Search

Background Postpartum depression (PPD) affects up to one in five mothers and birthing parents, yet as few as 10% access evidence-based treatment. One-day cognitive behavioral therapy (CBT)-based workshops for PPD have the potential to reach large numbers of sufferers and be integrated into stepped models of care. Methods This randomized controlled trial of 461 mothers and birthing parents in Ontario, Canada with Edinburgh Postnatal Depression Scale (EPDS) scores ⩾10, age ⩾18 years, and an infant Results Workshops led to meaningful reductions in EPDS scores (m = 15.77 to 11.22; b = −4.6, p < 0.01) and were associated with three times higher odds of a clinically significant decrease in PPD [odds ratio (OR) 3.00, 95% confidence interval (CI) 1.93–4.67]. Anxiety also decreased and participants had three times the odds of clinically significant improvement (OR 3.20, 95% CI 2.03–5.04). Participants reported improvements in mother–infant bonding, infant-focused rejection and anger, and effortful control in their toddlers. The workshop plus TAU achieved similar quality-adjusted life-years at lower costs than TAU alone. Conclusions One-day CBT-based workshops for PPD can lead to improvements in depression, anxiety, and the mother–infant relationship and are cost-saving. This intervention could represent a perinatal-specific option that can treat larger numbers of individuals and be integrated into stepped care approaches at reasonable cost.

Objective The effectiveness of ECT under naturalistic conditions has not been well-studied. The current study aimed to 1) characterize a naturalistic sample of ECT patients; and 2) examine the long-term outcomes of ECT on depressive symptoms (Beck Depression Inventory-II; BDI-II) and functional disability symptoms (WHO Disability Assessment Schedule 2.0) in this sample. Methods Participants were adults who received ECT for a major depressive episode at an ambulatory ECT clinic between September 2010 and November 2020. Clinical and cognitive assessments were completed at baseline ( n = 100), mid-ECT ( n = 94), 2–4 weeks post-ECT ( n = 64), 6-months post-ECT ( n = 34), and 12-months post-ECT ( n = 19). Results At baseline, participants had severe levels of depressive symptoms (BDI-II: M = 41.0, SD = 9.4), and 62.9% screened positive for multiple psychiatric diagnoses on the MINI International Neuropsychiatric Interview. Depressive symptoms ( F(4,49.1) = 49.92, P Conclusions Participants were severely symptomatic and clinically complex. ECT was effective at reducing depressive symptoms and functional disability in this heterogeneous sample. Although a large amount of missing data may have distorted our calculated response/remission rates, it is also likely that clinical heterogeneity and severity contribute to lower-than-expected remission and response rates to ECT.

Serious mental illness is a major risk factor for aggression and violence. The present study aimed to develop and test an algorithm to predict inpatient aggressions that involve a risk of harm to self or others. This work is based on a retrospective study aimed to investigate the prediction of risk of harm and aggressions at St. Joseph's Healthcare Hamilton, between 2016 and 2017. An analysis of the risk factors most strongly associated with harmful incidents is, followed by the description of the process involved in the development of a predictive model which estimates the risk of harm. The efficiency of the model developed is finally evaluated, showing an overall accuracy of 75%: the specificity to identify episodes considered not at risk of harm is equal to 91.85%, whereas the sensitivity to identify episodes considered harmful is equal to 28.57%. The model proposed can be seen as a seminal project towards the development of a more comprehensive, precise and effective tool capable to predict the risk of harm in the inpatient setting.

We study violence risk prediction at St. Joseph's Healthcare Hamilton. Data from January 2016 to December 2017 have been anonymized and collected, for a total of 870 episodes of inpatient aggressions perpetrated by 337 patients. We examine the predictive performance of a clinical indicator embedded in a mandatory assessment tool for psychiatric facilities in Ontario, the Resident Assessment Instrument for Mental Health (RAI-MH): the Risk of Harm to Others Clinical Assessment Protocol (RHO CAP). The RHO CAP's performance is studied among two groups of patients. Moreover, an analysis of the most important risk factors associated with harmful incidents is presented. The RHO CAP has demonstrated a better performance in discriminating which patients were more at risk to commit some type of aggression than at identifying the risk of harm among those who will commit aggression.

Objectives To examine the effectiveness of group cognitive behavioural therapy (CBT) for postpartum depression (PPD) delivered by public health nurses with little to no previous psychiatric training at improving depression, worry, social support and the mother-infant relationship. Methods Mothers (n = 141) living in Ontario, Canada with Edinburgh Postnatal Depression Scale Scores ≥10 and an infant Results Participants in the experimental group had statistically significantly greater reductions in PPD symptoms immediately post-treatment (T2) (B = -5.35, p Conclusions Public health nurses with little to no previous psychiatric training can be trained to deliver effective group CBT for PPD to improve depression, worry, and the mother-infant relationship. Task shifting PPD treatment with group CBT to public health nurses could improve treatment uptake and lead to better outcomes for mothers, families, and the healthcare system. (Trial Registration NCT03039530)

