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This paper explores the bidirectional relationship between trauma and Substance Use Disorders (SUDs), emphasising the need for integrated treatment approaches. Trauma exposure, often associated with various psychological disorders, contributes to the high comorbidity observed in SUDs. Early childhood trauma, in particular, is linked to vulnerability in developing SUDs later in life. In response to the challenges of treating SUDs, this paper outlines emerging evidence for schema therapy as a transdiagnostic intervention. Schema therapy, an extension of cognitive behavioural therapy, targets maladaptive schemas and core beliefs by integrating cognitive, behavioural, and experiential techniques. Schema therapy recognises the role of unmet core emotional needs in the development of early maladaptive schemas, offering a holistic approach to address entrenched psychological patterns. Empirical evidence suggests a significant association between early maladaptive schemas and SUDs, highlighting the potential of schema therapy in addressing substance use. Despite limited research, studies demonstrate promising outcomes, including reductions in SUD severity and symptoms of comorbid conditions. Clinical implications include the integration of trauma screening in SUD assessments, adopting a holistic approach to treatment, and exploring schema therapy as a viable intervention through rigorous research methodologies. Ultimately, this paper highlights that the integration of schema therapy into substance use treatment programs holds promise in revolutionising the approach to SUDs, providing a nuanced and effective therapeutic intervention for individuals seeking lasting recovery and improved quality of life.

Purpose Evidence is lacking as to the superiority of dual-focused versus single-focused approaches in treating depression and alcohol use comorbidity. Different people may also value the different features of treatment options differently, necessitating a decision-support tool. This study aims to test the acceptability, feasibility, safety and potential usefulness of the Alcohol and Depression Decision-Aid for Psychological Treatments (ADDAPT). Design/methodology/approach ADDAPT was developed according to International Patient Decision-Aid Standards and in consultation with potential end users. Adults with depression and alcohol use comorbidity, who were considering/recently considered psychological treatments, were recruited via online advertisements. After clicking on the study URL, participants accessed the ADDAPT e-book and completed validated and purpose-designed questionnaires. Findings Of the 24 participants, most would recommend ADDAPT to others (79.2% agree) and endorsed it as easy-to-use (75%), useful in decision-making (79.2%), presenting balanced (87.5%), up-to-date (91.7%), easy-to-understand (79.2%) and trustworthy information (83.3%), which did not provoke anxiety (i.e. safety; 75%). Post-use, participants felt well prepared to decide on treatment (M = 3.48/5) and demonstrated good treatment knowledge (M = 65.83%). All but one participant indicated a treatment choice supported by best available evidence, and decisional conflict scores except for the uncertainty subscale were below the threshold for decisional delay (all M < 37.5/100). Originality/value ADDAPT is the first decision-aid of its kind, with pilot findings supporting its acceptability, feasibility, safety and potential usefulness for improving decision-making quality among people considering psychological treatment options for depression and alcohol use comorbidity.

IntroductionEmerging research indicates that integrated treatment of co-occurring post-traumatic stress disorder (PTSD) and substance use disorder can be effective among adolescents and young people. However, various barriers exist to young people accessing evidence-based treatments. Telehealth offers an opportunity to address these barriers and provide a scalable and accessible alternative to inperson treatment. This paper describes the study protocol for a randomised controlled trial (RCT) examining the efficacy, safety and cost-effectiveness of an integrated trauma-focused cognitive-behavioural treatment for traumatic stress and substance use among adolescents and young adults (Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure – Adolescent and Young Adult version (COPE-A)) when delivered in person compared with via telehealth.Methods and analysisA two-arm, parallel group, single-blind, non-inferiority RCT with follow-up at 4 months and 12 months post study entry will be conducted in Sydney, Australia. Participants (170 adolescents and young adults aged 12–25 years) will be allocated to receive COPE-A either in person or via telehealth (allocation ratio 1:1) using minimisation. Project psychologists will administer treatment via both modes of delivery over a maximum of 16 sessions of 60–90 min. The primary outcome will be between-group differences in change in the severity of PTSD symptoms from baseline to 4-month follow-up, as measured by the Clinician-Administered PTSD Scale for Children and Adolescents for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.Ethics and disseminationThis study has been approved by the Sydney Children’s Hospitals Network Human Research Ethics Committee (2024/ETH01050). Research findings will be published in peer-reviewed journals and presented at scientific conferences.Trial registration numberACTRN12624000776505.Protocol versionV.2.3, 20 March 2025.

