Adherence to the iFightDepression® online self-help tool for depression - A pilot study.

Background and purpose:

The aim of the current observational study was to examine the level of adherence of Hungarian patients suffering from depression, using iFightDep­ression (iFD) guided online self-help tool with and without an extra weekly phone call support as well as identifying the predictors of adherence. Our hypotheses were: the additional weekly phone-calls would increase the adherence with the online self-help tool; furthermore, symptoms of depression will significantly decrease in the weekly phone support group.

During the 6 weeks of iFD® intervention, patients were divided into two groups: the first, alongside of the treatment as usual (TAU) and iFD®, received a 20-minu­tes weekly phone call support while the other group partook in only the TAU+iFD® intervention. Measures: number of completed modules and Patient Health Questionnaire-9. The study included 102 participants with diagnosis of depression (70% female, mean age: 36.9 [SD = 11.40] ys). 

Participants completed on average 4.8 (SD = 1.73) out of 6 modules. The intervention group with additional phone support completed more modules than the group of no additional phone calls (Z = –5.416, p < 0.001, rank Cohen’s d = –1.267). Participants with higher level of education completed more modules than those with lower level of education (Z = –2.198, p = 0.028, rank Cohen’s d = –0.444). Baseline depressive symptoms correlated negatively with the number of completed modules (rS = –0.22, p = 0.028). Depressive symptoms were significantly reduced between the two measurement points (main effect of time: (F(1) = 179.173, p < 0.001, partial η2 = 0.642), the improvement was significantly larger in the iFD® + phone support group (time × group interaction: F(1) = 6.492, p = 0.012, partial η2 = 0.061).

Weekly phone support increased treatment adherence. Negative correlation of symptom severity with adherence suggests that iFD can be effective in mild or moderate forms of depression. With regards to sociodemographic variables, only the level of education showed significant correlation with adherence. Our results support applicability of the iFD intervention in various kinds of sociodemographic groups.

Effectiveness of iFightDepression® online guided self-help tool in depression - A pilot study.

BACKGROUND: Depression is one of the leading causes of human misery and disability worldwide. For those fortunate enough to have access to the rapidly expanding World Wide Web, online self-help tools can guide those suffering from depression, with or without professional intervention, to better manage their symptoms and maintain some measure of self-actualization. This study assesses the efficacy of the widely used, online self-help tool, iFightDepression®. METHODS: A six-week, observational study was conducted with 143 participants (29.4% men, mean age: 37.8; standard deviation [SD] = 12.05, range = 18-70, years) in three intervention groups, as follows: 1) Treatment As Usual (TAU), 2) TAU combined with access to the iFightDepression® tool (TAU + iFD®), 3) TAU combined with iFightDepression® and weekly phone support (TAU + iFD® + phone). Depression symptoms were measured pre- and post- by Patient Health Questionnaire-9. RESULTS: There was a significantly greater decrease of depressive symptoms in both iFD® groups compared to the TAU group (time × group interaction: F(2) = 34.657, p < 0.001, partial η2 = 0.331). The reliable change index calculation identified one participant (0.7%) as having experienced a statistically reliable deterioration in depression. A total of 102 participants (71.3%) showed no reliable change, while 40 participants (28.0%) showed a statistically reliable improvement. Multiple binary logistic regression analysis found odds of reliable improvement to be significantly higher in both iFD® groups compared to the TAU group (TAU + iFD®: OR = 18.52, p = 0.015, TAU + iFD® + Phone: OR = 126.72, p < 0.001). Participants living in Budapest were found to have significantly higher odds for a reliable improvement compared to those living in the countryside (odds ratio [OR] = 4.04, p = 0.023). Finally, higher levels of depressive symptoms at baseline (pretest) were also associated with increased odds for post-intervention improvement (OR = 1.58, p < 0.001). The variance explained by the model is 62.0%. With regards to the iFD® self-help program, the mean of completed modules was 4.8 (SD = 1.73, range = 1-6). Participants in the group supported by weekly phone calls completed significantly more modules (n = 50, M = 5.7, SD = 0.76) than participants without weekly telephone support (n = 52, M = 3.9, SD = 1.94, Z = 5.253, p < 0.001). However, there was no significant difference in the number of completed modules between respondents with a reliable improvement in depression (n = 39, M = 4.9, SD = 1.57) and those without a reliable change (n = 63, M = 4.7, SD = 1.83, Z = 0.343, p = 0.731). CONCLUSION: Our results confirm previous findings regarding the efficacy of web-based interventions with the low-intensity guidance of mental health professional. Findings suggest that a relatively short additional weekly call may result in a significant decrease in depressive symptoms and higher number of completed iFD® modules. The study confirms that the IFD® tool, both alone and with additional phone support, is a possible and effective way to help patients with mild to moderate and, in some cases, even severe depression. Providing mental and primary health care systems with the availability of online self-help tools may contribute to the efficacious treatment of depression and prevention of the increase in depressive symptoms.