Objective: To determine if a 9-week group cognitive-behavioral therapy (CBT) intervention delivered by women who have recovered from postpartum depression (peers) can effectively reduce symptoms of postpartum depression (PPD) and anxiety and improve social support and the mother-infant relationship.Methods: A sample of 73 mothers living in Ontario, Canada, were randomized into experimental and waitlist control groups between March 2018 and February 2020. Participants were ≥ 18 years of age, had an infant < 12 months old, were fluent in English, and scored ≥ 10 on the Edinburgh Postnatal Depression Scale. The experimental group completed the 9-week group CBT intervention immediately after study enrollment, while the control group did so after a 9-week waiting period. All outcomes were assessed at enrollment (n = 54) and 9 weeks later (n = 38). Outcomes were assessed in the experimental group at 6 months to assess treatment stability.Results: Peer-delivered group CBT for PPD led to clinically and statistically significant improvements in symptoms of depression (F1,47 = 22.52, P < .01) and anxiety (F1,45 = 20.56, P < .05) in the experimental group, and these improvements were stable at the 6-month follow-up. Perceptions of impaired mother-infant bonding (t15 = 3.72, P < .01) and rejection and pathological anger (t15 = 3.01, P < .01) also decreased at the 6-month follow-up in the experimental group.Conclusions: Peer-delivered group CBT for PPD effectively treats symptoms of PPD and anxiety and may lead to improvements in the mother-infant relationship. This intervention is an effective and potentially scalable means by which access to a treatment that meets the needs and wants of mothers with PPD can be increased.Trial Registration: ClinicalTrials.gov Identifier: NCT03285139.

$\gamma p \rightarrow K^+ \Lambda$ differential cross sections and recoil polarisation data from threshold for extremely forward angles are presented. The measurements were performed at the BGOOD experiment at ELSA, utilising the high angular and momentum resolution forward spectrometer for charged particle identification. The data discriminates between conflicting results in the world data set and enable extraction of the cross section as the minimum momentum transfer to the recoiling hyperon is approached., Comment: 12 pages (including a 2 page appendix), 14 figures

Background: Serious mental illness is a major risk factor for aggression and violence. The aim of the present study was to develop and test an algorithm to predict inpatient aggressions that involve a risk of harm to self or others.Methods: This work is based on a retrospective study aimed to investigate the prediction of risk of harm and aggressions at St. Joseph’s Healthcare Hamilton, between 2016 and 2017. An analysis of the risk factors most strongly associated with harmful incidents is, followed by the description of the process involved in the development of a predictive model which estimates the risk of harm. Results: The efficiency of the model developed is finally evaluated, showing an overall accuracy of 75%: the specificity to identify episodes considered not at risk of harm is equal to 91.85%, whereas the sensitivity to identify episodes considered harmful is equal to 28.57%. a Conclusions: The model proposed can be seen as a seminal project towards the development of a more comprehensive, precise and effective tool capable to predict the risk of harm in the inpatient setting.

In Fig. 5 on p. 311 of our Phys. Lett. B 740 (2015) 303 an adjustment by 180 ∘ is required for the phases with respect to the L = 2 , M = 1 wave, of the following waves: L = 1 , 3 , 5 with M = 1 , and L = 2 with M = 2 . After this correction (Fig. 5 (corrected) below), the extracted partial waves describe the angular distribution of the η ( ′ ) in the Gottfried-Jackson (GJ) frame, using Eq. (4) with implicit Condon-Shortley phase convention. The other results of our paper are not affected. The right-handed GJ coordinate system was defined by the z-axis pointing in the direction of the beam in the η ( ′ ) π − center-of-mass system and the y-axis pointing in the direction of p recoil GJ × p beam GJ .

We study violence risk prediction at St. Joseph's Healthcare Hamilton. Data from January 2016 to December 2017 have been anonymized and collected, for a total of 870 episodes of inpatient aggressions perpetrated by 337 patients. We examine the predictive performance of a clinical indicator embedded in a mandatory assessment tool for psychiatric facilities in Ontario, the Resident Assessment Instrument for Mental Health (RAI-MH): the Risk of Harm to Others Clinical Assessment Protocol (RHO CAP). The RHO CAP's performance is studied among two groups of patients. Moreover, an analysis of the most important risk factors associated with harmful incidents is presented. The RHO CAP has demonstrated a better performance in discriminating which patients were more at risk to commit some type of aggression than at identifying the risk of harm among those who will commit aggression.

Objectives Public Health Nurses (PHNs) often provide support to women with postpartum depression (PPD) in the absence of specialized training. The objective of this study was to explore the experiences of six PHNs who were trained to deliver a group cognitive behavioral therapy (CBT) intervention for PPD in the public health setting, and to describe how learning and delivering this intervention affected their professional roles and personal lives. Design This qualitative study employed a phenomenological approach. Sample Six PHNs who completed the CBT training program and delivered at least one CBT group in their community. Measurements Individual in-depth interviews were conducted and transcribed verbatim. Transcripts were analyzed according to thematic derivation procedures. Results The themes that emerged from the interviews with the PHNs included: (a) components of the CBT training program that nurses most valued, (b) benefits of training for their professional role as a PHN, (c) implications for practice, and (d) using CBT skills in their personal lives. Conclusions The provision of CBT training to PHNs may not only positively impact their work with clients with mental illness, but may also have the potential to provide broader clinical and professional benefits for these skilled professionals and their other clients.

