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Using Best-Worst Scaling to assess preferences for online psychological interventions to decrease cannabis use in young adults with psychosis
- O. Tatar, A. Abdel-Baki, H. Bakouni, A. Bahremand, T. Lecomte, J. Côté, D. Crockford, S. L’Heureux, C. Ouellet-Plamondon, M.-A. Roy, P. G. Tibbo, M. Villeneuve, D. Jutras-Aswad
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S528-S529
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Introduction
In individuals with first episode psychosis (FEP) and cannabis use disorder (CUD), reducing cannabis use is associated with improved clinical outcomes. Access to evidence-based psychological interventions to decrease cannabis use in FEP clinics is highly variable; E-mental health interventions may help to address this gap. Development of E-interventions for CUD in individuals with FEP is in its incipient phases.
ObjectivesTo assess preferences for online psychological interventions aiming at decreasing or stopping cannabis use in young adults with psychosis and CUD.
MethodsIndividuals aged 18 to 35 years old with psychosis and CUD were recruited from seven FEP intervention programs in Canada and responded to an electronic survey between January 2020-July 2022. We used the Case 2 Best Worst Scaling methodology that is grounded in the trade-off utility concept to collect and analyse data. Participants selected the best or worst option for each of the nine questions corresponding to three distinct domains. For each domain we used conditional logistic regression and marginal models (i.e., three models in total) to estimate preferences for attributes (e.g., duration, frequency of online intervention sessions) and attribute levels (e.g., 15 minutes, every day).
ResultsParticipants (N=104) showed higher preferences for the following attributes: duration of online sessions; mode of receiving the intervention; method of feedback delivery and the frequency of feedback from clinicians (Table 1). Attribute-level analyses showed higher preferences for participating once a week in short (15 minutes) online interventions (Figure 1). Participants valued the autonomy offered by online interventions which aligns with their preference for completing the intervention outside the clinic and only require assistance once a week (Figure 2). Participants’ preferences were higher for receiving feedback related to cannabis consumption both from the application and clinicians at a frequency of once a week from clinicians (Figure 3).
Table 1. Preferences for Attributes. Results of conditional logistic regression Attributes Domains OR 95% CI for OR Duration session A 1.62 1.45; 1.82 Frequency sessions 0.98 0.87; 1.09 Duration intervention ref Preferred mode of receiving the intervention B 1.63 1.46; 1.83 Preferred location for participating 1.07 0.96; 1.20 Frequency of assistance from the clinician ref Preference for the feedback delivery method C 1.21 1.08; 1.36 Frequency of feedback from the treating clinician 1.14 1.02; 1.28 Frequency of feedback from the application ref Note: In boldface significant odds ratios (OR) and confidence intervals (CI)
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ConclusionsUsing advanced methodologies to assess preferences, our results can inform the development of highly acceptable E-Mental health interventions for decreasing cannabis use in individuals with CUD and FEP.