Controlling invasive alien shrub species, enhancing biodiversity and mitigating flood risk: A win-win-win situation in grazed floodplain plantations.

The high nature conservation value of floodplain ecosystems is severely threatened by invasive alien species. Besides adversely affecting native biodiversity, these species also pose a major threat from a wider socio-ecological perspective (e.g. 'roughness' increases flood risk). Finding options to control dense shrub layers consisting of invasive alien species is therefore of high priority for multipurpose management. We studied cattle grazing impacts on the cover, composition and diversity of the herb and shrub layers in floodplain poplar plantations along the Tamis river, Serbia. Non-grazed, moderately grazed, intensively grazed and resting place stands were sampled in five locations in three sampling points. Non-grazed stands had substantially higher cover of invasive alien shrub species (on average 65%) than moderately and intensively grazed stands, and resting places (5.17, 0.02 and 0.00%, respectively), but without considerable differences between the grazing intensity categories. The number of invasive alien species in the shrub layer decreased considerably from non-grazed to intensively grazed stands. Species composition in the herb layer changed from non-grazed to intensively grazed stands, while resting places differed substantially from the other categories. Total species richness, richness of native generalist herbaceous grassland species, and the cover of palatable grasses were the highest in moderately and intensively grazed stands. Our results suggest that cattle grazing in floodplains is effective at controlling invasive alien shrub species. Furthermore, continuous moderate or intensive grazing would contribute to multifunctional management of invaded floodplains by enhancing local biodiversity, reducing flood risk, and providing additional grazing areas for the local community.

Prohibited, but still present: local and traditional knowledge about the practice and impact of forest grazing by domestic livestock in Hungary.

BACKGROUND: Forests have been grazed for millennia. Around the world, forest grazing by livestock became a controversial management practice, gradually restricted in many countries over the past 250 years. This was also the case in most Central and Eastern European countries, including Hungary, where forest grazing was a legally prohibited activity between 1961 and 2017. Until the 2010s, ecologists and nature conservationists considered it merely as a historical form of forest use. As a result, there is little contemporary scientific information available about the impact of forest grazing on vegetation and the traditional ecological knowledge associated with it. Our aim was to explore and summarize this type of knowledge held by herders in Hungary. METHODS: We interviewed 58 knowledgeable herders and participated in forest grazing activities in 43 study locations across the country. The results were analysed qualitatively. RESULTS: We revealed a living ecological knowledge tradition and practice of forest grazing in native and non-native forest stands. The impact of livestock grazing on native and non-native forests is not considerably different, in the view of the herders. For both forest types, the greatest impact of grazing was the suppression of the shrub layer, while grazing also increased the dominance and palatability ("tameness") of the grasses. Livestock could cause significant damage to seedlings during forest grazing, but if done with care, grazing could also be an integral part of forestry management. CONCLUSIONS: Sustainability of current forest grazing practices depends on the depth of local and traditional knowledge applied and herders' stewardship. We stress the importance of collaborating with holders of local and traditional knowledge in order to gain a better understanding of the effects of livestock grazing on vegetation in temperate forests.

