Cost-effectiveness of cognitive-behavioural therapy and drug interventions for major depression

Objective: Antidepressant drugs and cognitive-behavioural therapy (CBT) are effective treatment options for depression and are recommended by clinical practice guidelines. As part of the Assessing Cost-effectiveness - Mental Health project we evaluate the available evidence on costs and benefits of CBT and drugs in the episodic and maintenance treatment of major depression. Method: The cost-effectiveness is modelled from a health-care perspective as the cost per disability-adjusted life year. Interventions are targeted at people with major depression who currently seek care but receive non-evidence based treatment. Uncertainty in model inputs is tested using Monte Carlo simulation methods. Results: All interventions for major depression examined have a favourable incremental cost-effectiveness ratio under Australian health service conditions. Bibliotherapy, group CBT, individual CBT by a psychologist on a public salary and tricyclic antidepressants (TCAs) are very cost-effective treatment options falling below $A10 000 per disability-adjusted life year (DALY) even when taking the upper limit of the uncertainty interval into account. Maintenance treatment with selective serotonin re-uptake inhibitors (SSRIs) is the most expensive option (ranging from $A17 000 to $A20 000 per DALY) but still well below $A50 000, which is considered the affordable threshold. Conclusions: A range of cost-effective interventions for episodes of major depression exists and is currently underutilized. Maintenance treatment strategies are required to significantly reduce the burden of depression, but the cost of long-term drug treatment for the large number of depressed people is high if SSRIs are the drug of choice. Key policy issues with regard to expanded provision of CBT concern the availability of suitably trained providers and the funding mechanisms for therapy in primary care.

Assembly processes of invertebrate communities in springs across different spatial scales

