Randomised controlled effectiveness trial of a needs-based psychosocial intervention service for carers of people with schizophrenia

BACKGROUND

Family interventions are effective in reducing relapse in patients with schizophrenia, but there is little work demonstrating the effectiveness of the interventions in routine service settings.

AIMS

To test the effectiveness of a needs-based family intervention service for patients recruited as out-patients and their carers, including those of low expressed emotion status.

METHOD

Carers of out-patient schizophrenia sufferers selected only on illness history factors were randomly allocated to receive either family support alone or in combination with systematic psychosocial interventions based on an assessment of need. Delivery of family interventions attempted to involve the clinical team.

RESULTS

Relapse outcomes were superior for family-treated patients at six-month follow-up, although most of the clinical and symptom patient variables assessed remained stable, as did measures of carer burden.

CONCLUSIONS

The study demonstrated the effectiveness of family interventions in routine service settings. Problems with staff, patient and carer engagement and participation were identified.

Needs-based cognitive-behavioural family intervention for carers of patients suffering from schizophrenia: 12-month follow-up

OBJECTIVE

To examine longer-term effectiveness of a needs-based family intervention for carers and out-patients suffering from schizophrenia.

METHOD

Seventy-nine unselected patient-carer pairs were recruited from a geographical area and allocated randomly to one of two conditions. One group received needs-based cognitive-behavioural family intervention in combination with general family support plus the standard care. The control group received the general family support and standard care only.

RESULTS

Analysis was carried out on an intention-to-treat basis. There was a significant advantage for family intervention, in terms of relapse (37% relapsed compared to 72%, NNT=3) and on other clinical measures. Treatment group and medication compliance were significant and independent predictors of relapse. There was a significant reduction in carer needs in the intervention group.

CONCLUSION

Family intervention directed at carers' needs within a standard mental health service can produce benefits for patients beyond the term of intervention.

A draft genome sequence of Cellulomonas sp. ICMP 17802, isolated from root nodules of Vicia faba

Here, we report the draft genome sequence of Cellulomonas sp. ICMP 17802. This bacterium was obtained from the International Collection of Microorganisms from Plants and was originally isolated from root nodules of Vicia faba. The draft genome contains 154 predicted carbohydrate-active enzyme genes.

Plant-pathogen management in a native forest ecosystem

Forest ecosystems all over the world are facing a growing threat from plant-disease outbreaks. As pollution, climate change, and global pathogen movement intensify, so too do the impacts of forest pathogens. In this essay, we examine a case study of the New Zealand kauri tree (Agathis australis) and its oomycetepathogen, Phytophthora agathidicida. We focus on the interactions between the host, pathogen, and environment - the building blocks of the 'disease triangle', a framework used by plant pathologists to understand and manage diseases. We delve into why this framework is more challenging to apply to trees than crops, taking into account the differences in reproductive time, level of domestication, and surrounding biodiversity between the host (a long-lived native tree species) and typical crop plants. We also address the difficulties in managing Phytophthora diseases compared to fungal or bacterial pathogens. Furthermore, we explore the complexities of the environmental aspect of the disease triangle. In forest ecosystems, the environment is particularly complex, encompassing diverse macro- and microbiotic influences, forest fragmentation, land use, and climate change. By exploring these complexities, we emphasize the importance of targeting multiple components of the disease triangle simultaneously to make effective management gains. Finally, we highlight the invaluable contribution of indigenous knowledge systems in bringing a holistic approach to managing forest pathogens in Aotearoa New Zealand and beyond.