Importance: Postpartum depression (PPD) affects as many as 20% of mothers, yet just 1 in 10 of these women receives evidence-based treatment. The COVID-19 pandemic has increased PPD risk, reduced treatment access, and shifted preferences toward virtual care. Objective: To determine whether an online 1-day cognitive behavioral therapy (CBT)-based workshop added to treatment as usual improves PPD, anxiety, social support, mother-infant relationship quality, and infant temperament more than treatment as usual alone. Design, Setting, and Participants: This randomized clinical trial included 403 women with PPD who were recruited across Ontario, Canada, during the COVID-19 pandemic (April 20 to October 4, 2020). Women with Edinburgh Postnatal Depression Scale (EPDS) scores of at least 10 who were 18 years or older and had an infant younger than 12 months were eligible. Interventions: Women were randomly assigned to receive a live, interactive online 1-day CBT-based workshop delivered by a registered psychotherapist, psychiatrist, or clinical psychology graduate student in addition to treatment as usual (n = 202) or to receive treatment as usual and wait-listed to receive the workshop 12 weeks later (n = 201). Main Outcomes and Measures: The primary outcome was change in PPD (EPDS scores) in experimental and wait list control groups 12 weeks after baseline. Secondary outcomes included maternal anxiety (7-item Generalized Anxiety Disorder Questionnaire [GAD-7]), social support (Social Provisions Scale), quality of the mother-infant relationship (Postpartum Bonding Questionnaire), and infant temperament (Infant Behavior Questionnaire-Revised Very Short Form). Results: Participants all identified as women with a mean (SD) age of 31.8 (4.4) years. The workshop led to significant mean (SD) reductions in EPDS scores (from 16.47 [4.41] to 11.65 [4.83]; B = -4.82; P < .001) and was associated with a higher odds of exhibiting a clinically significant decrease in EPDS scores (odds ratio, 4.15; 95% CI, 2.66-6.46). The mean (SD) GAD-7 scores decreased from 12.41 (5.12) to 7.97 (5.54) after the workshop (B = -4.44; 95% CI, -5.47 to -3.38; P < .001) and participants were more likely to experience a clinically significant change (odds ratio, 3.09; 95% CI, 1.99-4.81). Mothers also reported improvements in bonding (B = -3.22; 95% CI, -4.72 to -1.71; P < .001), infant-focused anxiety (B = -1.64; 95% CI, -2.25 to 1.00; P < .001), social support (B = 3.31; 95% CI, 1.04 to 5.57; P < .001), and positive affectivity/surgency in infants (B = 0.31; 95% CI, 0.05 to 0.56; P < .001). Conclusions and Relevance: In this randomized clinical trial, an online 1-day CBT-based workshop for PPD provides an effective, brief option for mothers, reducing PPD and anxiety as well as improving social support, the mother-infant relationship, and positive affectivity/surgency in offspring. Trial Registration: ClinicalTrials.gov Identifier: NCT04485000.

The γ p → K + Σ 0 differential cross section at extremely forward angles was measured at the BGOOD experiment. A three-quarter drop in strength over a narrow range in energy and a strong dependence on the polar angle of the K + in the centre-of-mass of the reaction is observed at a centre-of-mass energy of 1900 MeV. Residing close to multiple open and hidden strangeness thresholds, the structure appears consistent with meson-baryon threshold effects which may contribute to the reaction mechanism.

We modeled design factors influencing the intent to use a university mental health service.Between November 2012 and October 2014, 909 undergraduates participated.Using a discrete choice experiment, participants chose between hypothetical campus mental health services.Latent class analysis identified three segments. A Psychological/Psychiatric Service segment (45.5%) was most likely to contact campus health services delivered by psychologists or psychiatrists. An Alternative Service segment (39.3%) preferred to talk to peer-counselors who had experienced mental health problems. A Hesitant segment (15.2%) reported greater distress but seemed less intent on seeking help. They preferred services delivered by psychologists or psychiatrists. Simulations predicted that, rather than waiting for standard counseling, the Alternative Service segment would prefer immediate access to E-Mental health. The Usual Care and Hesitant segments would wait 6 months for standard counseling.E-Mental Health options could engage students who may not wait for standard services.