Il presente lavoro ha lo scopo di comprendere i processi sottesi ai pattern di coesistenza tra le specie di invertebrati sorgentizi, distinguendo tra dinamiche stocastiche e deterministiche. Le sorgenti sono ecosistemi complessi e alcune loro caratteristiche (ad esempio l’insularità, la stabilità termica, la struttura ecotonale “a mosaico”, la frequente presenza di specie rare ed endemiche, o l’elevata diversità in taxa) le rendono laboratori naturali utili allo studio dei processi ecologici, tra cui i processi di assembly. Al fine di studiare queste dinamiche è necessario un approccio multi-scala, per questo motivi sono state prese in considerazione tre scale spaziali. A scala locale è stato compiuto un campionamento stagionale su sette sorgenti (quattro temporanee e tre permanenti) del Monte Prinzera, un affioramento ofiolitico vicino alla città di Parma. In questa area sono stati valutati l’efficacia e l’impatto ambientale di diversi metodi di campionamento e sono stati analizzati i drivers ecologici che influenzano le comunità. A scala più ampia sono state campionate per due volte 15 sorgenti della regione Emilia Romagna, al fine di identificare il ruolo della dispersione e la possibile presenza di un effetto di niche-filtering. A scala continentale sono state raccolte informazioni di letteratura riguardanti sorgenti dell’area Paleartica occidentale, e sono stati studiati i pattern biogeografici e l’influenza dei fattori climatici sulle comunità. Sono stati presi in considerazione differenti taxa di invertebrati (macroinvertebrati, ostracodi, acari acquatici e copepodi), scegliendo tra quelli che si prestavano meglio allo studio dei diversi processi in base alle loro caratteristiche biologiche e all’approfondimento tassonomico raggiungibile. I campionamenti biologici in sorgente sono caratterizzati da diversi problemi metodologici e possono causare impatti sugli ambienti. In questo lavoro sono stati paragonati due diversi metodi: l’utilizzo del retino con un approccio multi-habitat proporzionale e l’uso combinato di trappole e lavaggio di campioni di vegetazione. Il retino fornisce dati più accurati e completi, ma anche significativi disturbi sulle componenti biotiche e abiotiche delle sorgenti. Questo metodo è quindi raccomandato solo se il campionamento ha come scopo un’approfondita analisi della biodiversità. D’altra parte l’uso delle trappole e il lavaggio della vegetazione sono metodi affidabili che presentano minori impatti sull’ecosistema, quindi sono adatti a studi ecologici finalizzati all’analisi della struttura delle comunità. Questo lavoro ha confermato che i processi niche-based sono determinanti nello strutturare le comunità di ambienti sorgentizi, e che i driver ambientali spiegano una rilevante percentuale della variabilità delle comunità. Infatti le comunità di invertebrati del Monte Prinzera sono influenzate da fattori legati al chimismo delle acque, alla composizione e all’eterogeneità dell’habitat, all’idroperiodo e alle fluttuazioni della portata. Le sorgenti permanenti mostrano variazioni stagionali per quanto riguarda le concentrazioni dei principali ioni, mentre la conduttività, il pH e la temperatura dell’acqua sono più stabili. È probabile che sia la stabilità termica di questi ambienti a spiegare l’assenza di variazioni stagionali nella struttura delle comunità di macroinvertebrati. L’azione di niche-filtering delle sorgenti è stata analizzata tramite lo studio della diversità funzionale delle comunità di ostracodi dell’Emilia-Romagna. Le sorgenti ospitano più del 50% del pool di specie regionale, e numerose specie sono state rinvenute esclusivamente in questi habitat. Questo è il primo studio che analizza la diversità funzionale degli ostracodi, è stato quindi necessario stilare una lista di tratti funzionali. Analizzando il pool di specie regionale, la diversità funzionale nelle sorgenti non è significativamente diversa da quella misurata in comunità assemblate in maniera casuale. Le sorgenti non limitano quindi la diversità funzionale tra specie coesistenti, ma si può concludere che, data la soddisfazione delle esigenze ecologiche delle diverse specie, i processi di assembly in sorgente potrebbero essere influenzati da fattori stocastici come la dispersione, la speciazione e le estinzioni locali. In aggiunta, tutte le comunità studiate presentano pattern spaziali riconoscibili, rivelando una limitazione della dispersione tra le sorgenti, almeno per alcuni taxa. Il caratteristico isolamento delle sorgenti potrebbe essere la causa di questa limitazione, influenzando maggiormente i taxa a dispersione passiva rispetto a quelli a dispersione attiva. In ogni caso nelle comunità emiliano-romagnole i fattori spaziali spiegano solo una ridotta percentuale della variabilità biologica totale, mentre tutte le comunità risultano influenzate maggiormente dalle variabili ambientali. Il controllo ambientale è quindi prevalente rispetto a quello attuato dai fattori spaziali. Questo risultato dimostra che, nonostante le dinamiche stocastiche siano importanti in tutte le comunità studiate, a questa scala spaziale i fattori deterministici ricoprono un ruolo prevalente. I processi stocastici diventano più influenti invece nei climi aridi, dove il disturbo collegato ai frequenti eventi di disseccamento delle sorgenti provoca una dinamica source-sink tra le diverse comunità. Si è infatti notato che la variabilità spiegata dai fattori ambientali diminuisce all’aumentare dell’aridità del clima. Disturbi frequenti potrebbero provocare estinzioni locali seguite da ricolonizzazioni di specie provenienti dai siti vicini, riducendo la corrispondenza tra gli organismi e le loro richieste ambientali e quindi diminuendo la quantità di variabilità spiegata dai fattori ambientali. Si può quindi concludere che processi deterministici e stocastici non si escludono mutualmente, ma contribuiscono contemporaneamente a strutturare le comunità di invertebrati sorgentizi. Infine, a scala continentale, le comunità di ostracodi sorgentizi mostrano chiari pattern biogeografici e sono organizzate lungo gradienti ambientali principalmente collegati altitudine, latitudine, temperatura dell’acqua e conducibilità. Anche la tipologia di sorgente (elocrena, reocrena o limnocrena) è influente sulla composizione delle comunità. La presenza di specie rare ed endemiche inoltre caratterizza specifiche regioni geografiche.

