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.

TCL/TK for EDA tools

Tcl/Tk scripting language has become the de-facto standard for EDA tools. This paper explains how to start working with Tcl/Tk using simple examples. Two complete applications are presented to show in more detail the capabilities of the language. In one script average power consumption of a digital system is automated. A second script creates a virtual display driven by the simulation of a graphic card.

Urban economic openness and IPO underpricing

We examine the empirical impact of trade openness on the short-run underpricing of initial public offerings (IPOs) using city-level real estate data. This paper represents a first attempt to employ a macroeconomic approach to explain IPO performance. We investigate an openness effect in which urban economic openness (UEO) has a significant impact on the productivity and on the prices of both direct and indirect real estate due to productivity gains of companies in more open areas. This in turn positively affects the firm’s profitability, enhancing the confidence in the local real estate market and the future company performance and decreasing the uncertainty of the IPO valuation. And as a result, we find that issuers have less incentive to underprice the IPO shares. China provides a suitable experimental ground to study the immense underpricing in developing markets, which cannot solely be accounted for by firm specific effects. First, Chinese real estate companies show strong geographic patterns focusing their businesses locally – usually at a city level. Second, we observe a degree of openness which is significantly heterogeneous across Chinese cities. Controlling for company-specific variables, location and state ownership, we find the evidence that companies whose businesses are in economically more open areas experience less IPO underpricing. Our results show high explanatory power and are robust to diverse specifications.