New approaches are needed to help the large number of emerging adults (EA) presenting with early-stage mental health problems. The goal of this pilot study was to carry out a randomized controlled trial to investigate whether motivational enhancement therapy (MET) improved the treatment effects of a 12-week psychological intervention, Dialectical Behaviour Therapy Skills Training (DBT-ST), for EA presenting in the early stages of mental health difficulties. Participants were recruited from the Youth Wellness Centre at St. Joseph's Healthcare Hamilton and McMaster University's Student Wellness Centre in Hamilton, Canada.Seventy-five participants were randomized to receive MET followed by DBT-ST or to DBT-ST alone. We assessed psychological distress, emotion dysregulation, and depression and anxiety symptoms as outcomes.We found that both treatment groups had significant reductions in emotional dysregulation, psychological distress, depression, and anxiety at post-treatment and at the three-month follow-up. Participants assigned to MET pre-treatment experienced greater improvement in psychological distress at the end of treatment.This pilot study provides preliminary evidence of the potential augmentation of DBT-ST using MET in a real-world setting. Future studies should examine whether MET uniquely augments DBT-ST through the use of a comparable pre-treatment control group.De nouvelles approches sont nécessaires pour aider le grand nombre d’adultes émergeants (AE) qui présentent des problèmes de santé mentale au stade précoce. La présente étude pilote avait pour but d’exécuter un essai randomisé contrôlé afin de rechercher si la thérapie d’amélioration motivationnelle (TAM) améliorait les effets du traitement d’une intervention psychologique de 12 semaines, soit la formation technique à la thérapie comportementale dialectique (FT-TCD), pour les AE qui présentent les premiers stades de difficultés de santé mentale. Les participants ont été recrutés au centre Youth Wellness de St. Joseph’s Healthcare Hamilton et au centre Student Wellness de l’Université McMaster, à Hamilton, Canada.Soixante-quinze participants ont reçu au hasard la TAM suivie de la FT-TCD ou uniquement la FT-TCD. Nous avons évalué la détresse psychologique, la dérégulation émotionnelle, et les symptômes dépressifs et anxieux comme résultats.Nous avons constaté que les deux groupes du traitement avaient des réductions significatives de la dérégulation émotionnelle, de la détresse psychologique, de la dépression et de l’anxiété au post-traitement et au suivi de 3 mois. Les participants affectés à la TAM de prétraitement ont eu une plus grande amélioration de la détresse psychologique en fin de traitement.Cette étude pilote offre des données probantes préliminaires de l’augmentation potentielle de la FT-TCD utilisant la TAM dans une situation réelle. Les futures études devraient examiner si la TAM n’augmente seulement la FT-TCD que par le recours à un groupe témoin prétraitement comparable.

Objectives Although postpartum depression (PPD) affects 1 in 5 women, just 15% receive treatment. Cognitive Behavioural Therapy (CBT) is a first-line treatment for PPD. The objective of this pilot study was to determine the feasibility and acceptability of public health nurse (PHN)-delivered group CBT for PPD and to determine preliminary estimates of effect. Design A pre-posttest design was used. Participants provided data before and after the CBT groups. Sample Seven women who were over the age of 18 and had given birth in the past year participated. Measurements Feasibility and acceptability focused on PHN training, recruitment, retention, and adherence to the intervention. Participants provided data on depression, worry, health care utilization and mother-infant relations. Women and their partners reported on infant temperament. Intervention Participants attended a 9-week CBT group delivered by two PHNs. Results The PHN training, CBT intervention and our study protocol were found to be feasible and acceptable to participants. Reductions were seen in depression and worry. The number of health care visits decreased; mother-infant relations improved. Conclusions These findings highlight the feasibility of PHN-delivered group CBT for PPD and suggest that it could reduce the burden of PPD on women and their children.

Aim This article describes the development and design of the Youth Wellness Centre (YWC), an innovative, youth-friendly centre providing mental health and addiction services for emerging adults aged 17 to 25 in Hamilton, Canada. We also report on demographic and clinical characteristics of clients to evaluate how the YWC is serving populations at increased risk of developing mental disorders. Methods Data were extracted from clinic databases for 1520 youth at the YWC between March 2015 and 2018 to report on demographic characteristics, clinical profiles, primary presenting problems, service use and overall satisfaction with services. Results Marginalized groups, particularly street-involved individuals and LGBTQ+ youth, are highly represented at the YWC, keeping with the centre's mandate of reaching at-risk populations. Youth at the YWC carry significant mental health burdens, with 80.8% having a history of suicidal ideation and 32.8% having a history of a substance use disorder. The primary route of referral is self-referral and the number of new clients has increased by nearly 20% in the first 3 years of operations. Overall satisfaction with the centre is on par with or slightly above provincial averages. Conclusions The YWC was developed to meet the mental health needs of transition-aged youth in Hamilton by providing early intervention, system navigation and transition services. The success of the YWC in reaching high-risk youth is demonstrated by the significant proportion of clients reporting demographic and clinical risk factors associated with increased risk for development of mental disorders. The increasing referrals to the YWC highlight the ongoing need for similar services.

Many individuals with obsessive-compulsive disorder (OCD) have residual symptoms after undergoing cognitive behavioral therapy (CBT). Mindfulness meditation techniques may help alleviate these residual symptoms. This study qualitatively evaluates the acceptability and perceived benefit of a Mindfulness-Based Cognitive Therapy (MBCT) intervention tailored to individuals with OCD who continue to suffer symptoms following CBT. A sample of 32 participants (which included seven pilot phase participants) with a principal diagnosis of OCD completed an 8-week MCBT intervention and were interviewed approximately 2 weeks post-intervention. The satisfaction interviews consisted of 21 questions that assessed treatment outcomes and treatment acceptability. An inductive thematic approach was used to identify, analyze, and describe overall patterns and themes (i.e., codes) within the participant responses. We identified 64 (+6 miscellaneous) data-generated codes and a total of eight (+1 miscealleous) key themes that encompassed participants’ reported treatment outcomes. Participants verbally reported a decrease in perceived OCD symptoms, an increase in mindfulness and coping skills, high treatment acceptability, and overall quality of life improvement after undergoing the MBCT intervention. Our results provide a detailed description of participants’ perspectives regarding the efficacy and acceptability of MBCT for OCD and support for the perceived benefit of MBCT as an augmentative strategy following CBT to optimize treatment outcomes for individuals with OCD.