NEUROSAT: an overview

This report gives an overview of the work being carried out, as part of the NEUROSAT project, in the Neural Computing Research Group at Aston University. The aim is to give a general review of the work and methods, with reference to other documents which provide the detail. The document is ongoing and will be updated as parts of the project are completed. Thus some of the references are not yet present. In the broadest sense, the Aston part of NEUROSAT is about using neural networks (and other advanced statistical techniques) to extract wind vectors from satellite measurements of ocean surface radar backscatter. The work involves several phases, which are outlined below. A brief summary of the theory and application of satellite scatterometers forms the first section. The next section deals with the forward modelling of the scatterometer data, after which the inverse problem is addressed. Dealiasing (or disambiguation) is discussed, together with proposed solutions. Finally a holistic framework is presented in which the problem can be solved.

Quantitative risk assessment of groundwater quality utilizing GIS technology and coupled groundwater models

The thesis presents a two-dimensional Risk Assessment Method (RAM) where the assessment of risk to the groundwater resources incorporates both the quantification of the probability of the occurrence of contaminant source terms, as well as the assessment of the resultant impacts. The approach emphasizes the need for a greater dependency on the potential pollution sources, rather than the traditional approach where assessment is based mainly on the intrinsic geo-hydrologic parameters. The risk is calculated using Monte Carlo simulation methods whereby random pollution events were generated to the same distribution as historically occurring events or a priori potential probability distribution. Integrated mathematical models then simulate contaminant concentrations at the predefined monitoring points within the aquifer. The spatial and temporal distributions of the concentrations were calculated from repeated realisations, and the number of times when a user defined concentration magnitude was exceeded is quantified as a risk. The method was setup by integrating MODFLOW-2000, MT3DMS and a FORTRAN coded risk model, and automated, using a DOS batch processing file. GIS software was employed in producing the input files and for the presentation of the results. The functionalities of the method, as well as its sensitivities to the model grid sizes, contaminant loading rates, length of stress periods, and the historical frequencies of occurrence of pollution events were evaluated using hypothetical scenarios and a case study. Chloride-related pollution sources were compiled and used as indicative potential contaminant sources for the case study. At any active model cell, if a random generated number is less than the probability of pollution occurrence, then the risk model will generate synthetic contaminant source term as an input into the transport model. The results of the applications of the method are presented in the form of tables, graphs and spatial maps. Varying the model grid sizes indicates no significant effects on the simulated groundwater head. The simulated frequency of daily occurrence of pollution incidents is also independent of the model dimensions. However, the simulated total contaminant mass generated within the aquifer, and the associated volumetric numerical error appear to increase with the increasing grid sizes. Also, the migration of contaminant plume advances faster with the coarse grid sizes as compared to the finer grid sizes. The number of daily contaminant source terms generated and consequently the total mass of contaminant within the aquifer increases in a non linear proportion to the increasing frequency of occurrence of pollution events. The risk of pollution from a number of sources all occurring by chance together was evaluated, and quantitatively presented as risk maps. This capability to combine the risk to a groundwater feature from numerous potential sources of pollution proved to be a great asset to the method, and a large benefit over the contemporary risk and vulnerability methods.

On the use of likert-type scales in multilevel data:Influence on aggregate variables

In multilevel analyses, problems may arise when using Likert-type scales at the lowest level of analysis. Specifically, increases in variance should lead to greater censoring for the groups whose true scores fall at either end of the distribution. The current study used simulation methods to examine the influence of single-item Likert-type scale usage on ICC(1), ICC(2), and group-level correlations. Results revealed substantial underestimation of ICC(1) when using Likert-type scales with common response formats (e.g., 5 points). ICC(2) and group-level correlations were also underestimated, but to a lesser extent. Finally, the magnitude of underestimation was driven in large part to an interaction between Likert-type scale usage and the amounts of within- and between-group variance. © Sage Publications.