Ken Herman stated in a June 24 letter that after fumigation of a home for termites, \"concentrations of pesticide inside the residence may actually increase for many years.\"

Sanborn Fire Insurance maps contain a wealth of building-level information about U.S. cities dating back to the late 19th century. They are a valuable resource for studying changes in urban environments, such as the legacy of urban highway construction and urban renewal in the 20th century. However, it is a challenge to automatically extract the building-level information effectively and efficiently from Sanborn maps because of the large number of map entities and the lack of appropriate computational methods to detect these entities. This paper contributes to a scalable workflow that utilizes machine learning to identify building footprints and associated properties on Sanborn maps. This information can be effectively applied to create 3D visualization of historic urban neighborhoods and inform urban changes. We demonstrate our methods using Sanborn maps for two neighborhoods in Columbus, Ohio, USA that were bisected by highway construction in the 1960s. Quantitative and visual analysis of the results suggest high accuracy of the extracted building-level information, with an F-1 score of 0.9 for building footprints and construction materials, and over 0.7 for building utilizations and numbers of stories. We also illustrate how to visualize pre-highway neighborhoods.

The posterior parietal cortex exhibits choice-selective activity during perceptual decision-making tasks 1 – 10 . However, it is not known how this selective activity arises from the underlying synaptic connectivity. Here we combined virtual-reality behaviour, two-photon calcium imaging, high-throughput electron microscopy and circuit modelling to analyse how synaptic connectivity between neurons in the posterior parietal cortex relates to their selective activity. We found that excitatory pyramidal neurons preferentially target inhibitory interneurons with the same selectivity. In turn, inhibitory interneurons preferentially target pyramidal neurons with opposite selectivity, forming an opponent inhibition motif. This motif was present even between neurons with activity peaks in different task epochs. We developed neural-circuit models of the computations performed by these motifs, and found that opponent inhibition between neural populations with opposite selectivity amplifies selective inputs, thereby improving the encoding of trial-type information. The models also predict that opponent inhibition between neurons with activity peaks in different task epochs contributes to creating choice-specific sequential activity. These results provide evidence for how synaptic connectivity in cortical circuits supports a learned decision-making task. Excitatory pyramidal neurons preferentially target inhibitory interneurons with the same selectivity and, in turn, inhibitory interneurons preferentially target pyramidal neurons with opposite selectivity, forming an opponent inhibition motif that supports decision-making.

With recent growth in funding and research on “resilience building”, interest in climate services has risen dramatically. Included in this trend is an increased emphasis on the use of climate and weather information for a range of purposes across multiple scales. Non-governmental organisations (NGOs) and other non-state actors across Africa have responded accordingly, and are increasingly acting as brokers, and sometimes producers, of climate services as part of their activities. Drawing on research from Burkina Faso and Ethiopia as part of the Building Resilience and Adaptation to Climate Extremes and Disasters (BRACED) programme, this paper critically examines the evolving climate services landscape and raises questions about what the future holds for climate services in sub-Saharan Africa. We ask two questions: How have national climate services in these countries evolved since the early 2000s when they first came to prominence? And how have NGO contributions to these services evolved over time? Our findings highlight a considerable evolution in the aims and capacities of climate service systems over this period. NGOs have contributed to this progress on multiple fronts, but we note that important opportunities for innovation remain. We also raise concerns about how the current financing and governance models may influence priority setting and the sustainability of “projectised” services. Accordingly, we call for a better understanding how power and politics shape the development and deployment of climate services. This paper provides insight on the evolving landscape of climate services, actors involved in its provision and implications for the future.