The population cost-effectiveness of delivering universal and indicated school-based interventions to prevent the onset of major depression among youth in Australia

AIMS: School-based psychological interventions encompass: universal interventions targeting youth in the general population; and indicated interventions targeting youth with subthreshold depression. This study aimed to: (1) examine the population cost-effectiveness of delivering universal and indicated prevention interventions to youth in the population aged 11-17 years via primary and secondary schools in Australia; and (2) compare the comparative cost-effectiveness of delivering these interventions using face-to-face and internet-based delivery mechanisms. METHODS: We reviewed literature on the prevention of depression to identify all interventions targeting youth that would be suitable for implementation in Australia and had evidence of efficacy to support analysis. From this, we found evidence of effectiveness for the following intervention types: universal prevention involving group-based psychological interventions delivered to all participating school students; and indicated prevention involving group-based psychological interventions delivered to students with subthreshold depression. We constructed a Markov model to assess the cost-effectiveness of delivering universal and indicated interventions in the population relative to a 'no intervention' comparator over a 10-year time horizon. A disease model was used to simulate epidemiological transitions between three health states (i.e., healthy, diseased and dead). Intervention effect sizes were based on meta-analyses of randomised control trial data identified in the aforementioned review; while health benefits were measured as Disability-adjusted Life Years (DALYs) averted attributable to reductions in depression incidence. Net costs of delivering interventions were calculated using relevant Australian data. Uncertainty and sensitivity analyses were conducted to test model assumptions. Incremental cost-effectiveness ratios (ICERs) were measured in 2013 Australian dollars per DALY averted; with costs and benefits discounted at 3%. RESULTS: Universal and indicated psychological interventions delivered through face-to-face modalities had ICERs below a threshold of $50 000 per DALY averted. That is, $7350 per DALY averted (95% uncertainty interval (UI): dominates - 23 070) for universal prevention, and $19 550 per DALY averted (95% UI: 3081-56 713) for indicated prevention. Baseline ICERs were generally robust to changes in model assumptions. We conducted a sensitivity analysis which found that internet-delivered prevention interventions were highly cost-effective when assuming intervention effect sizes of 100 and 50% relative to effect sizes observed for face-to-face delivered interventions. These results should, however, be interpreted with caution due to the paucity of data. CONCLUSIONS: School-based psychological interventions appear to be cost-effective. However, realising efficiency gains in the population is ultimately dependent on ensuring successful system-level implementation.

Workshop proceedings, special national workshop : prevention and detection of fraud, waste and abuse of public funds : Washington, D.C., November 1979

Proceedings of a workshop sponsored by the Law Enforcement Assistance Administration, Nov. 14-16, 1979

Evolving nature of fraud investigation and prevention

This thesis is concerned with the evolution of fraud investigation and prevention in light of the advances in computing technology. These recent advances have impacted upon traditional fraud offences as well as creating a range of new crimes. The financial significance of fraud is growing whereas law enforcement and the judicial system appear to be unable to meet the demands of these emerging crimes and its victims. This research compares the responses of our present and future investigators with those of our current business leaders from the government and the commercial sectors. This research establishes the needs of corporate decision-makers and the attitudes of police with regard to fraud. Data relating to persons arrested and convicted of fraud was also analysed to identify the issues that may be responsible for the non-reporting of offences to police by victims. The research found that victims are seeking solutions that are not available through law enforcement, for example financial compensation. Law enforcement also under-utilises the potential of proactive responses to prevent offences and they are reluctant to acknowledge the benefits of preventative measures and to incorporate this strategy within criminal investigation training programmes. The lack of deterrence offered by the judicial system does not make the situation any better. The police function is still primarily a reactive one. In order to overcome fraud and to be able to adapt to changes there needs to be collaboration between stakeholders. This requires a joint effort from the police, government, commerce and the victims of fraud. An innovative model involving stakeholders has been formulated that represents an alternative to the current system. This approach utilises the financial resources and expertise from the commercial sector as well as the skills of criminal investigators from the police. This means adopting a combined package of both reactive and proactive measures in order to minimise the impact of fraud. This model will be adaptive and will be able to accommodate any future requirements arising out of further inevitable advances in computer technology.

Internet-based indicated prevention for panic disorder: An effectiveness trial in primary care

Previous studies have shown that an internet delivered indicated prevention program for panic disorder can be effective. However, those studies were done with select populations. Most individuals who are at risk for panic disorder present to hospital emergency rooms and primary care settings. This paper reports on a study currently being undertaken in Scotland where the program is being trialed in primary care. The intervention and experimental design will be described. However the key research question is whether General Practitioners will make use of the internet-based intervention system. Preliminary results will be reported. The results of the study will have implications for the way that primary care is recruited into the prevention of mental health problems.