Efficiency improvements to the Groupe Special Mobile (GSM) digital mobile radio system

Groupe Spécial Mobile (GSM) has been developed as the pan-European second generation of digital mobile systems. GSM operates in the 900 MHz frequency band and employs digital technology instead of the analogue technology of its predecessors. Digital technology enables the GSM system to operate in much smaller zones in comparison with the analogue systems. The GSM system will offer greater roaming facilities to its subscribers, extended throughout the countries that have installed the system. The GSM system could be seen as a further enhancement to European integration. GSM has adopted a contention-based protocol for multipoint-to-point transmission. In particular, the slotted-ALOHA medium access protocol is used to coordinate the transmission of the channel request messages between the scattered mobile stations. Collision still happens when more than one mobile station having the same random reference number attempts to transmit on the same time-slot. In this research, a modified version of this protocol has been developed in order to reduce the number of collisions and hence increase the random access channel throughput compared to the existing protocol. The performance evaluation of the protocol has been carried out using simulation methods. Due to the growing demand for mobile radio telephony as well as for data services, optimal usage of the scarce availability radio spectrum is becoming increasingly important. In this research, a protocol has been developed whereby the number of transmitted information packets over the GSM system is increased without any additional increase of the allocated radio spectrum. Simulation results are presented to show the improvements achieved by the proposed protocol. Cellular mobile radio networks commonly respond to an increase in the service demand by using smaller coverage areas. As a result, the volume of the signalling exchanges increases. In this research, a proposal for interconnecting the various entitles of the mobile radio network over the future broadband networks based on the IEEE 802.6 Metropolitan Area Network (MAN) is outlined. Simulation results are presented to show the benefits achieved by interconnecting these entities over the broadband Networks.

Design and characterization of zeolite membranes for fluid separation

Experimental and theoretical methods have been used to study zeolite structures, properties and applications as membranes for separation purposes. Thin layers of silicalite-1 and Na-LTA zeolites have been synthesised onto carbon-graphite supports using a hydrothermal synthesis procedure. The separation behaviour of the composite membranes was characterized by gas permeation studies of pure, binary and ternary mixtures of methane, ethane and propane. The influence of temperature and feed gas mixture composition on the separation and selectivity performance of the membranes was also investigated. It was found that the silicalite-1 composite membranes synthesised onto the 4 hour oxidized carbon-graphite supports showed the most promising separation behaviour of all the composite membranes investigated. Molecular simulation methods were used to gain an understanding of how hydrocarbon molecules behave both within the pores and on the surfaces of silicalite-1, mordenite and LTA zeolites. Molecular dynamic simulations were used to investigate the influence of temperature and molecular loadings on the diffusional behaviour of hydrocarbons in zeolites. Both hydroxylated (surface termination with hydroxyl groups) and non-hydroxylated silicalite-1 and Na-mordenite surfaces were generated. For both zeolites the most stable surfaces correspond to the {010} surface. For the silicalite-1 {010} surface the adsorption of hydrocarbons and molecular water onto the hydroxylated surface showed a favourable exothermic adsorption process compared to adsorption on the non-hydroxylated surface. With the Na-mordenite {010} surface the adsorption of hydrocarbons onto both the hydroxylated and non-hydroxylated surfaces had a combination of favourable and non-favourable adsorption energies, while the adsorption of molecular water onto both types of surface was found to be a favourable adsorption process.

