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.

Making Money from Monsters

It seems Australia is the place to be at the moment when it comes to making and creating horror films. Mark David Ryan explains how you can get involved in this boom industry. If you’re a writer with a passion for scary movies, a wordsmith who watches the occasional horror flick and writing your own has crossed your mind, or a writer who terrifies readers with an interest in screenwriting, then there has never been a better time to write Aussie horror flicks. This article introduces the horror genre’s core characteristics, issues to consider when crafting a horror flick, and provides tips for getting scripts into the hands of producers.

Emerging strategies for sponsorship on the Internet

Internet sponsorship is a rapidly evolving communications platform at a fledgling stage for sponsorship-linked marketing. The complex and involving nature of the phenomena offers new research opportunities and the potential for innovative marketing strategies. The Internet presents the opportunity to combine aspects of traditional event/activity sponsorship and media sponsorship innovatively and to extend marketing strategy in new directions. This paper presents an overview of emerging Internet sponsorships strategies, identifies virtual and reality sponsorship opportunities, and explores emerging sponsorship extension strategies that relate to media, brand, channel development, consumer experience, and networking. Finally, future directions for researchers and practitioners are suggested.

Measuring the use of information and communication technologies (ICTs) in the classroom

In 2003, the “ICT Curriculum Integration Performance Measurement Instrument” was developed froman extensive review ofthe contemporary international and Australian research pertaining to the definition and measurement of ICT curriculum integration in classrooms (Proctor, Watson, & Finger, 2003). The 45-item instrument that resulted was based on theories and methodologies identified by the literature review. This paper describes psychometric results from a large-scale evaluation of the instrument subsequently conducted, as recommended by Proctor, Watson, and Finger (2003). The resultant 20-item, two-factor instrument, now called “Learning with ICTs: Measuring ICT Use in the Curriculum,” is both statistically and theoretically robust. This paper should be read in association with the original paper published in Computers in the Schools(Proctor, Watson, & Finger, 2003) that described in detail the theoretical framework underpinning the development of the instrument.

International epidemiology of prostate cancer : geographical distribution and secular trends

This review outlines current international patterns in prostate cancer incidence and mortality rates and survival, including recent trends and a discussion of the possible impact of prostate-specific antigen (PSA) testing on the observed data. Internationally, prostate cancer is the second most common cancer diagnosed among men (behind lung cancer), and is the sixth most common cause of cancer death among men. Prostate cancer is particularly prevalent in developed countries such as the United States and the Scandinavian countries, with about a six-fold difference between high-incidence and low-incidence countries. Interpretation of trends in incidence and survival are complicated by the increasing impact of PSA testing, particularly in more developed countries. As Western influences become more pronounced in less developed countries, prostate cancer incidence rates in those countries are tending to increase, even though the prevalence of PSA testing is relatively low. Larger proportions of younger men are being diagnosed with prostate cancer and living longer following diagnosis of prostate cancer, which has many implications for health systems. Decreasing mortality rates are becoming widespread among more developed countries, although it is not clear whether this is due to earlier diagnosis (PSA testing), improved treatment, or some combination of these or other factors.

Validation of the Edinburgh Postnatal Depression Scale for men, and comparison of item endorsement with their partners

BACKGROUND: The Edinburgh Postnatal Depression Scale (EPDS) has been validated and used extensively in screening for depression in new mothers, both in English speaking and non-English speaking communities. While some studies have reported the use of the EPDS with fathers, none have validated it for this group, and thus the appropriate cut-off score for screening for depression or anxiety caseness for this population is not known. METHODS: Couples were recruited antenatally and interviewed at six weeks postpartum. EPDS scores and distress caseness (depression or anxiety disorders) for 208 fathers and 230 mothers were determined using the Diagnostic Interview Schedule. RESULTS: Analyses of the EPDS for fathers using distress caseness (depression or anxiety disorders) as the criterion shows that a cut-off of 5/6 has optimum receiver operating characteristics. Furthermore acceptable reliability (split-half and internal consistency) and validity (concurrent) coefficients were obtained. For mothers the optimum cut-off screening value to detect distress caseness was 7/8. Item analysis revealed that fathers endorsed seven of the ten items at lower rates to mothers, with the most significant being that referring to crying. CONCLUSIONS: The EPDS is a reliable and valid measure of mood in fathers. Screening for depression or anxiety disorders in fathers requires a two point lower cut-off than screening for depression or anxiety in mothers, and we recommend this cut-off to be 5/6

Temperature enhanced effects of ozone on cardiovascular mortality in 95 large US communities, 1987-2000 - assessment using the NMMAPS data

A few studies examined interactive effects between air pollution and temperature on health outcomes. This study is to examine if temperature modified effects of ozone and cardiovascular mortality in 95 large US cities. A nonparametric and a parametric regression models were separately used to explore interactive effects of temperature and ozone on cardiovascular mortality during May and October, 1987-2000. A Bayesian meta-analysis was used to pool estimates. Both models illustrate that temperature enhanced the ozone effects on mortality in the northern region, but obviously in the southern region. A 10-ppb increment in ozone was associated with 0.41 % (95% posterior interval (PI): -0.19 %, 0.93 %), 0.27 % (95% PI: -0.44 %, 0.87 %) and 1.68 % (95% PI: 0.07 %, 3.26 %) increases in daily cardiovascular mortality corresponding to low, moderate and high levels of temperature, respectively. We concluded that temperature modified effects of ozone, particularly in the northern region.

