Integrating socioeconomic and ecological data into restoration practice.

Driven by the United Nations Decade on Restoration and international funding initiatives, such as the Mangrove Breakthrough, investment in mangrove restoration is expected to increase. Yet, mangrove restoration efforts frequently fail, usually because of ad hoc site-selection processes that do not consider mangrove ecology and the socioeconomic context. Using decision analysis, we developed an approach that accounts for socioeconomic and ecological data to identify sites with the highest likelihood of mangrove restoration success. We applied our approach in the Biosphere Reserve Marismas Nacionales Nayarit, Mexico, an area that recently received funding for implementing mangrove restoration actions. We identified 468 potential restoration sites, assessed their restorability potential based on socioeconomic and ecological metrics, and ranked sites for implementation with spatial optimization. The metrics we used included favorable conditions for propagules to establish and survive under sea-level rise, provision of ecosystem services, and community dynamics. Sites that were selected based on socioeconomic or ecological metrics alone had lower likelihood of mangrove restoration success than sites that were selected based on integrated socioeconomic and ecological metrics. For example, selecting sites based on only socioeconomic metrics captured 16% of the maximum attainable value of functioning mangroves able to provide propagules to potential restoration sites, whereas selecting sites based on ecological and socioeconomic metrics captured 46% of functioning mangroves. Our approach was developed as part of a collaboration between nongovernmental organizations, local government, and academics under rapid delivery time lines given preexisting mangrove restoration implementation commitments. The systematic decision process we used integrated socioeconomic and ecological considerations even under short delivery deadlines, and our approach can be adapted to help mangrove restoration site-selection decisions elsewhere.

Integración de datos socioeconómicos y ecológicos en las prácticas de restauración Resumen Se espera que la inversión en la restauración de los manglares incremente debido a la Década de Restauración de las Naciones Unidad y las iniciativas internacionales de financiamiento, como The Mangrove Breakthrough. Sin embargo, los esfuerzos de restauración de manglares fallan con frecuencia, generalmente por los procesos de selección de sitios ad­hoc que no consideran la ecología del manglar y el contexto socioeconómico. Usamos el análisis de decisiones para desarrollar una estrategia que considera los datos socioeconómicos y ecológicos para identificar los sitios con mayor probabilidad de éxito de restauración. Aplicamos nuestra estrategia en la Reserva de la Biósfera Marismas Nacionales Nayarit, México, un área que recibió financiamiento reciente para la restauración del manglar. Identificamos 468 sitios potencialmente restaurables, evaluamos su potencial de restauración con base en medidas ecológicas y socioeconómicas y clasificamos los sitios para la implementación con la optimización espacial. Las medidas que usamos incluían las condiciones favorables para que los propágulos se establezcan y sobrevivan con el incremento en el nivel del mar, el suministro de servicios ambientales y las dinámicas de la comunidad. Los sitios seleccionados sólo con base en las medidas ecológicas o socioeconómicas tuvieron una menor probabilidad de éxito de restauración que los sitios que se seleccionaron con base en medidas socioeconómicas y ecológicas integradas. Por ejemplo, la selección de sitios con base sólo en las medidas socioeconómicas capturó el 16% del máximo valor alcanzable de manglares funcionales capaces de proporcionar propágulos a los sitios potenciales de restauración, mientras que la selección basada en medidas ecológicas y socioeconómicas capturó el 46% de los manglares funcionales. Desarrollamos nuestra estrategia como parte de una colaboración entre organizaciones no gubernamentales, el gobierno local y académicos sujetos a una fecha pronta de entrega debido a los compromisos preexistentes para la restauración de manglares. El proceso de decisión sistemática que usamos integró las consideraciones ecológicas y socioeconómicas incluso con plazos cortos de entrega. Nuestra estrategia puede adaptarse para apoyar en la selección de sitios de restauración de manglares en otros sitios.

Feasibility, acceptability, and effectiveness of web-based and mobile PTSD Coach: a systematic review and meta-analysis.

Background: Timely and effective interventions can alleviate or prevent the development of clinical symptomatology in trauma-exposed individuals. However, due to limited access to these interventions, and/or stigma around accessing mental health services, there is an unmet need. Internet-and mobile-based interventions may help to address this need.Aims: This review aims to (i) synthesise the evidence on feasibility, acceptability, and effectiveness of the 'PTSD Coach' intervention (both web-based and mobile applications) in trauma-exposed individuals; (ii) evaluate the quality of this research; and (iii) identify challenges and recommendations related to 'PTSD Coach' intervention delivery.Method: Systematic database searches were conducted (PubMed/MEDLINE, PsycINFO, EMBASE, PLoS, Web of Science, PTSDpubs, Scopus, and clinical trial databases). Review inclusion was based on predefined inclusion criteria, and study quality was assessed with the mixed methods appraisal and the risk-of-bias tools for randomised trials. Where feasible, meta-analytical pooling of intervention effects on posttraumatic stress symptoms (PTSS) was conducted.Results: Seventeen manuscripts reporting on 16 primary studies were included with the majority evaluating a self-managed PTSD Coach mobile application intervention. Most studies were conducted in higher-income countries and females were over-represented. For both platforms, satisfaction and perceived helpfulness were generally high but type of smart device operating system was identified as an influence. The pooled effect size in symptom severity in the intervention group compared to the comparison group was not significant (standardised mean difference =  - 0.19) (95% CI - 0.41 to - 0.03, p = .09). Heterogeneity was not significant (p = .14; I2 = 40%). No study was excluded based on quality assessment.Conclusion: Findings support the feasibility and acceptability of 'PTSD Coach' in trauma-exposed individuals. However, evidence on the effectiveness on PTSS remains limited. More research is still needed in low-middle-income countries, particularly those in which supported 'PTSD Coach' interventions are evaluated in larger and more diverse samples.