Reliability analysis for hazard and operability studies

Fault tree analysis is used as a tool within hazard and operability (Hazop) studies. The present study proposes a new methodology for obtaining the exact TOP event probability of coherent fault trees. The technique uses a top-down approach similar to that of FATRAM. This new Fault Tree Disjoint Reduction Algorithm resolves all the intermediate events in the tree except OR gates with basic event inputs so that a near minimal cut sets expression is obtained. Then Bennetts' disjoint technique is applied and remaining OR gates are resolved. The technique has been found to be appropriate as an alternative to Monte Carlo simulation methods when rare events are countered and exact results are needed. The algorithm has been developed in FORTRAN 77 on the Perq workstation as an addition to the Aston Hazop package. The Perq graphical environment enabled a friendly user interface to be created. The total package takes as its input cause and symptom equations using Lihou's form of coding and produces both drawings of fault trees and the Boolean sum of products expression into which reliability data can be substituted directly.

An opportunity for system dynamics in manufacturing system modelling

The computer simulation of manufacturing systems is commonly carried out using discrete event simulation (DES). Indeed, there appears to be a lack of applications of continuous simulation methods, particularly system dynamics (SD), despite evidence that this technique is suitable for industrial modelling. This paper investigates whether this is due to a decline in the general popularity of SD, or whether modelling of manufacturing systems represents a missed opportunity for SD. On this basis, the paper first gives a review of the concept of SD and fully describes the modelling technique. Following on, a survey of the published applications of SD in the 1990s is made by developing and using a structured classification approach. From this review, observations are made about the application of the SD method and opportunities for future research are suggested.

Molecular dynamics simulations of the adsorption and diffusion behavior of pure and mixed alkanes in silicalite

The adsorption and diffusion of mixed hydrocarbon components in silicalite have been studied using molecular dynamic simulation methods. We have investigated the effect of molecular loadings and temperature on the diffusional behavior of both pure and mixed alkane components. For binary mixtures with components of similar sizes, molecular diffusional behavior in the channels was noticed to be reversed as loading is increased. This behavior was noticeably absent for components of different sizes in the mixture. Methane molecules in the methane/propane mixture have the highest diffusion coefficients across the entire loading range. Binary mixtures containing ethane molecules prove more difficult to separate compared to other binary components. In the ternary mixture, however, ethane molecules diffuse much faster at 400 K in the channel with a tendency to separate out quickly from other components. © 2005 Elsevier Inc. All rights reserved.

Performance modelling and analysis of multiple coexisting IEEE 802.15.4 wireless sensor networks

With the features of low-power and flexible networking capabilities IEEE 802.15.4 has been widely regarded as one strong candidate of communication technologies for wireless sensor networks (WSNs). It is expected that with an increasing number of deployments of 802.15.4 based WSNs, multiple WSNs could coexist with full or partial overlap in residential or enterprise areas. As WSNs are usually deployed without coordination, the communication could meet significant degradation with the 802.15.4 channel access scheme, which has a large impact on system performance. In this thesis we are motivated to investigate the effectiveness of 802.15.4 networks supporting WSN applications with various environments, especially when hidden terminals are presented due to the uncoordinated coexistence problem. Both analytical models and system level simulators are developed to analyse the performance of the random access scheme specified by IEEE 802.15.4 medium access control (MAC) standard for several network scenarios. The first part of the thesis investigates the effectiveness of single 802.15.4 network supporting WSN applications. A Markov chain based analytic model is applied to model the MAC behaviour of IEEE 802.15.4 standard and a discrete event simulator is also developed to analyse the performance and verify the proposed analytical model. It is observed that 802.15.4 networks could sufficiently support most WSN applications with its various functionalities. After the investigation of single network, the uncoordinated coexistence problem of multiple 802.15.4 networks deployed with communication range fully or partially overlapped are investigated in the next part of the thesis. Both nonsleep and sleep modes are investigated with different channel conditions by analytic and simulation methods to obtain the comprehensive performance evaluation. It is found that the uncoordinated coexistence problem can significantly degrade the performance of 802.15.4 networks, which is unlikely to satisfy the QoS requirements for many WSN applications. The proposed analytic model is validated by simulations which could be used to obtain the optimal parameter setting before WSNs deployments to eliminate the interference risks.