[Advantage of obsessive-compulsive symptoms from the aspect of individual selection and group selection: an evolutionary psychological approach to obsessive-compulsive disorder]. / Obszesszív-kompulzív tünetek elonyei az egyéni szelekció és a csoportszelekció szempontjából: a kényszerbetegség evolúciós pszichológiai megközelítése.

Psychiatric disorders are difficult to explain from an evolutionary aspect, since it is hard to reason how a characteristic carrying a reproductive disadvantage survives through natural selection. There are several evolution-based papers concerning obsessive-compulsive disorder (OCD), which aim at resolving this contradiction. Recent studies provided considerable evidence in support for the evolutionary theories of OCD. Research confirmed an important role for genetic factors in the background of OCD, and neuroanatomic studies supported that neuroanatomical structures playing a role in OCD are those areas which are activated during the processing of danger and threat. From the evolutionary aspect OCD can be explained both from the individual and group selection aspect. According to the theory of individual selection, OCD symptoms are based on such behaviors which are by themselves advantageous serving individual survival and reproduction and therefore carry on through natural selection. According to group selection theory, although OCD is disadvantageous for the individual, it is adaptive for the survival of the group. In our paper we review the individual and group selection theories of OCD, and we also outline the continuity and discontinuity theories which show a significant overlap with the evolutionary theories. We review characteristic age and gender differences related to OCD from this aspect. The evolutionary approach to OCD is important in understanding the background factors, development and symptoms of OCD, which mean new tools in the prevention and treatment of this disorder.

[Hungarian national dietary survey, 2003-2004. Micronutrients: mineral salts]. / Táplálkozási vizsgálat Magyarországon, 2003-2004. Mikro-tápanyagok: ásványi sók.

In the course of the 3rd national nutritional survey data were collected in 2003, and the paper on the energy and nutrition intake of a sample group consisting of 1179 people all aged above 19, was published in the Hungarian Medical Journal (Vol. 146, No. 34, 2005). The present paper focuses on one group of micronutrients, namely the minerals' intake. The authors evaluated the results mainly in comparison with the data of the two previous Hungarian national surveys, and the international and national recommendations. The average magnesium intake was considered adequate in both sexes, while iron, zinc and copper intakes also met the recommended level in men. On the other hand, the insufficient calcium and the excessive phosphorus intakes, as well as the disproportionate calcium-phosphorus ratio in both sexes are unfavourable facts. The adverse results include insufficient iron, zinc and copper intake in women and the excessive sodium intake in both sexes, as well. The authors emphasize the importance of spreading the principles of healthy nutrition as well as co-operating with the food industry in order to prevent the occurrence of mineral nutrients deficiency.

[Dietary survey in Hungary, 2003-2004]. / Táplálkozási vizsgálat Magyarországon, 2003-2004.

The third Hungarian national dietary survey was conducted in 2003-2004. This publication describes the first part of the energy and nutrient intake findings in a sample consisting of a population of 1179 persons over 19 years of age (energy and macro nutrients). Energy and nutrient intake values were calculated based on 3 x 24- hour dietary records filled out by the subjects themselves. The authors evaluated the results in light of the two previous dietary surveys in Hungary and the Hungarian and international reference intake data. The total fat intake found in this survey lower than the previous data marks a favourable development, just as the higher unsaturated fatty acid and lower saturated fatty acid energy percent, and furthermore the lower cholesterol intake level. The favourable developments include further a polyunsaturated/saturated fatty acid ratio considerably higher than that obtained earlier (the values conforming to the international reference data), a higher carbohydrate energy percentage, as well as lower added sugar energy percentage, this latter being in the recommended range. The overweight ratio in men was 58.9%, while the female value was 49.5%, not much different from the previous survey data.