Cost-effectiveness of a preventive counseling and support package for postnatal depression

Objectives: This study reports the cost-effectiveness of a preventive intervention, consisting of counseling and specific support for the mother-infant relationship, targeted at women at high risk of developing postnatal depression. Methods: A prospective economic evaluation was conducted alongside a pragmatic randomized controlled trial in which women considered at high risk of developing postnatal depression were allocated randomly to the preventive intervention (n = 74) or to routine primary care (n = 77). The primary outcome measure was the duration of postnatal depression experienced during the first 18 months postpartum. Data on health and social care use by women and their infants up to 18 months postpartum were collected, using a combination of prospective diaries and face-to-face interviews, and then were combined with unit costs ( pound, year 2000 prices) to obtain a net cost per mother-infant dyad. The nonparametric bootstrap method was used to present cost-effectiveness acceptability curves and net benefit statistics at alternative willingness to pay thresholds held by decision makers for preventing 1 month of postnatal depression. Results: Women in the preventive intervention group were depressed for an average of 2.21 months (9.57 weeks) during the study period, whereas women in the routine primary care group were depressed for an average of 2.70 months (11.71 weeks). The mean health and social care costs were estimated at 2,396.9 pound per mother-infant dyad in the preventive intervention group and 2,277.5 pound per mother-infant dyad in the routine primary care group, providing a mean cost difference of 119.5 pound (bootstrap 95 percent confidence interval [Cl], -535.4, 784.9). At a willingness to pay threshold of 1,000 pound per month of postnatal depression avoided, the probability that the preventive intervention is cost-effective is .71 and the mean net benefit is 383.4 pound (bootstrap 95 percent Cl, -863.3- pound 1,581.5) pound. Conclusions: The preventive intervention is likely to be cost-effective even at relatively low willingness to pay thresholds for preventing 1 month of postnatal depression during the first 18 months postpartum. Given the negative impact of postnatal depression on later child development, further research is required that investigates the longer-term cost-effectiveness of the preventive intervention in high risk women.

The effects of maternal depression and parental conflict on children's peer play

Background Little is known about the relative effects of exposure to postnatal depression and parental conflict on the social functioning of school-aged children. This is, in part, because of a lack of specificity in the measurement of child and parental behaviour and a reliance on children's reports of their hypothetical responses to conflict in play. Methods In the course of a prospective longitudinal study of children of postnatally depressed and well women, 5-year-old children were videotaped at home with a friend in a naturalistic dressing-up play setting. As well as examining possible associations between the occurrence of postnatal depression and the quality of the children's interactions, we investigated the influence of parental conflict and co-operation, and the continuity of maternal depression. The quality of the current mother-child relationship was considered as a possible mediating factor. Results Exposure to postnatal depression was associated with increased likelihood, among boys, of displaying physical aggression in play with their friend. However, parental conflict mediated the effects of postnatal depression on active aggression during play, and was also associated with displays of autonomy and intense conflict. While there were no gender effects in terms of the degree or intensity of aggressive behaviours, girls were more likely to express aggression verbally using denigration and gloating whereas boys were more likely to display physical aggression via interpersonal and object struggles. Conclusions The study provided evidence for the specificity of effects, with strong links between parental and child peer conflict. These effects appear to arise from direct exposure to parental conflict, rather than indirectly, through mother-child interactions.

Supporting ad hoc collaborations in peer-to-peer networks

Traditionally, applications and tools supporting collaborative computing have been designed only with personal computers in mind and support a limited range of computing and network platforms. These applications are therefore not well equipped to deal with network heterogeneity and, in particular, do not cope well with dynamic network topologies. Progress in this area must be made if we are to fulfil the needs of users and support the diversity, mobility, and portability that are likely to characterise group work in future. This paper describes a groupware platform called Coco that is designed to support collaboration in a heterogeneous network environment. The work demonstrates that progress in the p development of a generic supporting groupware is achievable, even in the context of heterogeneous and dynamic networks. The work demonstrates the progress made in the development of an underlying communications infrastructure, building on peer-to-peer concept and topologies to improve scalability and robustness.