Disclosure of InterestNone Declared
A global threats overview for Numeniini populations: synthesising expert knowledge for a group of declining migratory birds
- JAMES W. PEARCE-HIGGINS, DANIEL J. BROWN, DAVID J. T. DOUGLAS, JOSÉ A. ALVES, MARIAGRAZIA BELLIO, PIERRICK BOCHER, GRAEME M. BUCHANAN, ROB P. CLAY, JESSE CONKLIN, NICOLA CROCKFORD, PETER DANN, JAANUS ELTS, CHRISTIAN FRIIS, RICHARD A. FULLER, JENNIFER A. GILL, KEN GOSBELL, JAMES A. JOHNSON, ROCIO MARQUEZ-FERRANDO, JOSE A. MASERO, DAVID S. MELVILLE, SPIKE MILLINGTON, CLIVE MINTON, TAEJ MUNDKUR, ERICA NOL, HANNES PEHLAK, THEUNIS PIERSMA, FRÉDÉRIC ROBIN, DANNY I. ROGERS, DANIEL R. RUTHRAUFF, NATHAN R. SENNER, JUNID N. SHAH, ROB D. SHELDON, SERGEJ A. SOLOVIEV, PAVEL S. TOMKOVICH, YVONNE I. VERKUIL
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- Journal:
- Bird Conservation International / Volume 27 / Issue 1 / March 2017
- Published online by Cambridge University Press:
- 01 March 2017, pp. 6-34
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The Numeniini is a tribe of 13 wader species (Scolopacidae, Charadriiformes) of which seven are Near Threatened or globally threatened, including two Critically Endangered. To help inform conservation management and policy responses, we present the results of an expert assessment of the threats that members of this taxonomic group face across migratory flyways. Most threats are increasing in intensity, particularly in non-breeding areas, where habitat loss resulting from residential and commercial development, aquaculture, mining, transport, disturbance, problematic invasive species, pollution and climate change were regarded as having the greatest detrimental impact. Fewer threats (mining, disturbance, problematic native species and climate change) were identified as widely affecting breeding areas. Numeniini populations face the greatest number of non-breeding threats in the East Asian-Australasian Flyway, especially those associated with coastal reclamation; related threats were also identified across the Central and Atlantic Americas, and East Atlantic flyways. Threats on the breeding grounds were greatest in Central and Atlantic Americas, East Atlantic and West Asian flyways. Three priority actions were associated with monitoring and research: to monitor breeding population trends (which for species breeding in remote areas may best be achieved through surveys at key non-breeding sites), to deploy tracking technologies to identify migratory connectivity, and to monitor land-cover change across breeding and non-breeding areas. Two priority actions were focused on conservation and policy responses: to identify and effectively protect key non-breeding sites across all flyways (particularly in the East Asian- Australasian Flyway), and to implement successful conservation interventions at a sufficient scale across human-dominated landscapes for species’ recovery to be achieved. If implemented urgently, these measures in combination have the potential to alter the current population declines of many Numeniini species and provide a template for the conservation of other groups of threatened species.
Outcomes of Patients with Parkinson Disease and Pathological Gambling
- A. Bharmal, C. Lu, J. Quickfall, D. Crockford, O. Suchowersky
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 37 / Issue 4 / July 2010
- Published online by Cambridge University Press:
- 02 December 2014, pp. 473-477
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Objective:
To determine the outcomes of patients with Parkinson disease (PD) with pathological gambling (PG) from one Canadian Movement Disorders Clinic.
Methods:Assessments were performed in-person during routine clinic visits of all patients currently followed by one neurologist (OS). Pathological gambling was defined according to DSM-IV-TR criteria. Chart review was performed to obtain details on medication use, dosages, and patient demographics. Follow-up of patients with PG collected information on gambling behavior, PG management interventions, medications, treatment, and psychosocial outcomes.
Results:146 patients were surveyed with an overall prevalence of PG of 4.1% (6/146). The rate of pathological gambling for those patients on dopamine agonist therapy (DA) was 8.1% (6/74). Only patients who were recreational gamblers prior to starting DA developed PG. All PG patients discontinued, decreased, or switched to another DA, and experienced a partial or full remission of PG. 3 (50%) patients described financial losses of $100,000 or more, and 75% (3/4) patients described significant marital stresses. At follow-up (August 2008), 4 of the 6 patients with PG continued to gamble in a controlled fashion despite medication changes. No significant difference in levodopa equivalent daily dose (LEDD) pre- and post-PG were observed; however, the relative amount of DA was decreased (p= 0.0593), while levodopa was relatively increased (p= 0.5277). Despite control of PG, patients still experience financial and marital strains.
Conclusions:DA (in combination with levodopa) was associated with a significantly higher prevalence of PG in PD, particularly in patients who were recreational gamblers previously. Despite control of PG, patients continued to experience significant financial and marital stresses that should be regularly enquired upon in follow-up care and managed appropriately.