The Living Economy

Report published in the Proceedings of the National Conference on "Education and Research in the Information Society", Plovdiv, May, 2015

High resolution demodulation platform for large capacity hybrid WDM/FDM microstructures sensing system assisted by tunable FP filter

In this paper we proposed a demodulation scheme based on tunable FP filter for the WDM/FDM sensing system of the microstructure mentioned in the previous work. Simulation is done to prove the feasibility of demodulating the microstructure with the tunable FP filter. The experiments result showed high consistence with the simulation. And with the help of the high speed FPGA module and a high resolution AD/DA card, the system has achieved a very high resolution, up to 2.5 pm, and wavelength ranges 1520nm to 1590 nm.

Avaliação da estrutura e processo de trabalho dos centros de atenção psicossocial

Objective: Evaluate the work structure and process in Psychos ocial Care Centers (CAPS) and the professionals profile, the satisfaction, conditions and work overload. Methods: Cross - sectional study conducted in five CAPS in Campina Grande city. The study sample consisted of five coordinators, 42 graduate professional s, 26 mid - level (technical and auxiliary nurses, and caregivers), and the medical records pertaining to 413 users followed up. Data were collected using validated questionnaires (CAPSUL - rating CAPS in southern Brazil) and adapted to the study, between July and October 2014. The questionnaires were double entered and submitted to validation in the sub - program “Validate Epi Info 3.5.4” , used along with the “SPSS 17.0” for processing the statistical analyzes. Measures of central tendency and dispersion were ap plied to the descriptive analyzes; “Fisher's” exact test to check the CAPS impact on hospital admissions and the “Bonferroni” adjusted to verify the diagnoses according to sex. 5% significance level was adopted. The study was approved by the Ethics Committ ee of the Rio Grande do Norte Federal University (UFRN), protocol 719.435, of 05.30.2014. Results: From the structure analysis were identified contextual factors that influenced the work process of CAPS professionals, such as: deficiencies with regard to h uman resources; forms of health professionals employment and qualifications; temporary contract existence. As to process dimension, it was found that the home visits performance by health professionals shows to be ineffective, given its insufficiency and i rregularity, which can be explained by the high demand, reduced staff and transportation lack. It was low coverage of items inherent to Therapeutic Individual Project, as the income generation program, insertion at work and home visit. The reference and co unter reference flow are still not satisfactorily organized. There was statistically significant difference for the diagnosis, with a predominance of mood disorders related to stress among women and those related to alcohol and other drugs among men (p <0. 05). There was an association between the degree of health professionals satisfaction and working conditions, overload and factors related to the content and working conditions, the security measures, comfort and CAPS appearance, contact between the teams and users, families treatment by the teams, temporary employment relationship. Conclusion: The data collected indicate the need for the CAPS organization through increased investments in the sector in order to enhance the infrastructure as potentiating el ement of practices with a view to changing the care model for mental health proposed by the Psychiatric Reform. It is hoped therefore that this research will contribute to better planning in CAPS unit management, with another tool to improve the dimensions involving the structure and the professional work process and improve this mental health care model.

[N]pT ensemble and finite-size-scaling study of the critical isostructural transition in the generalized exponential model of index 4.

First-order transitions of system where both lattice site occupancy and lattice spacing fluctuate, such as cluster crystals, cannot be efficiently studied by traditional simulation methods, which necessarily fix one of these two degrees of freedom. The difficulty, however, can be surmounted by the generalized [N]pT ensemble [J. Chem. Phys. 136, 214106 (2012)]. Here we show that histogram reweighting and the [N]pT ensemble can be used to study an isostructural transition between cluster crystals of different occupancy in the generalized exponential model of index 4 (GEM-4). Extending this scheme to finite-size scaling studies also allows us to accurately determine the critical point parameters and to verify that it belongs to the Ising universality class.