 0% and 18%. The number needed to treat was 11, 95% CI [5, 242]. Use of the EYE resources was associated with engagement. Qualitiative feedback supported effects on communication, social network engagement, service user goals, mental health and well-being outcomes., Conclusion: The EYE intervention was designed from a service user, young person and carer perspective. Both qualitative and quantitative data support impacts on engagement. We now need to evaluate effectiveness, cost-effectiveness and implementation in a multi-site randomised controlled trial., (© 2024 The Author(s). Early Intervention in Psychiatry published by John Wiley & Sons Australia, Ltd.)

Plant biomass conversion by saprotrophic fungi plays a pivotal role in terrestrial carbon (C) cycling. The general consensus is that fungi metabolize carbohydrates, while lignin is only degraded and mineralized to CO 2 . Recent research, however, demonstrated fungal conversion of 13 C-monoaromatic compounds into proteinogenic amino acids. To unambiguously prove that polymeric lignin is not merely degraded, but also metabolized, carefully isolated 13 C-labeled lignin served as substrate for Agaricus bisporus , the world's most consumed mushroom. The fungus formed a dense mycelial network, secreted lignin-active enzymes, depolymerized, and removed lignin. With a lignin carbon use efficiency of 0.14 (g/g) and fungal biomass enrichment in 13 C, we demonstrate that A. bisporus assimilated and further metabolized lignin when offered as C-source. Amino acids were high in 13 C-enrichment, while fungal-derived carbohydrates, fatty acids, and ergosterol showed traces of 13 C. These results hint at lignin conversion via aromatic ring-cleaved intermediates to central metabolites, underlining lignin's metabolic value for fungi.