Impact of type of drug insurance on adherence, persistence and costs of antidepressant drugs : a Quebec population-based study

Contexte: À date, il existe peu de données sur l’adhésion, la persistance et les coûts associés aux antidépresseurs selon le type d’assurance médicament (privé ou public). Objectif: Comparer selon le régime d’assurance médicament (privé ou public), l'adhésion, la persistance et les coûts des antidépresseurs. Méthodes de recherche: Une étude de cohorte appariée a été réalisée en utilisant des bases de données du Québec. Sujets: Nous avons sélectionné 194 patients assurés par un régime privé et 1923 patients assurés par le régime public de la Régie de l’assurance maladie du Québec (RAMQ) (18-64 ans) qui ont rempli au moins une ordonnance pour un antidépresseur entre décembre 2007 et septembre 2009. Mesures: L’adhésion, mesurée sur une période d’un an, a été estimée en utilisant le proportion of prescribed days covered (PPDC). Un modèle de régression linéaire a été utilisé afin d’estimer la différence moyenne en PPDC entre les patients assurés par un régime privé et ceux assurés par le régime public de la RAMQ. La persistance a été comparé entre ces deux groupes avec un modèle de régression de survie Cox, et le coût mensuel d'antidépresseurs ($ CAN) a été comparé entre ces deux groupes en utilisant un modèle de régression linéaire. Résultats: Le PPDC parmi les patients assurés par un régime privé était de 86,4% (intervalle de confiance (IC) 95%: 83,3%-89,5%) versus 81,3% (IC 95%: 80,1%-82,5%) pour les patients assurés par le régime public de la RAMQ, pour une différence moyenne ajustée de 6,7% (IC 95%: 3,0%-10,4%). La persistance après un an parmi les patients assurés par un régime privé était de 49,5% versus 18,9% pour les patients assurés par le régime public de la RAMQ (p <0,001), et le rapport de risque ajusté était de 0,48 (IC 95%: 0,30-0,76). Comparativement aux patients assurés par le régime public de la RAMQ, les patients ayant une assurance privée ont payé 14,94 $ CAD (95% CI: $12,30-$17,58) de plus par mois en moyenne pour leurs antidépresseurs. Conclusion: Les patients assurés par un régime privé avaient une meilleure adhésion, persistance, mais avaient aussi un plus haut coût pour leurs antidépresseurs que ceux assurés par le régime public de la RAMQ. Cette différence de coûts peut être due aux différentes exigences de paiement en pharmacie entre les deux régimes ainsi qu’aux limites des honoraires des pharmaciens imposés par le régime public.

Emergence of a new type of porcine circovirus (PCV) in swine: a type 1 and type 2 PCV recombinant.

In late September 2008, tissue samples from piglets experiencing an acute outbreak of porcine reproductive and respiratory syndrome (PRRS) were submitted to the Veterinary diagnostic service of the University of Montreal. Several diagnostic assays were performed including a multiplex real-time quantitative PCR assay (mrtqPCR) for the detection and differentiation of porcine circovirus (PCV) type 2a and 2b genotypes in the lung and lymph nodes. The pig samples were found to be positive for PCV2a using the mrtqPCR but odd results were obtained. The Ct values obtained with mrtqPCR probes targeting the ORF1 and ORF2 of PCV2 were not as expected which suggested the presence of genomic variations in the PCV2 viral genome. Ultimately, a total of three diagnostic cases with mrtqPCR unusual results were investigated. After virus isolation and sequence analyses, a new type of PCV was identified in those three cases. Based on sequence analyses, this new PCV genome contains the ORF1 of PCV1 and the ORF2 of PCV2a and its entire viral genome nucleotide identity compared to PCV1, PCV2a and 2b are 86.4%, 88.7% and 86.5%, respectively. It is proposed to name this new PCV by taking into account the nomenclature of Segales et al. (2008) and by indicating the origin of the ORF1 at first and the origin of the ORF2 in second. Consequently, the name proposed for this new PCV is PCV1/2a. The prevalence of PCV1/2a seems to be very low in Quebec, Canada (2.5% of PCV positive cases), and its origin is now in debate.

