Objectives-Family members of patients with bipolar disorder experience high rates of subjective and objective burden which place them at risk for adverse physical health and mental health outcomes. We present preliminary efficacy data from a novel variation of Family Focused Treatment [Miklowitz DJ. Bipolar Disorder: A Family-Focused Treatment Approach (2 nd ed.). New York: The Guilford Press, 2008] that aimed to reduce symptoms of bipolar disorder by working with caregivers to enhance illness management skills and self-care.Methods-The primary family caregivers of 46 patients with bipolar I (n = 40) or II (n = 6) disorder, diagnosed by the Structured Clinical Interview for DSM-IV Axis I Disorders, were assigned randomly to receive either: (i) a 12-15-session family-focused, cognitive-behavioral intervention designed to provide the caregiver with skills for managing the relative's illness, attaining self-care goals, and reducing strain, depression, and health risk behavior [FamilyFocused Treatment-Health Promoting Intervention (FFT-HPI)]; or (ii) an 8-12-session health education (HE) intervention delivered via videotapes. We assessed patients pre-and posttreatment on levels of depression and mania and caregivers on levels of burden, health behavior, and coping.Results-Randomization to FFT-HPI was associated with significant decreases in caregiver depressive symptoms and health risk behavior. Greater reductions in depressive symptoms among patients were also observed in the FFT-HPI group. Reduction in patients' depression was partially mediated by reductions in caregivers' depression levels. Decreases in caregivers' depression were partially mediated by reductions in caregivers' levels of avoidance coping.Conclusions-Families coping with bipolar disorder may benefit from family interventions as a result of changes in the caregivers' ability to manage stress and regulate their moods, even when the patient is not available for treatment. Keywordsdepression; health burden; illness management; psychoeducation; stress Bipolar disorder affects the family members of a patient and is affected by the family environments associated with caregiving. From 89% to 91% of family members report NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript feelings of emotional distress (i.e., 'subjective burden') in relation to the severity of the patient's illness symptoms (1,2); between 24% and 38% score above the standard cutoffs on self-report measures of depressive symptoms (2). Patient suicidal ideation and behavior in particular have been associated with increased symptoms of caregiver depression (3). For family members with their own history of mood disorders, caregiving more than doubles the risk of recurrence of an episode of major depression in the caregiver compared to the risk of recurrence among persons with a history of mood disorder but without caregiving responsibilities (4).Recent studies suggest that subjective burden and/or depression also compromise caregivers' ability to effectively man...

Coral reefs are highly diverse and productive ecosystems, and certain oceanographic processes, such as El Niño, have resulted in severe coral bleaching and mortality of reef-building corals and to the global decline of the area covered by coral reefs. Here, we report the response of corals and both green and red filamentous and coralline algae from the central Mexican Pacific coast to the 2015-16 El Niño event. Sea surface temperature (SST) was recorded in the area between june 2012 and December 2018. Additionally, SST, DHW and the Oceanic El Niño Index (ONI) provided by NOAA for the El Niño 3 region during the same period were considered. Relative cover (%) of healthy, pale, bleached and dead corals, coral rubble, filamentous algae, rocks, and sand were recorded at five reefs during 2010, 2015, and 2018. Between April 2015 and April 2016, the SST was warmer than average, and the ONI showed temperature anomalies near 3, indicating a strong El Niño event. The response of corals varied among reefs and years. No relevant changes in substrata cover were recorded at two reefs through the years, but extensive coral bleaching occurred at the other reefs in June 2015, with dramatic coral mortality as a consequence. An inability to recover and the resulting dominance of filamentous algae over dead corals was evident at two reefs in January 2018. Multivariate analysis based on the cover of substrata and the comparison with previous studies suggested that the response of the coral reefs was not related to the previous state of conservation or the level of anthropogenic impact at each reef. The causes of such thermal resistance are uncertain; nonetheless, it has a high potential to cope with future El Niño impacts.

ABSTRACT. The study of the structure and dynamics of assemblages of benthic organisms has gained interest in recent decades because it can account for the influence of anthropogenic activities in the coastal zone and be incorporated into management and conservation plans. The region of Zihuatanejo, Mexico, has had an accelerated and unplanned urban development, negatively affecting coastal communities. However, studies on the structure and dynamics of algal assemblages, as well as some of the predominant physical factors in this region are scarce. The objective of this research was to carry out a preliminary study on the structure of macroalgal assemblages and their spatio-temporal variation in a depositional environment. The work was realized from June 2006 to December 2008 collecting randomly macroalgal samples and placing sediment traps on the bottom to characterize the deposition environment. The subtidal algal assemblages of the studied localities were predominantly turfs. The Detendred Correspondence Analysis showed that each locality had a particular species composition. The highest biomass was 37.82 ± 12.90 g dw m -2 and the lowest of 0-7.86 g dw m -2. The highest total sedimentation rate was 1818.10 ± 82.11 g dw m -2 day -1 and the lowest was 58.82 ± 8.75 g dw m -2 day -1 . Significant differences were found in calcareous and articulated biomass, as well as in fine, coarse and total sedimentation rates among localities. The results obtained provide a basis for further research on the effects of sedimentation on the subtidal macroalgae assemblages of the study region.

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