Reducing the global burden of depression : population level analysis of intervention cost-effectiveness in 14 world regions

International evidence on the cost and effects of interventions for reducing the global burden of depression remain scarce. Aims: To estimate the population-level cost-effectiveness of evidence-based depression interventions and their contribution towards reducing current burden. Method: Primary-care-based depression interventions were modelled at the level of whole populations in 14 epidemiological subregions of the world. Total population-level costs (in international dollars or I$) and effectiveness (disability adjusted life years (DALYs) averted) were combined to form average and incremental cost-effectiveness ratios. Results: Evaluated interventions have the potential to reduce the current burden of depression by 10–30%. Pharmacotherapy with older antidepressant drugs, with or without proactive collaborative care, are currently more cost-effective strategies than those using newer antidepressants, particularly in lower-income subregions. Conclusions: Even in resource-poor regions, each DALYaverted by efficient depression treatments in primary care costs less than 1 year of average per capita income, making such interventions a cost-effective use of health resources. However, current levels of burden can only be reduced significantlyif there is a substantialincrease substantial increase intreatment coverage.

Extending conceptual models for Web based applications

The next phase envisioned for the World Wide Web is automated ad-hoc interaction between intelligent agents, web services, databases and semantic web enabled applications. Although at present this appears to be a distant objective, there are practical steps that can be taken to advance the vision. We propose an extension to classical conceptual models to allow the definition of application components in terms of public standards and explicit semantics, thus building into web-based applications, the foundation for shared understanding and interoperability. The use of external definitions and the need to store outsourced type information internally, brings to light the issue of object identity in a global environment, where object instances may be identified by multiple externally controlled identification schemes. We illustrate how traditional conceptual models may be augmented to recognise and deal with multiple identities.

Story Circle : Digital Storytelling Around the World

Story Circle is the first collection ever devoted to a comprehensive international study of the digital storytelling movement. Exploring subjects of central importance on the emergent and ever-shifting digital landscape-consumer-generated content, memory grids, the digital storytelling youth movement, and micro-documentary- Story Circle pinpoints who is telling what stories, where, on what terms, and what they look and sound like.