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Introduction: Heavy drinking and depression frequently co-occur and make a substantial contribution to the global non-communicable disease burden. Positive evidence exists for the use of digital interventions with these conditions alone, but there has been limited assessment of combined approaches., Objective: A systematic review of the effectiveness of combined digital interventions for comorbid heavy drinking and major depression in community-dwelling populations., Methods and Analysis: Electronic databases were searched to October 2021 for randomised controlled trials that evaluated any personalised digital intervention for comorbid heavy drinking and depression. Primary outcomes were changes in quantity of alcohol consumed and depressive symptoms. Two reviewers independently assessed study eligibility, extracted data, and undertook risk of bias assessment. Due to the limited number and heterogeneity of studies identified, meta-analysis was not possible, therefore data were synthesised narratively., Results: Of 898 articles identified, 24 papers were reviewed in full, five of which met the inclusion criteria (N = 1503 participants). Three utilised web-based intervention delivery; two computer programmes delivered in a clinic setting. All involved multi-component interventions; treatment length varied from one to ten sessions. Four studies found no evidence for the superiority of combined digital interventions for comorbid heavy drinking and depression over therapist-delivered approaches, single condition interventions (including online), or assessment-only controls. Positive impacts of integrated online therapy compared to generalist online health advice were reported in a fifth study, but not maintained beyond the 1-month follow-up., Limitations: Few eligible, heterogeneous studies prevented meta-analysis., Conclusion: Limited evidence exists of the effectiveness of combined digital interventions for comorbid heavy drinking and depression in community dwelling populations., (Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.)

Ecosystem Design (ED) is an approach for constructing habitats that places human needs for ecosystem services at the center of intervention, with the overarching goal of establishing self-sustaining habitats which require limited management. This concept was originally developed for use in mangrove ecosystems, and is understandably controversial, as it markedly diverges from other protection approaches that assign human use a minor priority or exclude it. However, the advantage of ED lies within the considered implementation of these designed ecosystems, thus preserving human benefits from potential later disturbances. Here, we outline the concept of ED in tropical carbonate depositional systems and discuss potential applications to aid ecosystem services such as beach nourishment and protection of coastlines and reef islands at risk from environmental and climate change, CO 2 sequestration, food production, and tourism. Biological carbonate sediment production is a crucial source of stability of reef islands and reef-rimmed coastlines. Careful implementation of designed carbonate depositional ecosystems could help counterbalance sea-level rise and manage documented erosion effects of coastal constructions. Importantly, adhering to the core ethos of ED, careful dynamic assessments which provide a balanced approach to maximizing ecosystem services ( e.g., carbonate production), should identify and avoid any potential damages to existing functioning ecosystems., Competing Interests: The authors declare there are no competing interests., (©2022 Westphal et al.)

The study analyzed clinical, laboratory, and radiological characteristics of tuberculosis (TB) among adolescents from two Brazilian State capitals, according to the 2010 Updated Guidelines of the National TB Control Program (NTPC) through a descriptive, retrospective cross-sectional study of reported TB cases from Manaus and Salvador from 1996 to 2003. Patients were divided into two groups: 10 to 14 years and 15 to 19 years of age. Variables were studied through descriptive statistics; 1,781 adolescents were included; 928 (52.1%) were males. Median age was 16 years (SD = 2.3). Pulmonary TB (PTB) occurred in 1,447 patients (82.9%), pleural TB in 179 (10.3%), and peripheral adenopathy in 81 (4.6%). Cough was more frequent in the ≥ 15-year PTB group (p < 0.001). Chest x-rays were classified as: adult-type TB in 1,088 (98.6%) in the ≥-15 year group; 258 (98.1%) in the < 15-year group (p < 0.0001). Adult type bacteriological PTB increased in proportion to age.

Objective: Currently, substantial effort is made to establish prevention as one of the main parts of the German health care system. In this context we investigated the current role of prevention in social-psychiatric research., Methods: We analysed original papers published in the journal Psychiatrische Praxis in the years 2003-2004 by computer-aided full text analysis., Results: 16.5 % of the studies mentioned prevention, in one fourth of these, prevention was the main topic. Subject of these papers were suicide prevention in psychiatric patients, relapse prevention in mentally ill offenders, and prevention of acute confusional state after hip surgery. Most of the work was dedicated to tertiary prevention, followed by secondary prevention. Two papers mentioned primary preventive aspects and only one report was dedicated to primary prevention as a main topic., Conclusions: Although early diagnosis and intervention as well as rehabilitation of mental disorders are main topics of social psychiatry, only few reports relate explicitly to prevention. The role of social psychiatry in primary prevention has to be defined.