A peer-to-peer approach to content dissemination and search in collaborative networks

There are three key driving forces behind the development of Internet Content Management Systems (CMS) - a desire to manage the explosion of content, a desire to provide structure and meaning to content in order to make it accessible, and a desire to work collaboratively to manipulate content in some meaningful way. Yet the traditional CMS has been unable to meet the latter of these requirements, often failing to provide sufficient tools for collaboration in a distributed context. Peer-to-Peer (P2P) systems are networks in which every node is an equal participant (whether transmitting data, exchanging content, or invoking services) and there is an absence of any centralised administrative or coordinating authorities. P2P systems are inherently more scalable than equivalent client-server implementations as they tend to use resources at the edge of the network much more effectively. This paper details the rationale and design of a P2P middleware for collaborative content management.

Are you thinking what I’m thinking? Peer group similarities in adolescent hostile attribution tendencies

A bias towards attributing hostile intent to others has been linked to aggression. In an adolescent sample, we investigated whether peer group homophily exists in the tendency towards attributing hostile intent. We assessed hostile attribution tendencies and self-reported aggressive behaviours in a normative sample of 910 adolescents, and computed average peer group scores based on nominated friend scores. Results indicated that adolescents showed significant correlations between their own level of hostile attributions and that of their peer group. Further analyses indicated that this effect occurred specifically in reciprocal friendships, and was retained even once own and peer group level of aggression were controlled.

Citation and peer review of data: moving towards formal data publication

This paper discusses many of the issues associated with formally publishing data in academia, focusing primarily on the structures that need to be put in place for peer review and formal citation of datasets. Data publication is becoming increasingly important to the scientific community, as it will provide a mechanism for those who create data to receive academic credit for their work and will allow the conclusions arising from an analysis to be more readily verifiable, thus promoting transparency in the scientific process. Peer review of data will also provide a mechanism for ensuring the quality of datasets, and we provide suggestions on the types of activities one expects to see in the peer review of data. A simple taxonomy of data publication methodologies is presented and evaluated, and the paper concludes with a discussion of dataset granularity, transience and semantics, along with a recommended human-readable citation syntax.

An experimental investigation of peer influences on hostile attributions in adolescents

Aggression in young people has been associated with a bias towards attributing hostile intent to others; however, little is known about the origin of biased social information processing. The current study explored the potential role of peer contagion in the emergence of hostile attribution in adolescents. 134 adolescents were assigned to one of two manipulated ‘chat-room’ conditions, where they believed they were communicating with online peers (e-confederates) who endorsed either hostile or benign intent attributions. Adolescents showed increased hostile attributions following exposure to hostile e-confederates and reduced hostility in the benign condition. Further analyses demonstrated that social anxiety was associated with a reduced tendency to take on hostile peer attitudes. Neither gender nor levels of aggression influenced individual susceptibility to peer influence, but aggressive adolescents reported greater affinity with hostile e-confederates.

Virtual landmarking for locality aware peer IDs

In Peer-to-Peer (P2P) networks, it is often desirable to assign node IDs which preserve locality relationships in the underlying topology. Node locality can be embedded into node IDs by utilizing a one dimensional mapping by a Hilbert space filling curve on a vector of network distances from each node to a subset of reference landmark nodes within the network. However this approach is fundamentally limited because while robustness and accuracy might be expected to improve with the number of landmarks, the effectiveness of 1 dimensional Hilbert Curve mapping falls for the curse of dimensionality. This work proposes an approach to solve this issue using Landmark Multidimensional Scaling (LMDS) to reduce a large set of landmarks to a smaller set of virtual landmarks. This smaller set of landmarks has been postulated to represent the intrinsic dimensionality of the network space and therefore a space filling curve applied to these virtual landmarks is expected to produce a better mapping of the node ID space. The proposed approach, the Virtual Landmarks Hilbert Curve (VLHC), is particularly suitable for decentralised systems like P2P networks. In the experimental simulations the effectiveness of the methods is measured by means of the locality preservation derived from node IDs in terms of latency to nearest neighbours. A variety of realistic network topologies are simulated and this work provides strong evidence to suggest that VLHC performs better than either Hilbert Curves or LMDS use independently of each other.

