Treatment response for acute depression is not associated with number of previous episodes: lack of evidence for a clinical staging model for major depressive disorder

Mental illness has been observed to follow a neuroprogressive course, commencing with prodrome, then onset, recurrence and finally chronic illness. In bipolar disorder and schizophrenia responsiveness to treatment mirrors these stages of illness progression, with greater response to treatment in the earlier stages of illness and greater treatment resistance in chronic late stage illness.

Using data from 5627 participants in 15 controlled trials of duloxetine, comparator arm (paroxetine, venlafaxine, escitalopram) or placebo for the treatment of an acute depressive episode, the relationship between treatment response and number of previous depressive episodes was determined. Data was dichotomised for comparisons between participants who had >3 previous episodes (n=1697) or ≤3 previous episodes (n=3930), and additionally for no previous episodes (n=1381) or at least one previous episode (n=4246). Analyses were conducted by study arm for each clinical trial, and results were then pooled.

There was no significant difference between treatment response and number of previous depressive episodes. This unexpected finding suggests that treatments to reduce symptoms of depression during acute illness do not lose efficacy for patients with a longer history of illness.

Debris

Debris captures a moment of collision between the natural and built environment. Digital simulations conjure a strange version of gravity within the frame. This technique creates a surreal unease, breaking our expectations of figure and ground in traditional landscape photography. This unease mirrors the new landscape of natural disaster zones; where sea has blended with land and the built environment has been forced back into chaos.

Nearshore-offshore-basin species diversity and body size variation patterns in Late Permian (Changhsingian) brachiopods

 B.V. Body size is a fundamental and defining character of an organism, and its variation in space and time is generally considered to be a function of its biology and interactions with its living environment. A great deal of body size related ecological and evolutionary research has been undertaken, mostly in relation to extant animals. Among the many body size-related hypotheses proposed and tested, the size-bathymetry relationship is probably the least studied. In this study, we compiled a global body size dataset of Changhsingian (Late Permian, ca. 254. Ma-252. Ma) brachiopod species from low-latitude areas (30°S-30°N) and analyzed their species diversity and body size distribution patterns in relation to the nearshore-offshore-basin bathymetric gradient. The dataset contained 1768 brachiopod specimens in 435 species referred to 159 genera and 9 orders, from 135 occurrences (localities) of 18 different palaeogeographic regions. Treating the whole of the Changhsingian Stage as a single time slice, we divided the nearshore-offshore-basin bathymetric gradient into three broad depth-related environments: nearshore, offshore and basinal environments, and compared how the species diversity and body size varied along this large-scale bathymetric gradient.Here, we report an array of complex patterns. First, we found a clear overall inverse correlation between species diversity and water depth along the nearshore-offshore-basin gradient, with most species concentrating in the nearshore environment. Second, when the median sizes of all low-latitude brachiopod species from the three environments were compared, we found that there was no significant size difference between the nearshore and offshore environments, suggesting that neither the wave base nor the hydrostatic pressure exerts a critical influence on the body size of brachiopods. On the other hand, the median sizes of brachiopods from the nearshore environment and, to a lesser extent, the offshore environment were found to be significantly larger than that of basinal brachiopods. This trend of significant size reduction in basinal brachiopods mirrors the relative low species diversity in the basinal environment, and neither can be easily explained by the tendency of decreasing food availability towards deeper sea environments. Rather, both trends are consistent with the hypothesis of an expanding Oxygen Minimum Zone (OMZ) in the bathyal (slope to deepsea) environments, where hypoxic to anoxic conditions are considered to have severely restricted the diversification of benthos and favored the relative proliferation of small-sized brachiopods. Finally, a significant difference was also found between eurybathic and stenobathic species in their body size response to the nearshore-offshore-basin gradient, in that eurybathic species (species found in all three environments) did not tend to change their body size significantly according to depth, whereas stenobathic forms (species restricted to a single environment) exhibit a decline in body size towards the basinal environment. This pattern is interpreted to suggest that bathymetrically more tolerant species are less sensitive to depth control with respect to their body size change dynamics, in contrast to stenobathic species which tend to grow larger in shallower water depths.

Tackling disadvantage through student-centred learning - exploring 'Worlds of Work' in the Melbourne CBD

As the educational landscape increasingly mirrors deepening socio-economic cleavages within Australian society, the disparity in educational outcomes has been identified as one of the biggest challenges confronting secondary schooling. In contrast with most OECD countries, family background remains the most important determinant of educational achievement in Australia. More and more, schools are defined by location, reinforcing what has been dubbed the 'circular pattern of disadvantage'. At the same time, recognition of strong links between outcomes, socio economic status and location has elicited growing calls for systematic redefining of learning experiences and the public education framework. Focus on flexible, rigorous, community-oriented, person-centred learning opportunities has predicated multiple mentoring and youth schemes and has guided policy. Recognition of the need to re-engage Year 9 and 10 students underpinned development of VELS, for instance; it has also directed the programming priorities of Education Foundation Australia (EFA). This paper will discuss first, how schools perceive the programs have made a difference to both individual students and the curriculum offered in the schools, and second, how the experiences and activities provided through the program have changed the expectations and aspirations that many of the participants have in regard to how they perceive their future, their engagement with school and their careers. Both City Centre and Worlds of Work (WOW) program have received a very positive student response to real world activities that have demonstrably enhanced the development of reflective processes, interpersonal and social skills and social networks. Practical outcomes have included self-organised work experience, the development of mentor relationships and the re-engagement of some students with the schooling process. Interview data confirmed EFA's assessment that its programs have greatest impact when integrated into a school's curriculum rather than as "stand alone" electives.

Material damage: 4 projector film performance

Dirk de Bruyn’s expanded cinema performances engage the æsthetics of process at a number of levels. At the core of these performances are several of three- or four-screen, essentially abstract films of the same duration which comment upon and echo each other in a constant interplay of flicker-like positive and negative imagery. The soundtrack of the films works in a related way: the same or similar words and sound fragments are overlayed, or are repeated in an absurd call-and-answer pattern running from one speaker to another. This overall design or formal system is then set into play and relativised in the live event through a number of treatment-techniques. Reels are placed out of order or interspliced with other short films or fragments of found footage or tests, the bulb of one or more projectors can be occasionally turned off while the soundtrack continues, or the projector can be stopped altogether, extending, stretching out or disrupting completely the apparent synchrony between each screen and soundtrack. The light beam of each projector is filtered, distorted, split and multiplied using hand-held colour gels, plastic bottles, prisms and mirrors, or else silhouetted or blocked completely with the artist’s own hands and body. The projectors themselves can be inverted, turned around or physically transported across the space, mixing and overlaying the imagery, animating different areas of the performance environment and transforming the body of the audience itself into a screen medium.