The future of cognitive and behavioral therapies in the prevention and early management of psychosis : opportunities and risks

Behavioral and cognitive interventions for people with psychosis have a long and distinguished history, although the evidence for their application to young people remains limited. We anticipate that the next decades will show substantial research into psychological intervention for this population. Important targets will include the management of environmental stressors, reduction of substance misuse, and promotion of early treatment. Psychological management of positive symptoms, depression, and suicidal behavior will continue to be critical objectives. Important secondary prevention goals will be the retention of cognitive functioning, vocational options, social skills, and social network support, including appropriate family support. We expect primary prevention to include both universal programs and interventions for adolescents at particularly high risk. Technical innovations will include increasing use of Internet-based intervention and behavior cueing devices. Pressures for intervention brevity will continue, as will problems with the systematic delivery of effective procedures.

Detection and prevention of distributed denial of services attacks by collaborative effort of software agents, first prototype implementation

Distributed Denial of Services DDoS, attacks has become one of the biggest threats for resources over Internet. Purpose of these attacks is to make servers deny from providing services to legitimate users. These attacks are also used for occupying media bandwidth. Currently intrusion detection systems can just detect the attacks but cannot prevent / track the location of intruders. Some schemes also prevent the attacks by simply discarding attack packets, which saves victim from attack, but still network bandwidth is wasted. In our opinion, DDoS requires a distributed solution to save wastage of resources. The paper, presents a system that helps us not only in detecting such attacks but also helps in tracing and blocking (to save the bandwidth as well) the multiple intruders using Intelligent Software Agents. The system gives dynamic response and can be integrated with the existing network defense systems without disturbing existing Internet model. We have implemented an agent based networking monitoring system in this regard.

Guilt in victims of internet scams

This is a presentation made (by invitation from the Queensland Police, Fraud Squad) to a group of Queenslanders all of whom had fallen victim to internet scams. The paper addresses the subject of guilt and why we may 'suffer' from it after a traumatic experience where the individual and/or the family have gone through a major financial or emotional loss.

Critical analysis of spam prevention techniques

E-mail spam has remained a scourge and menacing nuisance for users, internet and network service operators and providers, in spite of the anti-spam techniques available; and spammers are relentlessly circumventing these anti-spam techniques embedded or installed in form of software products on both client and server sides of both fixed and mobile devices to their advantage. This continuous evasion degrades the capabilities of these anti-spam techniques as none of them provides a comprehensive reliable solution to the problem posed by spam and spammers. Major problem for instance arises when these anti-spam techniques misjudge or misclassify legitimate emails as spam (false positive); or fail to deliver or block spam on the SMTP server (false negative); and the spam passes-on to the receiver, and yet this server from where it originates does not notice or even have an auto alert service to indicate that the spam it was designed to prevent has slipped and moved on to the receiver’s SMTP server; and the receiver’s SMTP server still fail to stop the spam from reaching user’s device and with no auto alert mechanism to inform itself of this inability; thus causing a staggering cost in loss of time, effort and finance. This paper takes a comparative literature overview of some of these anti-spam techniques, especially the filtering technological endorsements designed to prevent spam, their merits and demerits to entrench their capability enhancements, as well as evaluative analytical recommendations that will be subject to further research.

Challenges of responding to online fraud victimisation in Australia

Online fraud occurs when an individual or a business responds in some manner to an unsolicited invitation received via the internet and suffers financial or other detrimental effects as a result. In 2010–11, the Australian Bureau of Statistics (2012) found that over 1.2 million Australians (6.7% of the population aged 15 years and over) had been a victim of personal fraud, losing approximately $1.4b in the preceding 12 months. More than half of these victims (55.7%) were contacted via the internet or email (online victimisation). In addition to monetary losses, victims of online fraud suffer serious psychological, emotional, social and even physical problems as a consequence of their victimisation. This paper explores the challenges of responding to online fraud victimisation in Australia and describes some of the specific support services that have recently emerged to support victims of this crime.

Love hurts: The costly reality of online romance fraud

Online dating and romance scams continue to lure in Australians with figures this week showing people have lost more than A$23 million this year alone, with average individual losses at A$21,000 – three times higher than other types of fraud. The Australian Competition and Consumer Commission (ACCC) set up the Scam Disruption Project in August to help target those it believes have been caught in such scams. Over three months it sent 1,500 letters to potential victims in New South Wales and the Australian Capital Territory. The figures released this week show that 50 people have been scammed, losing a total A$1.7 million – that’s an average of A$34,000 per victim. Almost three quarters of the scams were dating and romance related, which saw it evolve into the number one category of fraud victimisation. Romance scams continue to pose a problem – despite the efforts of the police and ACCC – so why is it that people continue to fall for them?