Equipped to deal with uncertainty in climate and impacts predictions: lessons from internal peer review

The quantification of uncertainty is an increasingly popular topic, with clear importance for climate change policy. However, uncertainty assessments are open to a range of interpretations, each of which may lead to a different policy recommendation. In the EQUIP project researchers from the UK climate modelling, statistical modelling, and impacts communities worked together on ‘end-to-end’ uncertainty assessments of climate change and its impacts. Here, we use an experiment in peer review amongst project members to assess variation in the assessment of uncertainties between EQUIP researchers. We find overall agreement on key sources of uncertainty but a large variation in the assessment of the methods used for uncertainty assessment. Results show that communication aimed at specialists makes the methods used harder to assess. There is also evidence of individual bias, which is partially attributable to disciplinary backgrounds. However, varying views on the methods used to quantify uncertainty did not preclude consensus on the consequential results produced using those methods. Based on our analysis, we make recommendations for developing and presenting statements on climate and its impacts. These include the use of a common uncertainty reporting format in order to make assumptions clear; presentation of results in terms of processes and trade-offs rather than only numerical ranges; and reporting multiple assessments of uncertainty in order to elucidate a more complete picture of impacts and their uncertainties. This in turn implies research should be done by teams of people with a range of backgrounds and time for interaction and discussion, with fewer but more comprehensive outputs in which the range of opinions is recorded.

Design patterns for promoting peer interaction in discussion forums in MOOCs

Design patterns are a way of sharing evidence-based solutions to educational design problems. The design patterns presented in this paper were produced through a series of workshops, which aimed to identify Massive Open Online Course (MOOC) design principles from workshop participants’ experiences of designing, teaching and learning on these courses. MOOCs present a challenge for the existing pedagogy of online learning, particularly as it relates to promoting peer interaction and discussion. MOOC cohort sizes, participation patterns and diversity of learners mean that discussions can remain superficial, become difficult to navigate, or never develop beyond isolated posts. In addition, MOOC platforms may not provide sufficient tools to support moderation. This paper draws on four case studies of designing and teaching on a range of MOOCs presenting seven design narratives relating to the experience in these MOOCs. Evidence presented in the narratives is abstracted in the form of three design patterns created through a collaborative process using techniques similar to those used in collective autoethnography. The patterns: “Special Interest Discussions”, “Celebrity Touch” and “Look and Engage”, draw together shared lessons and present possible solutions to the problem of creating, managing and facilitating meaningful discussion in MOOCs through the careful use of staged learning activities and facilitation strategies.

Interactional dynamics in on-line and face-to-face peer-tutoring sessions for second language writers

This paper reports the results of a study comparing the interactional dynamics of face-to-face and on-line peer-tutoring in writing by university students in Hong Kong. Transcripts of face-to-face tutoring sessions, as well as logs of on-line sessions conducted by the same peer-tutors, were coded for speech functions using a system based on Halliday's functional-semantic view of dialogue. Results show considerable differences between the interactional dynamics in on-line and face-to-face tutoring sessions. In particular, face-to-face interactions involved more hierarchal encounters in which tutors took control of the discourse, whereas on-line interactions were more egalitarian, with clients controlling the discourse more. Differences were also found in the topics participants chose to focus on in the two modes, with issues of grammar, vocabulary, and style taking precedence in face-to-face sessions and more “global” writing concerns like content and process being discussed more in on-line sessions.