Utmost good faith in insurance : reform overdue?

Considerable attention has been devoted to the duty or doctrine of utmost good faith in the academic literature and in the courts. This attention ranges from an analysis of the precise legal basis for the duty through a consideration of the continuing nature of that duty in the post-contract environment.It is quite clear that all contracts of insurance are subject to this duty of utmost good faith. What is less clear and certain are the incidents attendant upon such a duty and the scope of the obligations that such a duty imposes. This article examines the relative positions that have been reached in England and Australia and concludes with some recommendations for legislative reform to this area of the law.

Operative technique : acetabulum

BOOK: Written by the surgeons of the Exeter Hip Team and their colleagues from around the world, this book describes 40 years of innovation and development with cemented hip replacement. Topics covered include the basic science behind successful cemented hip replacement, modern surgical techniques and recent advances. There is also extensive coverage of the revision techniques developed at Exeter and elsewhere, focussing on femoral and acetabular impaction grafting. Each chapter is a self-contained article with an emphasis, where appropriate, on practical techniques and surgical tips, supported by line drawings and intra-operative photographs.

Estimation of WGEN Weather Generation Parameters in Arid Climates

This research discusses some of the issues encountered while developing a set of WGEN parameters for Chile and advice for others interested in developing WGEN parameters for arid climates. The WGEN program is a commonly used and a valuable research tool; however, it has specific limitations in arid climates that need careful consideration. These limitations are analysed in the context of generating a set of WGEN parameters for Chile. Fourteen to 26 years of precipitation data are used to calculate precipitation parameters for 18 locations in Chile, and 3–8 years of temperature and solar radiation data are analysed to generate parameters for seven of these locations. Results indicate that weather generation parameters in arid regions are sensitive to erroneous or missing precipitation data. Research shows that the WGEN-estimated gamma distribution shape parameter (α) for daily precipitation in arid zones will tend to cluster around discrete values of 0 or 1, masking the high sensitivity of these parameters to additional data. Rather than focus on the length in years when assessing the adequacy of a data record for estimation of precipitation parameters, researchers should focus on the number of wet days in dry months in a data set. Analysis of the WGEN routines for the estimation of temperature and solar radiation parameters indicates that errors can occur when individual ‘months’ have fewer than two wet days in the data set. Recommendations are provided to improve methods for estimation of WGEN parameters in arid climates.

Transition of chromium oxyhydroxide nanomaterials to chromium oxide : a hot stage Raman spectroscopic study

The transition of disc-like chromium hydroxide nanomaterials to chromium oxide nanomaterials has been studied by hot stage Raman spectroscopy. The structure and morphology of α-CrO(OH) synthesised using hydrothermal treatment was confirmed by X-ray diffraction and transmission electron microscopy. The Raman spectrum of α-CrO(OH) is characterised by two intense bands at 823 and 630 cm-1 attributed to ν1 CrIII-O symmetric stretching mode, bands at 1179 cm-1 attributed to CrIII-OH δ deformation modes. No bands are observed above 3000 cm-1. The absence of characteristic OH vibrational bands may be due to short hydrogen bonds in the α-CrO(OH) structure. Upon thermal treatment of α-CrO(OH), new Raman bands are observed at 599, 542, 513, 396, 344 and 304 cm-1, which are attributed to Cr2O3. This hot-stage Raman study shows that the transition of α-CrO(OH) to Cr2O3 occurs before 350 °C.

Voices of the Unheard

Adversity has the effect of eliciting talents, which, in prosperous circumstances, would have lain dormant. Horace - Roman lyric poet and satirist 65BC – 8 BC This quotation from Horace could well be the chorus to a medley of songs sung by people who face extraordinary adversity and have gained emotional resilience through music making. In this chapter we present three composition ventures that are stories or verses in a new song and whose chorus summarises the nature of the resilience factors present in the narratives. We are aware that words on a page like this can have the effect of filtering out the engaging nature of musical experience and reduce music to a critique or an evaluation of its aesthetic value. This disjuncture between language and the ephemeral, embodied experience is a problem for those who use these creative processes in therapeutic and salutogenic ways (Antonovsky, 1996) for public health. The notion of salutogenic health, put simply, delineates it from therapy in that the processes focus upon wellness rather than therapy. Whilst we include evidence from the fields of community music therapy (Pavlicevic, 2004; Leitschuh et al., 1991), neuroscience (Bittman et al., 2001) and community music (Bartleet et al., 2009) the framework for a salutogenic health outcome in community music is one which seeks to employ music practices and the qualities of music making that provide positive health benefit to communities –to enhance health and well being rather than the “treatment” of disorders. It is essentially a holistic and interdisciplinary study. Therapy and salutogenic health are not mutually exclusive as both depend upon the qualities of music experience to affect change. Collecting, analysing and presenting evidence of change in human behaviour that can be directly attributed to creative music making is a problem of evaluation.