Development of a new type of simulated scalar feed

This thesis presents the results of an investigation conducted for the development of a new type of feed horn antenna called "Simulated Scalar Feed". A schematic presentation of the work is given below. A review of the past important work done in the field of conventional/multimode electromagnetic horn antennas is presented in the first part of the second chapter. The work carried out on corrugated horns and surfaces are included in the second part of the review. In the third part, work on dielectric and dielectric loaded metal horns are reviewed. In all the parts of the review, special emphasis is given to theoretical design considerations. The methodology adopted for the experimental investigations is presented in the third chapter. The instrumentation utilized and thThis thesis presents the results of an investigation conducted for the development of a new type of feed horn antenna called "Simulated Scalar Feed". A schematic presentation of the work is given below. A review of the past important work done in the field of conventional/multimode electromagnetic horn antennas is presented in the first part of the second chapter. The work carried out on corrugated horns and surfaces are included in the second part of the review. In the third part, work on dielectric and dielectric loaded metal horns are reviewed. In all the parts of the review, special emphasis is given to theoretical design considerations. The methodology adopted for the experimental investigations is presented in the third chapter. The instrumentation utilized and the details of fabrication ofe details of fabrication of the new simulated scalar feed are described. The method of measurements of radiation characteristics of the antenna are also explained in this chapter. In the fourth chapter the outcome of the experimental results of the investigations carried out on horn antennas fabricated with different physical dimensions and different parameters for the E—plane boundary walls are highlighted. The theoretical explanation used to explain the experimental results is given in the fifth chapter of the thesis. A comparison between the experimental and the theoretical results is also presented in this chapter. In chapter six, the conclusions drawn from the experimental as well as the theoretical investigations are discussed. The advantages and features of the newly developed simulated scalar feed is examined in this chapter. Scope of further investigations in this field is also discussed at the end of this chapter.

Properties of Support Vector Machines

Support Vector Machines (SVMs) perform pattern recognition between two point classes by finding a decision surface determined by certain points of the training set, termed Support Vectors (SV). This surface, which in some feature space of possibly infinite dimension can be regarded as a hyperplane, is obtained from the solution of a problem of quadratic programming that depends on a regularization parameter. In this paper we study some mathematical properties of support vectors and show that the decision surface can be written as the sum of two orthogonal terms, the first depending only on the margin vectors (which are SVs lying on the margin), the second proportional to the regularization parameter. For almost all values of the parameter, this enables us to predict how the decision surface varies for small parameter changes. In the special but important case of feature space of finite dimension m, we also show that there are at most m+1 margin vectors and observe that m+1 SVs are usually sufficient to fully determine the decision surface. For relatively small m this latter result leads to a consistent reduction of the SV number.

On the Noise Model of Support Vector Machine Regression

Support Vector Machines Regression (SVMR) is a regression technique which has been recently introduced by V. Vapnik and his collaborators (Vapnik, 1995; Vapnik, Golowich and Smola, 1996). In SVMR the goodness of fit is measured not by the usual quadratic loss function (the mean square error), but by a different loss function called Vapnik"s $epsilon$- insensitive loss function, which is similar to the "robust" loss functions introduced by Huber (Huber, 1981). The quadratic loss function is well justified under the assumption of Gaussian additive noise. However, the noise model underlying the choice of Vapnik's loss function is less clear. In this paper the use of Vapnik's loss function is shown to be equivalent to a model of additive and Gaussian noise, where the variance and mean of the Gaussian are random variables. The probability distributions for the variance and mean will be stated explicitly. While this work is presented in the framework of SVMR, it can be extended to justify non-quadratic loss functions in any Maximum Likelihood or Maximum A Posteriori approach. It applies not only to Vapnik's loss function, but to a much broader class of loss functions.

Educational inequalities in quantity, duration and type of tobacco consumption among lung cancer patients in Asturias : Epidemiological analices

Resumen tomado de la publicaci??n

Exploring the factorial structure of the Sport Anxiety Scale-2 : invariance across language, gender, age and type of sport

Resumen tomado de la publicaci??n

New Ruthenium complexes containing N, P and S-donor type of ligands: coordination chemistry, characterization and application to asymetric and non-asymetric catalysis

Síntesi de nous complexos de Ruteni amb lligands no quirals que tenen per fórmula [Ru(phen)([9]aneS3)X] (on X = H2O, py i MeCN). Caracterització espectroscòpica electroquímica i estructural d'aquesta família de complexos. Estudi de les seves propietats catalítiques en front a l'oxidació de substrats orgànics com l'alcohol benzílic en reaccions d'electrocatàlisi. Avaluació cinètica dels mecanismes de substitució entre els complexos Ru-py i Ru-MeCN. Generació d'un interruptor molecular foto-induït. Síntesi de nous complexos quirals de Ru atropoisomèricament purs amb lligands oxazolínics que tenen per fórmula [Ru(trpy)(Ph-box-R)X] on (X = Cl, H2O, py, MeCN, 2-OH-py). Caracterització estructural exhaustiva en estat sòlid (Raig-X) en solució (RMN) i en fase gas (càlculs DFT). Avaluació de la seva activitat catalítica en reaccions asimmetriques d'epoxidació de substrats proquirals. Síntesi de nous lligands polipiridílics quirals amb simetria C3. Estudi de la seva química de coordinació i avaluació de la seva activitat catalítica en reaccions asimmetriques d'oxidació i reducció.