Most studies evaluated a self-managed PTSD Coach mobile application intervention in higher-income countries.Findings generally support the feasibility and acceptability of both PTSD Coach mobile application and PTSD Coach Online in trauma-exposed individuals but the evidence on the effectiveness on posttraumatic stress symptoms remains limited.More research is needed especially in low-middle-income countries where there is often limited access to the needed interventions.

EMDR therapy for misophonia: a pilot study of case series.

Background: Misophonia is a disorder in which patients suffer from anger or disgust when confronted with specific sounds such as loud chewing or breathing, causing avoidance of cue-related situations resulting in significant functional impairment. Though the first treatment studies with cognitive behavioural therapy (CBT) showed promising results, an average of 50% of the patients has not improved much clinically. Objective: The aim of this pilot study was to assess the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy as a trauma-focused approach in treating misophonia symptoms. Method: A sample of 10 adult participants with misophonia was studied at the outpatient clinic of the Academic Medical Center in Amsterdam. Participants were either on the waiting list for CBT or non-responders to CBT. EMDR was focused on misophonia-related emotionally disturbing memories and delivered in a mean of 2.6 sessions of 60-90 minutes. Pre- and post-treatment self-assessed ratings of misophonia symptoms (AMISOS-R, primary outcome), of general psychopathology (SCL-90-R) and of quality of life (SDS) were administered. The co-primary outcome was the Clinical Global Impression Improvement scale (CGI-I). Results: A paired t-test (n = 8) showed improvement on the primary outcome (-6.14 [MD], 5.34 [SD]) on the AMISOS-R (P = .023). Three of the eight patients showed clinically significant improvement measured with the CGI-I. No significant effect on secondary outcomes was found. Conclusions: These preliminary results suggest that EMDR therapy focused on emotionally disturbing misophonia-related memories can reduce misophonia symptoms. RCTs with sufficient sample sizes are required to firmly establish the value of EMDR therapy for misophonia.

Antecedentes: La misofonía es un trastorno en el que los pacientes sufren de rabia o desagrado cuando se enfrentan a sonidos específicos como la masticación o la respiración ruidosa, lo que provoca la evitación de las situaciones relacionadas con el estímulo y da lugar a un deterioro funcional significativo. Aunque los primeros estudios de tratamiento con terapia cognitivo-conductual (TCC) mostraron resultados prometedores, una media del 50% de los pacientes no ha mejorado mucho clínicamente.Objetivo: El objetivo de este estudio piloto fue evaluar la eficacia de la terapia de desensibilización y reprocesamiento por movimientos oculares (EMDR) como enfoque centrado en el trauma para tratar los síntomas de la misofonía.Método: Se estudió una muestra de 10 participantes adultos con misofonía en la clínica ambulatoria del Centro Médico Académico de Ámsterdam. Los participantes estaban en lista de espera para la TCC o no respondían a la TCC. La EMDR se centró en los recuerdos emocionalmente perturbadores relacionados con la misofonía y se aplicó en una media de 2,6 sesiones de 60­90 minutos. Se administraron calificaciones autoevaluadas antes y después del tratamiento de los síntomas de misofonía (AMISOS-R, resultado primario), de psicopatología general (SCL-90-R) y de calidad de vida (SDS). El resultado co-primario fue la escala de Mejora de la Impresión Clínica Global (CGI-I).Resultados: Una prueba t pareada (n=8) mostró una mejora en el resultado primario (−6,14 [DM]), 5,34 [DE] en la AMISOS-R (P= .023). Tres de los ocho pacientes mostraron una mejora clínicamente significativa medida con la CGI-I. No se encontró ningún efecto significativo en los resultados secundarios.EMDR para la misofonía Estos resultados preliminares sugieren que la terapia EMDR centrada en los recuerdos emocionalmente perturbadores relacionados con la misofonía puede reducir los síntomas de ésta. Se requieren ECAs con tamaños de muestra suficientes para establecer firmemente el valour de la terapia EMDR para la misofonía.