The validity of the 21-item version of the depression anxiety stress scales as a routine outcome measure

Objective: This study aimed to test the validity of the 21-item Depression Anxiety Stress Scales (DASS-21) as a routine clinical outcome measure in the private in-patient setting. We hypothesized that it would be a suitable routine outcome instrument in this setting.

Method: All in-patients treated at a private psychiatric hospital over a period of 24 months were included in the study. Data were collected on demographics, service utilization, diagnosis and a set of four routine measures both at admission and discharge. These measures consisted of the Clinical Global Impressions (CGI) scales, Health of the Nation Outcome Scales (HoNOS), the Mental Health Questionnaire (MHQ-14) and DASS-21. The results of these measures were compared.

Results: Of 786 admissions in total, the number of fully completed (ie paired admission and discharge) data sets for the DASS-21 depression, anxiety and stress subscales were 337, 328 and 347, respectively. All subscales showed statistically significant reductions in mean scores from admission to discharge (P < 0.001) and were significantly correlated with all MHQ-14 subscales and significantly related to CGI scale categories. The total DASS-21 and total HoNOS scores were also significantly correlated.

Conclusions: The findings from the present study support the validity of DASS-21 as a routine clinical outcome measure in the private in-patient setting.

I wish I was 21 now beyond doping in the Australian peloton

An investigation into the reasons for doping among professional athletes (cyclists) and attitudes towards and assessments of current attempts and form of legislation and regulation of doping, inlcuding prospects for reform, and types of reform required.

The social network learning cloud: architectural education for the 21 century

In less than a decade, architectural education has, in some ways, significantly evolved. The advent of computation has not so much triggered the change, but Social Networks (SN) have ignited a novel way of learning, interaction and knowledge construction. SN enable learners to engage with friends, tutors, professionals and peers, form the base for learning resources, allow students to make their voices heard, to listen to other views and much more. They offer a more authentic, inter-professional and integrated problem based, Just-in-Time (JIT), Just-in-Place (JIP) learning. Online SN work in close association with offline SN to form a blended social learning realm-the Social Network Learning Cloud (SNLC)-that greatly enables and enhances students' learning in a far more influential way than any other learning means, resources or methods do. This paper presents a SNLC for architectural education that provides opportunities for linking the academic Learning Management Systems (LMS) with private or professional SN such that it enhances the learning experience and deepens the knowledge of the students. The paper proposes ways of utilising SNLC in other learning and teaching areas of the curriculum and concludes with directions of how SNLC then may be employed in professional settings.

Changes in intervertebral disc morphology persist 5 mo after 21-day bed rest

As part of the nutrition-countermeasures (NUC) study in Cologne, Germany in 2010, seven healthy male subjects underwent 21 days of head-down tilt bed rest and returned 153 days later to undergo a second bout of 21-day bed rest. As part of this model, we aimed to examine the recovery of the lumbar intervertebral discs and muscle cross-sectional area (CSA) after bed rest using magnetic resonance imaging and conduct a pilot study on the effects of bed rest in lumbar muscle activation, as measured by signal intensity changes in T(2)-weighted images after a standardized isometric spinal extension loading task. The changes in intervertebral disc volume, anterior and posterior disc height, and intervertebral length seen after bed rest did not return to prebed-rest values 153 days later. While recovery of muscle CSA occurred after bed rest, increases (P ≤ 0.016) in multifidus, psoas, and quadratus lumborum muscle CSA were seen 153 days after bed rest. A trend was seen for greater activation of the erector spinae and multifidus muscles in the standardized loading task after bed rest. Greater reductions of multifidus and psoas CSA muscle and greater increases in multifidus signal intensity with loading were associated with incidence of low back pain in the first 28 days after bed rest (P ≤ 0.044). The current study contributes to our understanding of the recovery of the lumbar spine after 21-day bed rest, and the main finding was that a decrease in spinal extensor muscle CSA recovers within 5 mo after bed rest but that changes in the intervertebral discs persist.

Burning books and burying scholars: on the policies of the short-lived Qin Dynasty in ancient China (221-207 BC)

In 221 BC, the battle-hardened warriors of the Qin state, the western frontier state and the most aggressive of the Warring States, subjugated the last of its rival states, thus establishing the Qin dynasty, with itscapital in Xianyang, near the modern Xi’an. The Qin dynasty is customarily regarded by Chinese and Western scholars as the beginning of a new age – the Chinese empire – that lasted until 1911 AD. The dynasty lasted only fifteen years. This study examines the main policies of the Qin dynasty and seeks to address the question what brought the quick downfall of the Qin rule. This paper takes the cultural and political contexts carefully into consideration, and argues that the Qin annexation of its rival states might be better understood as an end of an old era as much as a beginning of a new epoch.