WHAT IS KNOWN ON THE SUBJECT?: Verbal de-escalation is an intervention aimed at calmly managing an agitated client to prevent violence. Effective de-escalation can help reduce the use of seclusion and restraint in psychiatric settings. Despite its importance in practice, there is little agreement on the necessary techniques of de-escalation and most of the research on the topic is based on expert opinion. To our knowledge, only one attempt at quantifying de-escalation skill has been pursued through the German-language De-Escalating Aggressive Behaviour Scale (DABS). While the DABS identified seven qualities necessary for de-escalation, it has not been validated in English and may lack important descriptors. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The present study enhanced the original DABS with best, acceptable and least desirable staff de-escalation practice descriptions for each of the seven items. This enhancement of the DABS lead to the creation of the English modified DABS (EMDABS). The EMDABS was psychometrically validated for use in research and practice: raters could use the EMDABS with a high level of agreement and consistency. Also, the scale appeared to measure a single cohesive construct - de-escalation. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: With further validation, the EMDABS has potential to be the first English quantitative measure of de-escalation. The EMDABS offers seven items, with associated best practice descriptions, that may be used to inform de-escalation practice. The EMDABS can be used to evaluate training and education programmes and inform how these programmes and independent de-escalation practice may be improved. ABSTRACT: Introduction Verbal de-escalation is crucial to a non-coercive psychiatric environment. Despite its importance, the literature on de-escalation is sparse and mostly qualitative. To address this, Nau et al. (2009) quantified de-escalation by creating the German-language De-Escalating Aggressive Behaviour Scale (DABS). The DABS provides seven skills necessary for de-escalation, however it has not been validated in English and lacks the necessary anchor descriptions to make it useful. Aim To modify the DABS to include descriptions of best, acceptable and least desirable staff practice and to validate the English modified DABS (EMDABS). METHOD To develop item descriptions for the EMDABS, 50 conflictual staff-patient interactions were reviewed, summarized and cross-referenced with the literature (n = 19). Three raters then used the EMDABS to evaluate 272 simulations depicting these interactions. RESULTS The EMDABS demonstrated very good inter-rater reliability [ICC (3, 1) = 0.752] and strong internal consistency (α = 0.901). A factor analysis revealed that the seven items were best represented by a single factor. DISCUSSION The EMDABS was validated for future use in research and practice. Additional validation and future research directions are discussed. Implications for practice The EMDABS holds promise as a quantitative measure of de-escalation. Its seven items and best practice guidelines have clinical implications for improving practice and training.© 2016 John Wiley & Sons Ltd. Language: en

Early intervention services (EISs) for mental illness may improve outcomes, although treatment engagement is often a problem. Incorporating patients' preferences in the design of interventions improves engagement. A discrete-choice conjoint experiment was conducted in Canada to identify EIS attributes that encourage treatment initiation.Sixteen four-level attributes were formalized into a conjoint survey, completed by patients, family members, and mental health professionals (N=562). Participants were asked which EIS option people with mental illness would contact. Latent-class analysis identified respondent classes characterized by shared preferences. Randomized first-choice simulations predicted which hypothetical options, based on attributes, would result in maximum utilization.Participants in the conventional-service class (N=241, 43%) predicted that individuals would contact traditional services (for example, hospital location and staffed by psychologists or psychiatrists). Membership was associated with being a patient or family member and being male. Participants in the convenient-service class (N=321, 57%) predicted that people would contact services promoting easy access (for example, self-referral and access from home). Membership was associated with being a professional. Both classes predicted that people would contact services that included short wait times, direct contact with professionals, patient autonomy, and psychological treatment information. The convenient-service class predicted that people would use an e-health model, whereas the conventional-service class predicted that people would use a primary care or clinic-hospital model.Provision of a range of services may maximize EIS use. Professionals may be more apt to adopt EISs in line with their beliefs regarding patient preferences. Considering several perspectives is important for service design.

The BGO-OD experiment at the ELSA accelerator facility uses an energy tagged bremstrahlung photon beam to investigate the excitation spectrum of the nucleon. The setup consists of a highly segmented BGO calorimeter surrounding the target, with a particle tracking magnetic spectrometer at forward angles. BGO-OD is ideal for investigating the photoproduction of hadrons of non-zero strangeness. The high momentum resolution at forward angles covers a kinematic region where t-channel exchange mechanisms play a dominant role. Access to this low momentum transfer region also allows the investigation of degrees of freedom not derived from constituent quark models, for example, the role of (vector) meson - baryon interactions and dynamically generated states in photoproduction reactions. Data taking for the first part of an extensive physics programme is complete and preliminary results and ongoing analysis are presented. (Less)

