Enhancing recovery rates: lessons from year one of IAPT

BACKGROUND: The English Improving Access to Psychological Therapies (IAPT) initiative aims to make evidence-based psychological therapies for depression and anxiety disorder more widely available in the National Health Service (NHS). 32 IAPT services based on a stepped care model were established in the first year of the programme. We report on the reliable recovery rates achieved by patients treated in the services and identify predictors of recovery at patient level, service level, and as a function of compliance with National Institute of Health and Care Excellence (NICE) Treatment Guidelines. METHOD: Data from 19,395 patients who were clinical cases at intake, attended at least two sessions, had at least two outcomes scores and had completed their treatment during the period were analysed. Outcome was assessed with the patient health questionnaire depression scale (PHQ-9) and the anxiety scale (GAD-7). RESULTS: Data completeness was high for a routine cohort study. Over 91% of treated patients had paired (pre-post) outcome scores. Overall, 40.3% of patients were reliably recovered at post-treatment, 63.7% showed reliable improvement and 6.6% showed reliable deterioration. Most patients received treatments that were recommended by NICE. When a treatment not recommended by NICE was provided, recovery rates were reduced. Service characteristics that predicted higher reliable recovery rates were: high average number of therapy sessions; higher step-up rates among individuals who started with low intensity treatment; larger services; and a larger proportion of experienced staff. CONCLUSIONS: Compliance with the IAPT clinical model is associated with enhanced rates of reliable recovery.

Wireless Sensor Networks: MAC protocols and real time applications

Wireless Senor Networks(WSNs) detect events using one or more sensors, then collect data from detected events using these sensors. This data is aggregated and forwarded to a base station(sink) through wireless communication to provide the required operations. Different kinds of MAC and routing protocols need to be designed for WSN in order to guarantee data delivery from the source nodes to the sink. Some of the proposed MAC protocols for WSN with their techniques, advantages and disadvantages in the terms of their suitability for real time applications are discussed in this paper. We have concluded that most of these protocols can not be applied to real time applications without improvement

Since we have been a dialogue: Blanchot's 'Entretiens'

At the turn of the 1960s, Maurice Blanchot began publishing texts that he named entretiens, this change in his writing responding to what deconstruction sees as the closure of logocentric or continuous discourse. Paradoxically, this closure does not prevent such discourse, in which philosophical enquiry and technological change are intertwined, from dominating the modern world. By changing his writing, and by reiterating the dialogical form so central to metaphysical tradition since Plato, Blanchot gives voice to the tensions between continuity and its ‘outside’, between philosophy and literature. This is one sense in which his entretiens do not engage in a representation of difference, but instead open themselves to the inflections of what Jean-Luc Nancy calls le partage des voix.

Children’s and adults’ processing of syntactically ambiguous sentences during reading

While there has been a fair amount of research investigating children’s syntactic processing during spoken language comprehension, and a wealth of research examining adults’ syntactic processing during reading, as yet very little research has focused on syntactic processing during text reading in children. In two experiments, children and adults read sentences containing a temporary syntactic ambiguity while their eye movements were monitored. In Experiment 1, participants read sentences such as, ‘The boy poked the elephant with the long stick/trunk from outside the cage’ in which the attachment of a prepositional phrase was manipulated. In Experiment 2, participants read sentences such as, ‘I think I’ll wear the new skirt I bought tomorrow/yesterday. It’s really nice’ in which the attachment of an adverbial phrase was manipulated. Results showed that adults and children exhibited similar processing preferences, but that children were delayed relative to adults in their detection of initial syntactic misanalysis. It is concluded that children and adults have the same sentence-parsing mechanism in place, but that it operates with a slightly different time course. In addition, the data support the hypothesis that the visual processing system develops at a different rate than the linguistic processing system in children.