Engagement with Activity Monitoring During a Behavioral Activation Intervention: A Randomized Test of Monitoring Format and Qualitative Evaluation of Participant Experiences.

Behavioural activation (BA) is an efficacious treatment approach. Activity monitoring is a key component of brief BA treatments; however, no studies have examined the most efficacious format for monitoring. The present pilot study tested brief versus intensive activity monitoring approaches during a BA intervention administered in a college orientation course. Outcomes characterised (1) engagement with the treatment protocol via activity monitoring and (2) participant qualitative experiences with monitoring and the intervention as reported during focus group interviews. Four course sections were randomly assigned to receive monitoring forms that were brief (assessed activities three times daily) or intensive (assessed activities hourly). Forms were provided electronically to students via a web-based platform which tracked completion. There were no significant differences in monitoring frequency (38.0 vs. 23.0 days; p = .154) or the duration of monitoring engagement (62.0 vs. 36.0 days; p = .054) between the brief and intensive conditions. Qualitative findings suggested that participants in both conditions found utility in activity monitoring, particularly during the first month as they transitioned to college. Overall, findings indicated that participants may find utility in monitoring during the first month of a BA intervention using either brief or intensive monitoring forms.

Detrimental effects of a novel flow regime on the functional trajectory of an aquatic invertebrate metacommunity.

Novel flow regimes resulting from dam operations and overallocation of freshwater resources are an emerging consequence of global change. Yet, anticipating how freshwater biodiversity will respond to surging flow regime alteration requires overcoming two challenges in environmental flow science: shifting from local to riverscape-level understanding of biodiversity dynamics, and from static to time-varying characterizations of the flow regime. Here, we used time-series methods (wavelets and multivariate autoregressive models) to quantify flow-regime alteration and to link time-varying flow regimes to the dynamics of multiple local communities potentially connected by dispersal (i.e., a metacommunity). We studied the Chattahoochee River below Buford dam (Georgia, U.S.A.), and asked how flow regime alteration by a large hydropower dam may control the long-term functional trajectory of the downstream invertebrate metacommunity. We found that seasonal variation in hydropeaking synchronized temporal fluctuations in trait abundance among the flow-altered sites. Three biological trait states describing adaptation to fast flows benefitted from flow management for hydropower, but did not compensate for declines in 16 "loser" traits. Accordingly, metacommunity-wide functional diversity responded negatively to hydropeaking intensity, and stochastic simulations showed that the risk of functional diversity collapse within the next 4 years would decrease by 17% if hydropeaking was ameliorated, or by 9% if it was applied every other season. Finally, an analysis of 97 reference and 23 dam-affected river sites across the U.S. Southeast suggested that flow variation at extraneous, human-relevant scales (12-hr, 24-hr, 1-week) is relatively common in rivers affected by hydropower dams. This study advances the notion that novel flow regimes are widespread, and simplify the functional structure of riverine communities by filtering out taxa with nonadaptive traits and by spatially synchronizing their dynamics. This is relevant in the light of ongoing and future hydrologic alteration due to climate non-stationarity and the new wave of dams planned globally.

Congeneric Predaceous Diving Beetle Species Fail to Segregate in a Floodplain System: A Case of Amplified Sympatry.

Coexistence of closely related species has long been a focus of biologists in their efforts to explain mechanisms that drive community assembly. Dytiscidae (predaceous diving beetles) are a group that shows a particularly high affinity for sympatry despite their relatedness. Our objective was to investigate the degree of overlap among Neoporus (Guignot) species (Coleoptera: Dytiscidae) in floodplains of the southeastern United States. We sampled two floodplain habitats (permanent oxbow lakes and temporarily flooded pools) of the Altamaha River (Georgia, USA) for Neoporus species over three years. Six species of Neoporus were collected during our study, and a significant amount of overlap (spatial and temporal) was documented. Analysis suggested that none of the species exhibited a preference toward one habitat type or the other. Temporally, no striking patterns of segregation emerged. No negative correlations between species were documented, but neither were significant positive correlations found. This absence of distinct patterns suggests a lack of segregation among Neoporus species in floodplains of the Altamaha River. While Dytiscidae in general appears to be a particularly sympatric group of organisms, overlap among congeneric species within the family has been documented less frequently. Our study provides new insight into the degree to which dytiscids are capable of coexisting in space and time.

Bilateral idiopathic osteonecrosis of the femoral head: a case report with an emphasis on differential diagnosis, imaging, and treatment.

OBJECTIVE: The purpose of this case report is to describe a patient with bilateral idiopathic osteonecrosis of the femoral head (ONFH), provide a discussion of differential diagnosis for anterior hip pain, imaging, and treatment recommendations for ONFH. CLINICAL FEATURES: A 34-year-old man was initially treated by a chiropractic physician for low back pain. At the end of a three week trial of care, the patient's low back pain resolved. However, he reported a new complaint of mild left anterior hip stiffness. After re-examination, a homecare exercise program was prescribed. The patient returned 1 month later with substantial left anterior hip pain and walked with a noticeable limp. Radiography of the left hip demonstrated advanced ONFH. Magnetic resonance imaging of both hips demonstrated the extent of involvement of the left hip while incidentally revealing ONFH on the right. INTERVENTION AND OUTCOME: A total hip arthroplasty was performed on the left hip and the right hip is being monitored without intervention. CONCLUSION: Osteonecrosis of the femoral head is a challenging clinical problem with non-specific and wide-ranging signs and symptoms requiring clinicians to engage a cautious and comprehensive differential diagnosis. Prompt recognition ensures that appropriate treatment can be initiated in a timely manner and optimal patient outcomes achieved.