Objective: Conducting high-quality design research in a mental health setting presents significant challenges, limiting the availability of high-quality evidence to support design decisions for built environments. Here, we outline key approaches to overcoming these challenges. Background: In conducting a rigorous post-occupancy evaluation of a newly built mental health and addictions facility, St. Joseph’s Healthcare, Hamilton, we identified a number of systematic barriers associated with conducting design research in mental health settings. Methods: Our approach to overcoming these barriers relied heavily upon (i) selecting established measures and methods with demonstrated efficacy in a mental health context, (ii) navigating institutional protocols designed to protect vulnerable members of this population, and (iii) designing innovative data collection strategies to increase participation in research by individuals with mental illness. Each of these approaches drew heavily on the expert knowledge of mental health settings and the experiences with mental health, facilities management, and research of a research team that was well integrated within the parent institution. Conclusions: Engaging multiple stakeholders (e.g., care providers, patients, ethics board, and hospital administrators) contributed their trust and support of the research. Traditionally, post-occupancy evaluation researchers are independent of the facilities they research, yet this is not an effective approach in mental health settings. We found that, in working toward solutions to the three obstacles we described, having team members who were well “networked” within the parent institution was necessary. This approach can turn “gatekeepers” into champions for patients’ engagement in the research, which is essential in generating high-quality evidence.

Persons with mental illness often struggle to meaningfully participate in decisions about their services. This study engaged persons with mental illness to understand how health information could empower them. Participants reported wanting information on diagnoses, medications, symptoms, and strengths as well as clinician notes and rationale. The Resident Assessment Instrument for Mental Health contains this information and is mandated in in-patient psychiatry. Its findings could be summarized and shared with individuals to promote and facilitate shared decision-making.

A search for the exclusive production of the Z(c)(+/-)(3900) hadron by virtual photons has been performed in the channel Z(c)(+/-)(3900). J/Psi pi(+/-). The data cover the range from 7GeV to 19GeV in the centre-of- mass energy of the photon-nucleon system. The full set of the COMPASS data set collected with a muon beam between 2002 and 2011 has been used. An upper limit for the ratio BR(Z(c)(+/-)(3900)-> J/Psi pi(+/-)) x sigma(gamma N) -> Z(c)(+/-)(3900) N/sigma gamma N -> J/Psi N 3.7 x10(-3) has been established at the confidence level of90%. (C) 2015 The Authors. Published by Elsevier B.V.

Background Persistent post-surgical pain affects 10–80% of individuals after common operations, and is more common among patients with psychological factors such as depression, anxiety, or catastrophising. Methods We conducted a systematic review and meta-analysis of randomised, controlled trials to evaluate the efficacy of perioperative psychotherapy for persistent post-surgical pain and physical impairment. Paired independent reviewers identified studies, extracted data, and assessed risk of bias. The Grading of Recommendations, Assessment, Development and Evaluation system was used to assess the quality of evidence. Results Our search of five electronic databases, up to September 1, 2016, found 15 trials (2220 patients) that were eligible for review. For both persistent post-surgical pain and physical impairment, perioperative education was ineffective, while active psychotherapy suggested a benefit (test of interaction P=0.01 for both outcomes). Moderate quality evidence showed that active perioperative psychotherapy (cognitive-behaviour therapy, relaxation therapy, or both) significantly reduced persistent post-surgical pain [weighted mean difference (WMD) −1.06 cm on a 10 cm visual analogue scale for pain, 95% confidence interval (CI) −1.56 to −0.55 cm; risk difference (RD) for achieving no more than mild pain (≤3 cm) 14%, 95% CI 8–21%] and physical impairment [WMD −9.87% on the 0–100% Oswestry Disability Index, 95% CI −13.42 to −6.32%, RD for achieving no more than mild disability (≤20%) 21%, 95% CI 13–29%]. Conclusions Perioperative cognitive behavioural therapy and relaxation therapy are effective for reducing persistent pain and physical impairment after surgery. Future studies should explore targeted psychotherapy for surgical patients at higher risk for poor outcome. Clinical trial registration PROSPERO CRD42016047335.

A significant number of obsessive–compulsive disorder (OCD) patients continue to experience symptoms that interfere with their functioning following cognitive behavioural therapy (CBT). Providing an additional augmentation treatment following CBT could help reduce these residual symptoms. Mindfulness interventions that facilitate less reactivity to thoughts and feelings may be helpful for patients suffering from residual OCD symptoms. The purpose of the current randomized waitlist control trial was to evaluate the feasibility and impact of providing an 8-week mindfulness-based cognitive therapy (MBCT) intervention following completion of a CBT intervention to OCD patients who continued to suffer from significant symptoms. Results indicated that compared to the waitlist control group, MBCT participants reported decreases in OCD symptoms (d = 1.38), depression symptoms (d = 1.25), anxiety symptoms (d = 1.02), and obsessive beliefs (d = 1.20) along with increases in self-compassion (d = 0.77) and mindfulness skills (d = 0.77). Additionally, participants reported high levels of satisfaction with the MBCT intervention. The results suggest that the use of MBCT for OCD as an augmentation therapy is acceptable to patients who continue to suffer from OCD symptoms after completing CBT and provides some additional relief from residual symptoms. Key Practitioner Message Mindfulness interventions teach skills that facilitate disengaging from cognitive routines and accepting internal experience, and these skills may be valuable in treating obsessive–compulsive disorder (OCD), as individuals describe getting “stuck” in repetitive thoughts and consequent rituals. The results of this study suggest that teaching mindfulness skills using an 8-week mindfulness-based cognitive therapy (MBCT) intervention provides an added benefit (decreases in OCD, depression, and anxiety symptoms) for patients with OCD who have completed a cognitive behavioural therapy intervention and continued to suffer from significant symptoms. Participation in MBCT was also associated with increases in mindfulness skills including increased ability to be nonjudgmental and nonreactive. By fostering a nonjudgmental stance towards intrusive thoughts, mindfulness may discourage suppression and avoidance of thoughts and this could lead to increased habituation and a decreased reliance on compulsions. The use of MBCT as an augmentation treatment should be further explored to elucidate whether this treatment is beneficial for preventing relapse of OCD and could be compared against further cognitive behavioural therapy to see if offering participants a different and theoretically compelling intervention, such as MBCT, would outperform “more of the same” for individuals with OCD.