Auditory speech-discrimination as a function of age and type of audiogram

This paper reviews a study to determine if loss of speech discrimination is related to age and patients with audiograms showing steep high-frequency losses.

Investigation of support vector machine for the detection of architectural distortion in mammographic images

This paper investigates detection of architectural distortion in mammographic images using support vector machine. Hausdorff dimension is used to characterise the texture feature of mammographic images. Support vector machine, a learning machine based on statistical learning theory, is trained through supervised learning to detect architectural distortion. Compared to the Radial Basis Function neural networks, SVM produced more accurate classification results in distinguishing architectural distortion abnormality from normal breast parenchyma.

Fruit and vegetables, and the role they have played in determining the EU’s aggregate measurement of support

In its periodic declarations of domestic support to the WTO, the EU has progressively reduced its amber-box declarations in line with its changing system of farm support. Surprisingly, however, in 2007/08 it managed to more than halve its amber box compared with that of the previous year, easily achieving the reduction targets being touted in the Doha Round. This was largely due to a change in the calculations for fresh fruits and vegetables. These had been linked to the entry price system, which was not affected by the 2008 fruit and vegetables reform. Why the EU chose to make this change during the ongoing Doha Round negotiations remains unclear.

Effective elements of cognitive behaviour therapy for psychosis: results of a novel type of subgroup analysis based on principal stratification

Background. Meta-analyses show that cognitive behaviour therapy for psychosis (CBT-P) improves distressing positive symptoms. However, it is a complex intervention involving a range of techniques. No previous study has assessed the delivery of the different elements of treatment and their effect on outcome. Our aim was to assess the differential effect of type of treatment delivered on the effectiveness of CBT-P, using novel statistical methodology. Method. The Psychological Prevention of Relapse in Psychosis (PRP) trial was a multi-centre randomized controlled trial (RCT) that compared CBT-P with treatment as usual (TAU). Therapy was manualized, and detailed evaluations of therapy delivery and client engagement were made. Follow-up assessments were made at 12 and 24 months. In a planned analysis, we applied principal stratification (involving structural equation modelling with finite mixtures) to estimate intention-to-treat (ITT) effects for subgroups of participants, defined by qualitative and quantitative differences in receipt of therapy, while maintaining the constraints of randomization. Results. Consistent delivery of full therapy, including specific cognitive and behavioural techniques, was associated with clinically and statistically significant increases in months in remission, and decreases in psychotic and affective symptoms. Delivery of partial therapy involving engagement and assessment was not effective. Conclusions. Our analyses suggest that CBT-P is of significant benefit on multiple outcomes to patients able to engage in the full range of therapy procedures. The novel statistical methods illustrated in this report have general application to the evaluation of heterogeneity in the effects of treatment.

How level and type of deafness affects user perception of multimedia video clips

Our research investigates the impact that hearing has on the perception of digital video clips, with and without captions, by discussing how hearing loss, captions and deafness type affects user QoP (Quality of Perception). QoP encompasses not only a user's satisfaction with the quality of a multimedia presentation, but also their ability to analyse, synthesise and assimilate informational content of multimedia . Results show that hearing has a significant effect on participants’ ability to assimilate information, independent of video type and use of captions. It is shown that captions do not necessarily provide deaf users with a ‘greater level of information’ from video, but cause a change in user QoP, depending on deafness type, which provides a ‘greater level of context of the video’. It is also shown that post-lingual mild and moderately deaf participants predict less accurately their level of information assimilation than post-lingual profoundly deaf participants, despite residual hearing. A positive correlation was identified between level of enjoyment (LOE) and self-predicted level of information assimilation (PIA), independent of hearing level or hearing type. When this is considered in a QoP quality framework, it puts into question how the user perceives certain factors, such as ‘informative’ and ‘quality’.

Circles of support and accountability: criminal justice volunteers as the 'Deliberative public'

This paper provides a review of the role played by volunteers within one particular offender management and reintegration scheme in the United Kingdom. Circles of Support and Accountability (COSA) draw on the expertise of volunteer members of the public to create supportive monitoring frameworks around sex offenders following their release from prison. The paper presents evidence as to the motivations of these volunteers, and argues that they play a crucial role in the success of the scheme, as they provide an instrumentally-useful form of reintegrative social contact to a socially-excluded offender population, and perform a symbolically important role as representatives of the wider community in taking ownership of offender management practices on behalf of the wider society. This is particularly significant in grounding those processes in the communicative practices of the social sphere, providing powerful reasons for intervention that reinforce the work that COSA do.