In 2011, the Board of Directors of the Canadian Psychological Association (CPA) launched the Task Force on Evidence-Based Practice of Psychological Treatments to support and guide practice as well as to inform stakeholders. This article describes the work of this task force, outlining its raison d'etre, providing a comprehensive definition of evidence-based practice (EBP), and advancing a hierarchy of evidence that is respectful of diverse research methodologies, palatable to different groups, and yet comprehensive and compelling. The primary objective was to present an overarching methodology or approach to thinking about EBP so that psychologists can provide and implement the best possible psychological treatments. To this end, our intention for this document was to provide a set of guidelines and standards that will foster interest, encourage development, and promote effectiveness in EBP.Keywords: evidence-based practice, evidence-based treatment, empirically supported treatment, psychotherapy, psychological treatmentAs part of the 2011-2012 Canadian Psychological Association (CPA) President's mandate (see Dozois, 2012, 2013), the Board of Directors voted in favor of a motion (March 2011) that the CPA establish a task force on the evidence-based practice (EBP) of psychological treatments that would generate a set of criteria and develop a position statement regarding the optimal integration of research evidence into practice. The board members believed that it was important for the CPA to develop a position on EBP in psychology to support and guide practice as well as to inform stakeholders. Psychological health and psychological disorders are clearly a priority for many of Canada's stakeholder groups (e.g., the Mental Health Commission of Canada, Treasury Board, Public Health Agency of Canada), and effective psychological treatment is also an important priority for CPA.BackgroundImportant objectives in professional psychology include the generation of treatment-relevant scientific knowledge and the ap- plication of this knowledge to the development of efficacious and effective interventions for mental and behavioral health problems (Baker, McFall, & Shoham, 2009; Kazdin, 2008; Lilienfeld, 2010; Treat, Bootzin, & Baker, 2012). Such objectives arise from a growing recognition in the field that the practice of psychological treatments should be based on valid evidence regarding which approaches to intervention are most likely to be successful. Al- though there is controversy regarding what constitutes "evidence," most psychologists believe in the utility of research for informing clinical practice and view EBP positively (Lilienfeld, Ritschel, Lynn, Cautin, & Latzman, 2013).In 1995, the American Psychological Association's (APA) So- ciety of Clinical Psychology Task Force on Promotion and Dis- semination of Psychological Procedures published its initial report, which listed treatments considered to be well-established or prob- ably efficacious according to a standard set of criteria (e.g., Chambless & Ollendick, 2001; Chambless et al., 1996). These criteria were subsequently adopted by the CPA Section on Clinical Psychology in their task force report, Empirically Supported Treat- ments in Psychology: Implications for Canadian Professional Psy- chology (Hunsley, Dobson, Johnston, & Mikail, 1999a, 1999b).Although many researchers and practitioners were enthusiastic about these efforts to promote empirically supported treatments, the criteria used to designate such treatments elicited considerable controversy. Concerns with the focus on empirically supported treatments have done little to narrow the gap between research and practice and to alter many clinicians' utilization of scientific liter- ature (see Hunsley, 2007a; Kazdin, 2008; Lilienfeld et al., 2013, for reviews of some of the challenges and solutions). For example, some psychologists have argued that the type of research deemed necessary to produce supportive evidence for a treatment is in- compatible with schools of psychotherapy outside of the cognitive behavioral therapy (CBT) framework (e. …

COMPASS has studied exclusive production of ρ 0 mesons using a 160 GeV/ c muon beam and a transversely polarised NH 3 target. Five single-spin and three double-spin azimuthal aymmetries were measured in dependence on Q 2 , x Bj , or p T 2 . Except the sin ϕ S asymmetry, obtained to be − 0.019 ± 0.008( stat .) ± 0.003( syst .), all others were found to be consistent with zero within experimental uncertainties. Phenomenological GPD-based model calculations agree well with the data and interpret the result as evidence for the existence of chiral-odd, transverse generalised parton distributions.

Mindfulness-based cognitive therapy (MBCT) and mindfulness-based stress reduction (MBSR) are particularly effective treatment approaches in terms of alleviating depressive symptoms and preventing relapse once remission has been achieved. Although engaging in mindfulness practice is an essential element of both treatments; it is unclear whether informal or formal practices differentially impact on symptom alleviation. The current study utilizes a correlational design to examine data provided by thirty-two previously depressed, remitted outpatients who received either MBCT or MBSR treatment. Outpatients in the MBCT group received treatment as part of a previously published randomized efficacy trial (Segal et al. in Arch Gen Psychiatry 67:1256–1264, 2010), while those in the MBSR group received treatment as part of a separate, unpublished randomized clinical trial. Throughout treatment, clients reported on their use of formal and informal mindfulness practices. Results indicate that engaging in formal (but not informal) mindfulness practice was associated with decreased rumination, which was associated with symptom alleviation.

Exclusive production of ηπ− and η π− has been studied with a 191 GeV/c π− beam impinging on a hydrogen target at COMPASS (CERN). Partial-wave analyses reveal different odd/even angular momentum (L) characteristics in the inspected invariant mass range up to 3 GeV/c2. A striking similarity between the two systems is observed for the L = 2, 4, 6 intensities (scaled by kinematical factors) and the relative phases. The known resonances a2(1320) and a4(2040) are in line with this similarity. In contrast, a strong enhancement of η π− over ηπ− is found for the L = 1, 3, 5 waves, which carry non-q¯q quantum numbers. The L = 1 intensity peaks at 1.7 GeV/c2 in η π− and at 1.4 GeV/c2 in ηπ−, the corresponding phase motions with respect to L =2 are different.

Aim While there is clearly much to be gained from ensuring that youth with emerging mental illness across a variety of psychiatric illnesses receive care that reduces symptoms and improves functioning, it is not at all clear how best to achieve these results within a health-care system that has limited resources. Outside of the area of psychosis, there is little evidence to guide us around a model of care that might be effective, efficient and linked to existing mental health systems. Methods We summarize the literature on early intervention (EI) in psychosis and derive five key lessons for transdiagnostic prevention. We then broadened our search to find clinical and systems models that shared challenges similar to those identified for EI, high levels of patient and family distress, need for rapid yet comprehensive diagnostic assessment and timely initiation of specific treatment. Results Cancer navigators have numerous functions that appear to overlap with the key issues in transdiagnostic psychiatric EI. A navigation clinic with a separate identity, but clearly connected to specialized mental health facilities has the potential to speed assessment, diagnosis and treatment streaming. Navigators would be involved with youth and their family throughout different levels of care, making clinical decisions based on illness and functional status. Conclusions In sum, the evidence from navigation services in cancer care offers the mental health field a progressive clinical model that might be an important guide for EI in youth.

We present a determination of the gluon polarisation Delta g/g in the nucleon, based on the longitudinal double-spin asymmetry of DIS events with Q(2) > 1 (GeV/c)(2) including a pair of large transverse-momentum hadrons in the final state. The data were obtained by the COMPASS experiment at CERN using a 160 GeV/c polarised muon beam scattering off a polarised (LiD)-Li-6 target. The gluon polarisation is evaluated by a Neural Network approach for three intervals of the gluon momentum fraction x(g) covering the range 0.04 < x(g) < 0.27. The values obtained at leading order in QCD do not show any significant dependence on x(g). Their average is Delta g/g = 0.125 +/- 0.060 (stat.) +/- 0.063 (syst.) at average x(g) = 0.09 and a scale of mu(2) = 3 (GeV/c)(2).

The transverse target spin azimuthal asymmetry A(UT)(sin(phi-phi s)) in hard exclusive production of rho(0) mesons was measured at COMPASS by scattering 160 GeV/c muons off transversely polarised protons and deuterons. The measured asymmetry is sensitive to the nucleon helicity-flip generalised parton distributions E-q, which are related to the orbital angular momentum of quarks in the nucleon. The Q(2), x-B-j and p(T)(2) dependence of A(UT)(sin(phi-phi s)) is presented in a wide kinematic range: 1 (GeV/c)(2) < Q(2) < 10 (GeV/c)(2), 0.003 < xB(j) < 0.3 and 0.05 (GeV/c)(2) < p(T)(2) < 0.5 (GeV/c)(2) for protons or 0.10 (GeV/c)(2) < p(T)(2) < 0.5 (GeV/c)(2) for deuterons. Results for deuterons are obtained for the first time. The measured asymmetry is small in the whole kinematic range for both protons and deuterons, which is consistent with the theoretical interpretation that contributions from GPDs E-u and E-d approximately cancel. (C) 2012 Elsevier B.V. All rights reserved.

Aim To understand what service features would sustain patient engagement in early intervention mental health treatment. Methods Mental health patients, family members of individuals with mental illness and mental health professionals completed a survey consisting of 18 choice tasks that involved 14 different service attributes. Preferences were ascertained using importance and utility scores. Latent class analysis revealed segments characterized by distinct preferences. Simulations were carried out to estimate utilization of hypothetical clinical services. Results Overall, 333 patients and family members and 183 professionals (N = 516) participated. Respondents were distributed between a Professional segment (53%) and a Patient segment (47%) that differed in a number of their preferences including for appointment times, individual vs group sessions and mode of after-hours support. Members of both segments shared preferences for many of the service attributes including having crisis support available 24 h per day, having a choice of different treatment modalities, being offered help for substance use problems and having a focus on improving symptoms rather than functioning. Simulations predicted that 60% of the Patient segment thought patients would remain engaged with a Hospital service, while 69% of the Professional segment thought patients would be most likely to remain engaged with an E-Health service. Conclusions Patients, family members and professionals shared a number of preferences about what service characteristics will optimize patient engagement in early intervention services but diverged on others. Providing effective crisis support as well as a range of treatment options should be prioritized in the future design of early intervention services.